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Professional liability (E&O) quote

Protection when a client says your advice, design or service cost them money. Complete this application and we'll compare E&O coverage from specialist insurers.

Takes about 15 minutes Multiple insurers compared Secure and private

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Your E&O application

Fields marked * are required.

Step 1 of 6
  1. 1General
  2. 2Company
  3. 3Financials
  4. 4Operations
  5. 5Contracts and coverage
  6. 6Claims and declaration
General information

Who's applying and how to reach you.

Enter the applicant name.
Enter the street address.
Enter the city.
Choose a province.
Enter a valid postal code, like T2P 1J9.
Enter a 10-digit phone number.
Enter a valid email, like name@example.com.
Company details

Structure, leadership and team size.

Choose the month and year.
Enter a number from 1 to 500.
2Company structure*
Choose a company structure.
4Details of directors, officers or partners*One card per person. You can attach resumes in the last step.
Complete every field for each person, or remove extra cards.
5Number of employees*
Total: 0 employeesEnter a number for each type. Use 0 if none.
6Are all employees covered by WCB?*
Choose yes or no.
Financials

Fees from the applicant's operations, in Canadian dollars. Enter 0 where something doesn't apply.

7Fees from operations (CAD)*
Last completed yearCurrent year (estimate)Next year (estimate)Canadian revenue
Last completed year
$
Current year (estimate)
$
Next year (estimate)
$
USA revenue
Last completed year
$
Current year (estimate)
$
Next year (estimate)
$
Foreign revenue
Last completed year
$
Current year (estimate)
$
Next year (estimate)
$
Profit / lossUse a minus sign for a loss
Last completed year
$
Current year (estimate)
$
Next year (estimate)
$
Fill in every box. Use 0 if none.
Enter a day and month, like 31/12.
$
Enter your annual payroll.
Operations of the company

What you do, where you do it and how it's regulated.

0 / 2000
11Breakdown of total revenue by activityPercentages should add up to 100%.
12Are you involved in any manufacture, construction, alteration, repair, installation, sale or supply of products, other than in a pure consultancy capacity?*
Choose yes or no.
13Does the applicant perform any activities or provide any services outside of Canada?*
Choose yes or no.
14Are any material changes to activities anticipated in the coming year?*
Choose yes or no.
15Does the applicant perform any hands-on work?*
Choose yes or no.
List your associations, or enter "None".
List the legislation, or enter "None".
18Does the applicant engage in any business or professional activities other than described above?*
Choose yes or no.
19Has the applicant ever been investigated or suspended from practice by any governing body of your profession?*
Choose yes or no.
20Is the applicant controlled, owned or associated with any other company, firm or corporation?*
Choose yes or no.
Contracts and coverage

How you contract your work, and the coverage you have and need.

21Does the applicant always use standard forms of contract, agreement or letter of appointment?*If yes, you can attach a copy in the last step.
Choose yes or no.
%
Enter a number from 0 to 100.
Insurance history and requirements
Do you currently have an errors and omissions (E&O) policy?*
Choose yes or no.
Required E&O policy
Choose a date.
Choose a date.
$
Enter an amount.
$
Enter an amount.
$
Enter an amount.
Enter the insurer name.
Do you also need commercial general liability (CGL) insurance?*
Choose yes or no.
Claims history and declaration

Regarding all types of insurance this application relates to, after enquiry.

Please consider the following:

  1. Are you aware of any loss or damage, whether insured or not, that has occurred to any of the companies to be insured (or to any existing or previous business of the partners or directors) within the last 5 years?
  2. Are you aware of any circumstances which may give rise to a claim against any of the companies to be insured or any partners or directors?
  3. Have any claims or cease and desist orders been made against any of the companies to be insured, or their partners or directors?
  4. Have any partners or directors been found guilty of any criminal, dishonest or fraudulent activity, or been investigated by any regulatory body?
With reference to questions a, b, c and d above, is the answer yes to any of them?*
Choose yes or no.
Attachments (optional)Resumes of directors, officers or partners, your standard contract, claim details or your current policy.
    Each file must be 10 MB or smaller, up to 25 files.
    Declaration*

    I / we declare that after proper enquiry the statements and particulars given above are true and that I / we have not mis-stated or suppressed any material fact.

    I / we agree that this application form, together with any other material information supplied by me / us, shall form the basis of any contract of insurance effected thereon.

    I / we undertake to inform underwriters of any material alteration to these facts occurring before the completion of the contract.

    Please agree to the declaration to submit.
    Enter your name.
    Choose a date.
    Your information is encrypted and secure

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    A Gem Insurance broker will review your application and contact you with your options shortly.

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