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WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD

WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD 2026

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The EPACK Renewal Application is a document for applicants seeking to renew their claims-made insurance policy. It outlines the necessary information required from the applicant, including general and financial details, employee information, and specific coverage requests. The application emphasizes the importance of understanding the policy provisions, particularly regarding claims made during the policy period and potential changes in business operations that may affect coverage terms. Additionally, it includes warnings about fraudulent applications and requires signatures from authorized company representatives.

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How to use or fill out WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD

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Click ‘Get Form’ to open it in the editor.
Begin with Section I: GENERAL INFORMATION. Fill in the Applicant's name, address, and website. Answer the questions regarding mergers or acquisitions by selecting 'Yes' or 'No'.
Proceed to Section II: FINANCIAL INFORMATION. Enter the total assets, liabilities, equity, and revenue for both the most recent and prior fiscal year.
In Section III: INTERNAL CONTROLS, indicate if there have been any weaknesses noted by outside auditors and any compliance changes related to Sarbanes-Oxley.
Move to Section IV: EMPLOYEE INFORMATION. Provide details on full-time employees, part-time seasonal workers, independent contractors, and volunteers.
Complete Section V: REQUESTED LINES OF COVERAGE by specifying limits of liability and retention for each coverage part you are applying for.
Finally, review all sections for accuracy before submitting your application through our platform.

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WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD 2026

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How to use or fill out WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD

See more WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD versions

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WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD 2026

Here's how it works

How to use or fill out WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD

See more WITH RESPECT TO ALL COVERAGE PARTS, THE POLICY YOU ARE APPLYING FOR IS A CLAIMS-MADE POLICY, AND SUBJECT TO ITS PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD versions

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