Applications
Yes
Professional and executive lines applications
Accountants
Submit the appropriate application(s) by emailing it to aplsub@hanover.com 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 DMESUB@hanover.com.
Durable Medical Equipment
- Durable Medical Equipment Advantage new business
- Durable Medical Equipment Advantage renewal
- Data breach (required for data breach limits over $10,000)
Healthcare facilities
The applications below are common applications required for all accounts*.
- Allied Healthcare facilities common application
- Data breach (*required for data breach limits over $10,000)
The following applications are facility-specific. Select the appropriate additional application below.
- Ambulatory surgery centers
- Applied Behavior Analysis (ABA) therapy
- Behavioral health facility
- Blood bank
- Clinical hyperbaric medical facilities
- Community health centers and free clinics
- Dialysis
- Eye bank
- Laboratories
- Medical imaging and diagnostic testing
- Rehabilitation
- Sleep clinic and laboratories
- Urgent care, convenience care and occupational clinics
Home Healthcare
- Home healthcare new business
- Home healthcare renewal
- Data breach (required for data breach limits over $10,000)
Orthotics and Prosthetics
Pharmacies
Architects and engineers
Submit the appropriate application or questionnaire by emailing it to aenewbiz@hanover.com.
Applications
Countrywide
- A&E New Business Application
- A&E RPG New Business Application
- A&E Bridge Application
- A&E Claim-Incident Supplement
- A&E Cyber Privacy & Security Application
- A&E Risk Management Supplement
Florida
- A&E Florida New Business Application
- A&E Florida RPG New Business Application
- A&E Florida Bridge Application
- A&E Florida Claim-Incident Supplement
- A&E Florida Cyber Privacy & Security Application
- A&E Florida Risk Management Supplement
NYFTZ
- A&E NYFTZ New Business Application
- A&E NYFTZ Bridge Application
- A&E NYFTZ Claim-Incident Supplement
- A&E NYFTZ Cyber Privacy & Security Application
- A&E NYFTZ Risk Management Supplement
Questionnaires
- A&E Condominium Questionnaire
- A&E Equity Interest Questionnaire
- A&E Foreign Projects Questionnaire
- A&E Joint Venture Questionnaire
- A&E Residential Questionnaire
- A&E Specified Project Client Excess Questionnaire
- A&E Traffic Engineering Questionnaire
Cyber
- Data Breach & Cyber Liability Supplemental Application
- Hanover Cyber Advantage Pro New Business Application
- Hanover Cyber Advantage Pro New Business Application (for use in WA and SD)
- New York Free Trade Zone Hanover Cyber Advantage Pro New Business Application
- Hanover Cyber Advantage Pro Renewal Application
- Hanover Cyber Advantage Pro Renewal Application (for use in WA and SD)
- New York Free Trade Zone Hanover Cyber Advantage Pro Renewal Application
- Hanover Cyber Advantage Pro Supplemental Questionnaire
- Small Firm Cyber supplemental questionnaire
Eldercare
Email the completed submission requirements to ELDRCARESUB@hanover.com.
- Eldercare Advantage skilled nursing and assisted living supplemental application
- Eldercare Advantage renewal skilled nursing and assisted living supplemental application
- Eldercare Advantage independent living facility new business supplemental application
- Eldercare Advantage independent living facility renewal supplemental application
Lawyers
Submit the appropriate application and questionnaires by emailing them to lplsubs@hanover.com.
