Fiduciary Liability Applications and Forms
As a fiduciary, you may be putting your own assets at risk. You can be held personally liable for a breach of fiduciary liability as well as any errors and omissions that may harm the plan's participants.
Applications and forms
Multi-Coverage Applications - SelectOne+® Asset Management Firms
- New Business - Investment Advisers and Funds
- Renewal - Investment Advisers and Funds
- New Business - Private Equity
- Renewal - Private Equity
- New/Renewal – Small Investment Advisers Application (for use by Registered Investment Advisers with up to $2 Billion in Assets Under Management and do not manage investment funds)
Multi-Coverage Applications - SelectOne+® Financial Institutions and Insurance Companies
- New Business - Community Banks - Private
- New Business - Community Banks - Public
- New Business - Credit Unions - Private
- New Business - Insurance Companies - Private
- Renewal - Community Banks & Credit Unions - Private
- Renewal - Community Banks - Public
- Renewal - Insurance Companies - Private
- Renewal - Insurance Companies - Public
Stand-Alone Applications - SelectOne+® Financial Institutions and Insurance Companies
- New Business
- Renewal
- Excess Policy Application - New Business and Renewal
- Acceptance of Competitor Application - Not for use in: AK, IL, KY, MO or NY
Supplemental Application
State Application Notices
- California
- Illinois
- Louisiana
- Minnesota
- Montana - Defense Within Limits
- New York Claims Made - Asset Management and Insurance Companies
- New York Claims Made
- New York Duty-to-Defend
- New York - Defense Within Limits
Sample Policy Forms - SelectOne+® Asset Management Firms
Sample Policy Forms - SelectOne+® Community Banks, Credit Unions and Insurance Companies
Multi-Coverage Applications - Wrap+®
- New Business - Private Company
- Renewal - Private Company
- New Business - Nonprofit
- Renewal - Nonprofit
Stand-Alone Applications - Wrap+®
- New Business
- Renewal
- Excess Policy Application - New Business and Renewal
- Acceptance of Competitor Application - Not for use in: AK, IL, KY, MO or NY
Supplemental Application
Small Business Applications
These applications accepted for nonprofit organizations with 30 or fewer employees and $5 million or less in assets and $5 million or less in revenues or privately held companies with 250 or fewer employees and $100 million or less in assets and $100 million or less in revenues.
- New Business - Multi-Coverage PDO with Fiduciary
- Renewal - Multi-Coverage PDO with Fiduciary
- New Business - Multi-Coverage NDO with Fiduciary
- Renewal Business - Multi-Coverage NDO with Fiduciary
- New Business - Stand-Alone
- Renewal - Stand-Alone
Designated Benefit Plan Applications
- New Business - Not available in MT, NH, PR
- Renewal - Not available in MT, NH, PR
State Application Notices
- Affiliate (non-Subsidiary) Application Addendum Notice - Note: Only applies to PNP Wrap+® applications and excludes all Programs, Chatham, Amwins Program Underwriters, Kevin Davis. This notice must physically attach to the PNP Wrap+® application.
- California
- Illinois
- Louisiana
- Minnesota
- Montana - Defense Within Limits
- New York Claims Made DOL - Nonprofit DOL only
- New York Claims Made
- New York Duty-to-Defend
Sample Policy Forms - Fiduciary
Sample Policy Forms - Designated Benefit Plan
Multi-Coverage Applications - Executive Choice+®
Stand-Alone Applications - Executive Choice+®
- New Business
- Renewal
- Excess Policy Application - New Business and Renewal
- Acceptance of Competitor Application - Not for use in: AK, IL, KY, MO or NY
State Application Notices
- California
- Illinois
- Louisiana
- Minnesota
- Montana - Defense Within Limits
- New York Claims Made
- New York Duty-to-Defend
Sample Policy Forms