Professional and executive lines applications
Accountants
Submit the appropriate application(s) by emailing it to [email protected] or faxing it to 508-635-1720.
- New business application
- Renewal application
- New business tax application
- Representation statements
- Claim/incident supplement
Questionnaires
- Financial institution questionnaire
- Financial planning investment questionnaire
- Funds controlled questionnaire
- Information technology questionnaire
- Investment venture questionnaire
- Mergers and acquisitions questionnaire
- Multiple location questionnaire
- Non-profit entity questionnaire
- Non-public audit questionnaire
- Outside interest questionnaire
- Public and private offerings questionnaire
- Public company questionnaire
- Separate entity questionnaire
- Trust or estate questionnaire
Allied Healthcare
Email the completed submission requirements to [email protected].
Durable Medical Equipment
Healthcare facilities
The applications below are common applications required for all accounts*.
The following applications are facility-specific. Select the appropriate additional application below.
Home Healthcare
Orthotics and Prosthetics
Pharmacies
Architects and engineers
Submit the appropriate application or questionnaire by emailing it to [email protected].
Applications
Countrywide
Florida
NYFTZ
Questionnaires
Cyber
- Data Breach & Cyber Liability Supplemental Application
- (for use in WA and SD)
- (for use in WA and SD)
Eldercare
Email the completed submission requirements to [email protected].
Lawyers
Submit the appropriate application and questionnaires by emailing them to [email protected].
Applications (for business effective on or after June 1, 2021)
Questionnaires
Management liability
Available coverage parts include directors officers and entity liability, employment practices liability, fiduciary liability, crime and kidnap and ransom. Email the completed submission to your underwriter.
Applications for clients in Alaska, California, Hawaii, Maryland, New Jersey, New York and Washington
- Private Company Portfolio Advantage applications
- Nonprofit Entity Portfolio Advantage applications
- Supplemental applications (Contact your underwriter for state-specific supplemental applications.)
- Claim supplemental application
- Third-party fidelity supplemental application
- Computer fraud and funds transfer supplemental crime application
- Employee stock ownership plan supplemental application
- Foreign operations supplemental application
- Healthcare institutions supplemental crime application
- Wage and hour supplemental employment practices application
Applications for all other clients - Hanover Executive Advantage Pro applications
- Multi-line coverage applications
Defense within limits
Defense outside limits
- Companion coverage part applications
Defense within limits
Defense outside limits
- Small business applications
Defense within limits
Defense outside limits
- Additional executive liability applications and questionnaires
Defense within limits
Defense outside limits
- Additional crime applications and questionnaires
Defense within limits
Defense outside limits
Miscellaneous professionals
Submit the appropriate application by emailing it to [email protected].
Supplements
- Beauty salon, barber and spa supplemental application
- Bookkeeping and tax preparation supplemental application
- Consultants supplemental application
- Employment agency and executive recruiting supplemental application
- Franchisor supplemental application
- Interior design supplemental application
- Investigative agency supplemental application
- Media supplemental application
- Medical billing supplemental application
- Mortgage broker supplemental application
- Property preservation/mortgage field services supplemental application
- Technology supplemental application
- Third-party administrators supplemental application
- Travel agent supplemental application
Standalone crime
Email submissions to [email protected]. Contact your underwriter for state-specific applications and supplemental applications.
Applications
For standalone public company crime business, complete the appropriate New Business or Renewal application available below. For standalone private company and not-for-profit crime business, complete the appropriate New Business or Renewal application available in the Management liability section above.
Applications for clients in Alaska, California, Hawaii, Maryland, New Jersey, New York and Washington
- Fidelity and crime new business application (for stand-alone public company crime business)
- Fidelity and crime renewal application (for stand-alone public company crime business)
- E-Z ERISA application for most states
- E-Z ERISA application for IL, IN, MI, NY and WI
- E-Z ERISA application for AK, CA, ID, KY, MT, NE, NV, NM, OR and UT
- E-Z ERISA application for WA