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Errors & Omissions

Realtors E & O
Express Application Form

Realtors E & O Program Highlights

Realtors E & O Form

Real Estate Agents & Brokers
E&O Program		 Realty Express Program
Per claim limits up to $1,000,000
A Separate Limit for Claim Expenses
Full Prior Acts Coverage for Qualified Applicants
Loss Only Deductible options
Lock Box Protection
Discrimination Coverage $250,000 Included $100,000 Included
Limited Pollution Coverage Equal to Per Claim Limit Equal to Per Claim Limit
Franchisor Coverage Included
Title Agent and Notary Coverage
Mortgage Brokering Coverage for Incidental Services No
Consent to Settle
Deductible reduction of 50% for Use of Alternative Dispute Resolution
Defendants Reimbursement
Regulatory Hearing Coverage
Sellers E & O Coverage No
Toll Free Pre Claim Asist Line

Name of Firm:
Contact Person:
Street Address:
City:
State:
Zip:
Phone:
Fax:
Email:
What year was the firm established:
Requested Effective Date:
if there is no insurance currently in force,
the effective date must be today's date or later.
Appliciant or Firm is a:
How many Professionals have a Professional Designation:

Gri, Broker, Associate Broker, MAI, etc
How many Professionals participate in annual continuing education programs:
Average number of years of experience of the Professionals in the Firm:
Does the Firm offer a Home Warranty Program at all closings?
Percent of Dual Agency:

Insurance History

  1. Current insurance company:
  2. Expiration Date or Requested Date of Coverage:


  3. Retroactive Date of Current Policy:
  4. Current Annual Premium:

  5. Requested Policy Limits:

  6. Requested Deductible:
Number of Professionals in the firm
Full-Time Part-Time Total

Professionals are defined as: Owners, Partners, Officers, Real Estate Brokers, Agents, Salespersons, Appraisers, Property Managers, Consultants, or Auctioneers including independent contractors for whom coverage is desired.

Part-Time Professional = Earning $20,000 or less annualy

Firm's Total Gross revenues (commisions) from last fiscal period:
$

Please provide commision revenue distribution. If new firm, estimate commissions in their categories.
Residential Sales:
Include residental row land and farm sales		 $
Commercial Sales:
Include nonresidental row land and farm/
industrial zoned property		 $
Appraisals: $
Property Management: $
Other:
 $

If you aware of any claim(s) made against the firm or anyone to whom this insurance would apply within the past five years?
If yes, please request our Claim Supplement.
 
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