Media Liability. Please describe the media activities of the Applicant or by others on behalf of the Applicant: Television Radio Print Applicant’s Website(s) Internet Advertising Social Media Marketing Materials Audio or Video Streaming Other (please describe: Does the Applicant have a formal review process in place to screen any published or broadcast material (including digital content), for intellectual property and privacy compliance prior to any publication, broadcast, distribution or use? Yes No N/A Are such reviews conducted by, or under the supervision, of a qualified attorney? Yes No N/A Are all employees that are responsible for disbursing or transmitting funds provided anti-fraud training, including detection of social engineering, phishing, business email compromise, and other scams on at least an annual basis? Yes No Before processing fund transfer requests from internal sources, does the Applicant confirm the instructions via a method other than the original means of the instruction? Yes No Does the Applicant confirm requested changes via a method other than the original means of request? If yes, please provide details: During the past five (5) years has the Applicant or other proposed insured transferred, paid or delivered money or securities as a result of fraudulent written, electronic, telegraphic, cable, teletype or telephone instructions provided by a third party? If yes, please provide details: Yes Yes No No PRIOR CLAIMS AND CIRCUMSTANCES Does the Applicant or other proposed insured (including any director, officer or employee) have knowledge of or information regarding any fact, circumstance, situation, event or transaction which may give rise to a claim, loss or obligation to provide breach notification under the proposed insurance? If yes, please provide details: Yes No During the past five (5) years has the Applicant: Received any claims or complaints with respect to privacy, breach of information or network security, or, unauthorized disclosure of information? Yes No Been subject to any government action, investigation or subpoena regarding any alleged violation of a privacy law or regulation? Yes No Received a complaint or cease and desist demand alleging trademark, copyright, invasion of privacy, or defamation with regard to any content published, displayed or distributed by or on behalf of the Applicant? Yes No Notified consumers or any other third party of a data breach incident involving the Applicant? Yes No Experienced an actual or attempted extortion demand with respect to its computer systems? Experienced an unexpected outage of a computer network, application or system lasting greater than four (4) hours? If ‘Yes’ to any of the above, please provide details regarding such incident(s) or event(s): Yes Yes No No THE UNDERSIGNED IS AUTHORIZED BY THE APPLICANT TO SIGN THIS APPLICATION ON THE APPLICANT’S BEHALF AND DECLARES THAT THE STATEMENTS CONTAINED IN THE INFORMATION AND MATERIALS PROVIDED TO THE INSURER IN CONJUNCTION WITH THIS APPLICATION AND THE UNDEWRITING OF THIS INSURANCE ARE TRUE, ACCURATE AND NOT MISLEADING. SIGNING OF THIS APPLICATION DOES NOT BIND THE APPLICANT OR THE INSURER TO COMPLETE THE INSURANCE, BUT IT IS AGREED THAT THE STATEMENTS CONTAINED IN THIS APPLICATION AND ANY OTHER INFORMATION AND MATERIALS SUBMITTED TO THE INSURER IN CONNECTION WITH THE UNDERWRITING OF THIS INSURANCE ARE THE BASIS OF THE CONTRACT SHOULD A POLICY BE ISSUED, AND HAVE BEEN RELIED UPON BY THE INSURER IN ISSUING ANY POLICY. THIS APPLICATION AND ALL INFORMATION AND MATERIALS SUBMITTED WITH IT SHALL BE RETAINED ON FILE WITH THE INSURER AND SHALL BE DEEMED ATTACHED TO AND BECOME PART OF THE POLICY IF ISSUED. THE INSURER IS AUTHORIZED TO MAKE ANY INVESTIGATION AND INQUIRY AS IT DEEMS NECESSARY REGARDING THE INFORMATION AND MATERIALS PROVIDED TO THE INSURER IN CONNECTION WITH THE UNDERWRITING AND ISSUANCE OF THE POLICY. THE APPLICANT AGREES THAT IF THE INFORMATION PROVIDED IN THIS APPLICATION OR IN CONNECTION WITH THE UNDERWRITING OF THE POLICY CHANGES BETWEEN THE DATE OF THIS APPLICATION AND THE EFFECTIVE DATE OF THE INSURANCE, THE APPLICANT WILL, IN ORDER FOR THE INFORMATION TO BE ACCURATE ON THE EFFECTIVE DATE OF THE INSURANCE, IMMEDIATELY NOTIFY THE INSURER OF SUCH CHANGES, AND THE INSURER MAY WITHDRAW OR MODIFY ANY OUTSTANDING QUOTATIONS OR AUTHORIZATIONS OR AGREEMENTS TO BIND THE INSURANCE. I HAVE READ THE FOREGOING APPLICATION FOR INSURANCE AND REPRESENT THAT THE RESPONSES PROVIDED ON BEHALF OF THE APPLICANT ARE TRUE AND CORRECT.
Appears in 3 contracts
Sources: Insurance Application, Insurance Application, Insurance Application