Management Liability
Available coverage parts include Directors and Officers Liability, Employment Practices Liability, Fiduciary Liability, Fidelity and Crime, Kidnap/Ransom and Extortion and Cyber Privacy and Security. Email the completed submission to your Underwriter.
Private Company Portfolio Advantage Applications
- Private Company New Business Application (all states excluding NH and NY)
- New Hampshire Private Company New Business Application
- New York Private Company New Business Application
- Private Company Renewal Application (all states excluding NH and NY)
- New Hampshire Private Company Renewal Application
- New York Private Company Renewal Application
Nonprofit Entity Portfolio Advantage Applications
- Nonprofit New Business Application (all states excluding MA, NH and NY)
- Massachusetts Nonprofit New Business Application
- New Hampshire Nonprofit New Business Application
- New York Nonprofit New Business Application
- Nonprofit Renewal Application (all states excluding MA, NH and NY)
- Massachusetts Nonprofit Renewal Application
- New Hampshire Nonprofit Renewal Application
- New York Nonprofit Renewal Application
Supplemental Applications
Contact your Underwriter for state-specific supplemental applications.
- Claim Supplemental Application (all states excluding NH and NY)
- Third Party Fidelity Supplemental Application (all states excluding AK, LA, NH and NY)
- Computer Fraud & Funds Transfer Supplemental Crime Application (all states excluding AK, NH and NY)
- Employee Stock Ownership Plan Supplemental Application (all states excluding MA, NH and NY)
- Foreign Operations Supplemental Application (all states excluding AK, NH and NY)
- Healthcare Institutions Supplemental Crime Application (all states excluding AK, NH and NY)
- Wage & Hour Supplemental Employment Practices Application (all states excluding NH and NY)
Stand-Alone Fidelity and Crime
Email submissions to FIDCRIMESUB@hanover.com. Contact your Underwriter for state-specific applications and supplemental applications.
Applications
For stand-alone public company crime business, complete the appropriate New Business or Renewal application available below. For stand-alone private company crime business, complete the appropriate New Business or Renewal application available in the Private Company Portfolio Advantage Applications section above.
- 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)
- Condominium Associations/Property Managers Application (all states excluding AK, LA, NH and NY)
- False Pretense Questionnaire
- 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
Supplemental Applications
- Computer Fraud & Funds Transfer Supplemental Crime Application (all states excluding AK, NH and NY)
- Construction Entity Supplemental Application (all states excluding AK, NH and NY)
- Healthcare Institutions Supplemental Crime Application (all states excluding AK, NH and NY)
- Law Firm Supplemental Application (all states excluding AK, NH and NY)
- Property Management Questionnaire
- Third Party Fidelity Supplemental Application (all states excluding AK, LA, NH and NY)
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
- Mergers and Acquisitions
- Multiple Location
- Non-Profit Entity
- Non-Public Audit
- Outside Interest
- Public and Private Offerings
- Public Company
- Separate Entity
- Trust or Estate
Architects and Engineers
Submit the appropriate application by emailing it to aenewbiz@hanover.com.
- Architects and Engineers New Business Application (all states excluding NY)
- Small Firm New Business Application – for firms with $500,000 in annual gross billings or less (all states excluding NY)
NY
Contact Margaret Teta, Regional Distribution Director, for New York applications.
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
- Blood Bank
- Clinic
- Community Health Center
- Community Health Center Addendum
- Dialysis
- Eye Bank
- Health Care Provider—Academic Programs
- Health Department
- Hyperbaric
- Medical Imaging Centers
- Rehabilitation
- Sleep Study Facilities
- Student Health Center
Home Healthcare
- Home Healthcare New Business
- Home Healthcare Renewal
- Data Breach (required for data breach limits over $10,000)
Orthotics and Prosthetics
Pharmacies
Business, Professional and Personal Services (MPL)
Submit the appropriate application by emailing it to mplsub@hanover.com.
- Miscellaneous Professional Liability New Business Application
- 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 Supplemental Application
- Property Preservation/Mortgage Field Services Supplemental Application
- Technology Supplemental Application
- Third Party Administrators Supplemental Application
- Travel Agent Supplemental Application
- Trustee Supplemental Application
Eldercare
Email the completed submission requirements to ELDRCARESUB@hanover.com.
- Eldercare Advantage New Business Supplemental Application
- Eldercare Advantage Independent Living Facility Supplemental Application
- Eldercare Renewal Application
- Data Breach (required for data breach limits over $10,000)
Lawyers
Submit the application by emailing it to lplsubs@hanover.com.