Important Note:  This is an application for a policy which, if issued, will be on a claims made basis.  To be covered, CLAIMS must be first made against the INSUREDS and reported during the POLICY PERIOD or applicable extended reporting period.  Also, the limits of liability of any such policy may be reduced by amounts paid for DEFENSE COSTS, and such payments for DEFENSE COSTS may also be applied against the deductible amount, unless we agree otherwise.

New York Agents, please call MARSH at (888) 424-2310.

This application only applies for an individual agent selling life and health coverage or mutual funds through personal production.  If you place business for any employee producers, for other agents or brokers, or for independent contractors or non-employee producers, or if you are involved in any business besides life and health or mutual funds products or services, please download and complete our standard new business application that will address these other products, services and producers.

Products or operations that do not qualify for this application include but are not limited to: self-insured or self-funded insurance benefits plans, Multiple Employer Welfare Arrangements (MEWAs), Multiple Employer Trusts (METs), Property and Casualty Insurance, and administration activities for benefit plans, pension plans, claims administration or COBRA administration services.  If you are unsure if this is the correct application for you, contact Marsh Affinity Services at (888) 424-2310. 

To complete and submit the application you will be required to provide the following information:

• Licensing Information
• Annual commissions and fees
• Total revenue information
• Names of companies you place business with
• Errors and Omissions coverage history for the past three years
• Errors and Omissions claims history

After you submit the application, a copy of your completed application will be emailed to you at the emails address you provide.   Please retain this copy for your records.