Utica National E&O Easy Estimate

Please completely fill out the questionnaire for the best consideration.

This questionnaire is for premium indication only and is NOT an offer of coverage NOR is it bindable. If premium indication is acceptable, you will be forwarded to underwriting for further consideration. Click here for Printable Form option.

If you have any questions, please contact Lisa Farnham lisaf@bianc.net (804-486-4222).

This Easy Estimate might help us provide you with better coverage for your agency!

Must be NC
Are you currently a contracted Utica National P&C agent?(Required)
Are you a member of an insurance association?(Required)
Is 50% or more of your premium volume crop insurance?(Required)
Is more than 25% of your business surety bonds, long haul trucking, aviation, wet marine or professional liability?(Required)
Have you had any E&O claims/incidents over $500 in the last three years?(Required)

Total annual P&C premium volume:

Percentage of total agency commissions by line - Must equal %100:

Staff count (include owners and principals):

Percentage of your agency's property & casualty premium volume placed:

Percentage of your agency's property & casualty premium volume that is received or assumed from the following:

Does 60% or more of your staff, including owners, have an insurance designation (CIC, CPCU, AAI, CISRF, LUTCF, CPIA)?(Required)
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Limits

Deductible

Type of Loss