Applications (for business effective on or after June 1, 2021)
- LPL new business application (all states excluding KS and NY)
- Kansas LPL new business application
- New York LPL new business application
- LPL renewal application (all states excluding KS)
- Kansas LPL renewal application
- LPL bridge application (all states excluding KS)
- Kansas LPL bridge application
- LPL claim supplemental application
- LPL new lawyer supplemental application (all states excluding KS)
- Kansas LPL new lawyer supplemental application
- LPL roster of lawyers
- LPL title agency supplemental application (all states excluding KS)
- Kansas LPL title agency supplemental application
Questionnaires
- LPL class action questionnaire
- LPL combined AOP supplemental questionnaire
- LPL cyber privacy security questionnaire
- LPL disciplinary questionnaire
- LPL EB-5 questionnaire
- LPL entertainment questionnaire
- LPL environmental practices questionnaire
- LPL fee suit questionnaire
- LPL financial institution questionnaire
- LPL firm management questionnaire
- LPL insurance defense questionnaire
- LPL intellectual property questionnaire
- LPL Middle Market risk management questionnaire
- LPL oil gas and minerals questionnaire
- LPL outside interest questionnaire
- LPL predecessor firm questionnaire
- LPL securities questionnaire
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
- Directors, officers and entity companion application DWL
- Employment practices liability companion application DWL
- Crime companion application DWL
- Fiduciary liability companion application DWL
Defense outside limits
- Small business applications
Defense within limits
Defense outside limits
- Additional executive liability applications and questionnaires
Defense within limits
- Additional insured application DWL
- Claim application DWL
- Downsizing and layoff application DWL
- Employee stock ownership plan application DWL
- Increased limit application DWL
- Wage and hour application DWL
- Excessive fee questionnaire DWL
Defense outside limits
- Additional crime applications and questionnaires
Defense within limits
- Small risk crime application DWL
- Large risk crime application DWL
- False pretense crime application DWL
- Abridged false pretense crime application DWL
- Accountants crime application DWL
- Casino gaming crime application DWL
- Condo association and property management crime application DWL
- Condominium association crime application DWL
- Foreign operations crime application DWL
- Forgery and alteration questionnaire DWL
- Healthcare crime application DWL
- Investment advisors crime application DWL
- Large ERISA limit crime application DWL
- Law firm crime application DWL
- Property management crime application DWL
- Repossessors employee theft crime application DWL
- Supermarkets crime application DWL
- Third party fidelity crime application DWL
- Temporary staffing crime application DWL
- Vending machine crime application DWL
Defense outside limits
- Small risk crime application DOL
- Large risk crime application DOL
- False pretense crime application DOL
- Abridged false pretense crime application DOL
- Accountants crime application DOL
- Casino gaming crime application DOL
- Condo association and property management crime application DOL
- Condominium association crime application DOL
- Foreign operations crime application DOL
- Forgery and alteration questionnaire DOL
- Healthcare crime application DOL
- Investment advisors crime application DOL
- Large ERISA limit crime application DOL
- Law firm crime application DOL
- Property management crime application DOL
- Repossessors employee theft crime application DOL
- Supermarkets crime application DOL
- Third party fidelity crime application DOL
- Temporary staffing crime application DOL
- Vending machine crime application DOL
Miscellaneous professionals
Submit the appropriate application by emailing it to mplsub@hanover.com.
- Miscellaneous professional liability new business application
- Miscellaneous professional liability small firm new business questionnaire - for firms with less than $15M in revenue
- Miscellaneous professional liability renewal application
- Real estate MPL new business application
- Real estate MPL renewal application
Supplements
- Beauty salon, barber and spa supplemental application
- Bookkeeping and tax preparation supplemental application
- Claims adjusters supplemental application
- Consultants supplemental application
- Employment agency and executive recruiting supplemental application
- Event planner supplemental application
- Franchisor supplemental application
- Freight broker supplemental application
- Graphic designer supplemental application
- Home inspector supplemental application
- Interior design supplemental application
- Investigative agency supplemental application
- Media supplemental application
- Medical billing supplemental application
- Mortgage broker supplemental application
- Property managers questionnaire
- Property preservation/mortgage field services supplemental application
- Technology supplemental application
- Third-party administrators supplemental application
- Travel agent supplemental application
- Trustee supplemental application
Standalone crime
Email submissions to FIDCRIMESUB@hanover.com. 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