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Due to changes in our questions and underwriting, we ask that you fill out this form to help us verify information you submitted last year. This will only take a few minutes.

Thank you for your understanding as we improve our renewal process.

Questions? Contact us at insurance@zeguro.com or (855) 980-0660.

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Where is your company headquartered?

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

What is your company's industry?

Industry option 1
Industry option 2
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

What are your company details?

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

What is your revenue and number of employees?

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None
Less than 20%
Between 20% and 50%
Greater than 50%
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

What are your operating expenses?

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

What customer data do you store?

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Do you store third-party data?

None
Less than 50,000 Records
Between 50,000 and 100,000 Records
More than 100,000 Records
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Do you have access to your customers' systems?

Yes
No
Yes
No
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Which industry standards do you comply with?

PCI DSS
NIST CSF
SOC 1/2
ISO 27001/2
ISO 8000/1
GDPR
HIPAA
FINRA
FDIC
HITECH
OTHER
NONE
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.
Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Do you have a security professional managing (Company)'s cybersecurity?

Yes
No
Internal employee
External consultant
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Do you encrypt your data?

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Do you have penetration tests performed on (Company)'s systems?

Yes
No
Monthly
Quarterly
Yearly
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

How often do you back up your data?

Daily
Monthly
Infrequently
We do not backup our data
30 days or more
2 to 30 days
1 day or less
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Do you have a process to review your own blogs and social posts?

Yes
No
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Has (company) experienced a cyber breach or claim in the last 3 years?

Yes
No
Less than $50,000
$50,000 to $150,000
More than $150,000
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Has (Company) previously had a cyber insurance policy?

Yes
No
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Was that policy cancelled or
non-renewed by the insurance provider?

Yes
No
Past Cyber Breach
Non-payment
Provider no longer serves my industry
Other
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

When would you like your coverage to begin?

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Coverage Requirements

Another company is asking me to add their name to this policy.
(I need to add an "additional insured" to my policy).
I am being asked to obtain cyber insurance as part of a contract or vendor requirement.
  • $500K
  • $1M
  • $2M
  • $3M
  • $4M
  • $5M
  • $6M
  • $7M
  • $8M
  • $9M
  • $10M
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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Please enter your contact information.

I will manage this policy through the policy period.

Policy Manager Information

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Review your information.

Ensure your info is up to date.

Company Overview

Company Details

Edit
Company name
Company name
Company website
Company website
Work email
Work email

Headquarters

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Headquarters

Industry

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Industry

Employees and Revenue

Edit
Number of Employees
Number of Employees
Projected revenue for next 12 months
Projected revenue for next 12 months
Percent of revenue from selling goods or providing services on the internet
Percent of revenue from selling goods or providing services on the internet
Operating expenses
Operating expenses

Data

Customer Data You Store

Edit
# of Social Security numbers
# of Social Security numbers
# of credit cards, debit cards, and bank accounts
# of credit cards, debit cards, and bank accounts
# of health care records
# of health care records

Third Party Data You Store

Edit
# of records
# of records
Total 3rd party records
Total 3rd party records

Data Encryption

Edit
Do you encrypt your data?
Do you encrypt your data?
When is your data encrypted?
When is your data encrypted?

Data Backup

Edit
Do you back up your data?
Do you back up your data?
How often do you back up your data?
How often do you back up your data?
How long does (Company) retain these backups?
How long does (Company) retain these backups?

Business Practices

Industry Standards and Security Policies

Industry standards you comply with
Edit
Industry standards you comply with
Security policies you use
Edit
Security policies you use

Cybersecurity Management

Edit
Does a security professional manage (Company)'s cybersecurity?
Does a security professional manage (Company)'s cybersecurity?
Who is managing (Company)'s cybersecurity?
Who is managing (Company)'s cybersecurity?

External Security Tests

Edit
Do you perform external security tests?
Do you perform external security tests?
How often do you perform external security tests?
How often do you perform external security tests?

Blogs and Social Posts

Edit
Do you have a process to review your own blogs and social posts?
Do you have a process to review your own blogs and social posts?

Insurance Details

Prior Claim

Edit
Has (Company) experienced a cyber breach or claim in the last 3 years?
Has (Company) experienced a cyber breach or claim in the last 3 years?
What was the total estimated monetary impact of the breach or claim?
What was the total estimated monetary impact of the breach or claim?

Prior Insurance

Edit
Has (Company) previously had a cyber insurance policy?
Has (Company) previously had a cyber insurance policy?
When did this this policy begin?
When did this this policy begin?
Was that policy cancelled or non-renewed by the insurance provider?
Was that policy cancelled or non-renewed by the insurance provider?
What was the reason for the cancellation?
What was the reason for the cancellation?

Coverage Start Date

Edit
When would you like your coverage to begin?
When would you like your coverage to begin?

Additional Insured

Edit
Is another company asking you to add their name to this policy?
(An additional insured.)
Is another company asking you to add their name to this policy?
(An additional insured.)
Who is the additional insured?
Who is the additional insured?

Contract or Vendor Requirement

Edit
I am being asked to obtain cyber insurance as part of a contract or vendor requirement.
I am being asked to obtain cyber insurance as part of a contract or vendor requirement.
What limit are they requesting?
What limit are they requesting?

Your Contact Information

Edit
Your Contact Information

Policy Manager

Edit
Policy Manager

Warranty

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Submit My Application
Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

Oh no! We don't support your industry as yet.

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.

You've already submitted a request for a quote.

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Insurance underwritten by Zeguro Insurance Services LLC. Licensed in all 50 states and the District of Columbia.
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