Professional Liability

Errors & Omissions (Professional Liability) Questionnaire

Please complete all applicable fields below.

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Basic Information

Basic Information

Years in Business

Entity Type

Number of Locations

Business Address

States of Operation

Ownership & Interest

Operations & Services

Describe Professional Services Provided

%Revenue per Service

Do you subcontract? (Y/N)

Type of Subcontracted work

Require subcontractors to carry E&O? (Y/N)

Do you use independent contractors? (Y/N)

Any high-risk services? If yes, describe.

Clients & Contracts

Clients & Contracts

Typical Clients

Written Contracts for All Services? (Y/N)

Contracts include limitation-of-liability clauses

Process for Client Approval of Work

Claims & Loss History

Claims & Loss History

Any past E&O claims? (Y/N)

Any client complaints or legal threats? (Y/N)

Any known incidents that may give rise to a complaint?

Risk Management Practices

Risk Management Practices

Written policies/procedures in place? (Y/N)

How do you document clients communications?

Record retention period (years)

Quality control or peer review process? (Y/N)

Staff continuing education /training? (Y/N)

Financial & Coverage Details

Financial & Coverage Details

Annual Gross Revenue

Expected changes in next 12 months?

Desired Coverage Limits

Desired Deductible

Need retroactive coverage for past work? (Y/N)

Other insurance policies in place?

Industry-Specific (Optional)

Industry-Specific (Optional)

Real Estate: Transactions annually

Technology: Develop software/manage clients

Financial Services: SEC/FINRA registered? (Y/N)

Consulting: Advice affects client revenue

Full Name

Email:

Phone:

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1380 Pantheon Way #200,

San Antonio, TX 78232

Follow Us

Contact Us

1380 Pantheon Way #200,

﻿San Antonio, TX 78232

San Antonio, TX 78232