Active Cyber Insurance Quote Form

Hidden

Fortix ID Opportunity

About Your Business

Your Name*

Business Name/s*

ABN

Email*

Phone*

Website & Email Domains*

Business Address*

Business Details

Describe your business activities*

Number of Employees*

1 - 25
26 - 50
51 - 250
251+

Expected turnover in the next 12 months*

Which states do you receive client fees / revenue from?*

Percentage of work done in NSW*

Percentage of work done in VIC*

Percentage of work done in QLD*

Percentage of work done in SA*

Percentage of work done in WA*

Percentage of work done in TAS*

Percentage of work done in NT*

Percentage of work done in ACT*

Percentage of work done in USA*

If overseas work, please advise the type of work and the countries where work is undertaken?*

Percentage of work done Overseas (Ex USA)*

If USA work, please advise the type of work undertaken?*

Is any of your above turnover generated from online activities?*

Yes
No
Unsure

If yes, roughly what percentage of your overall turnover is generated from online activities?*

Risk Management Questions

Do you collect, process, store, transmit, or have access to any of the following categories of information?*

Please select all that apply. Note also that there is overlap between the different categories so the same information can appear in two or more areas.

How many records in TOTAL across all the above categories do YOU collect, process, store, transmit, or have access to?*

None
Less than 100,000
100,000 - 500,000
More than 500,000
Don't know

If more than 500,000, please provide an estimate*

Do you collect, process, store, transmit, or have access to any Payment Card Information (PCI)?*

Yes
No
Unsure

What is the estimated annual volume of payment card transactions (credit cards, debit cards, etc)?*

None
Less than 100,000
100,000 - 500,000
More than 500,000
Don't know

If more than 500,000, please provide an estimate*

Within the last 3 years have you been subject to any complaints concerning the content of its website, advertising materials, social media, or other publications?*

Yes
No
Unsure

If yes, please provide further details*

Do you enforce procedures to remove content (including third party content) that may infringe or violate any intellectual property or privacy right?*

Yes
No
Unsure

Do you implement encryption on laptop computers, desktop computers, and other portable media devices?*

Yes, on all devices
Some, but not all devices
Not on any devices
Unsure

Do you maintain at least weekly backups of all sensitive or otherwise critical data and all critical business systems offline or on a separate network?*

Yes
No
Unsure

Do you enforce a password policy requiring strong and unique passwords for all accounts and devices being used in the business?*

Yes
No
Unsure

Do you use malware protection for all devices such as workstations, servers, laptops and any other applicable systems?*

Yes we do
No we do not
I am unsure

Do you apply updates and patches to software, operating systems and applications including anti-malware programs?*

Yes we do
No we do not
I am unsure

Do you implement Multi-Factor Authentication (MFA) on your email?*

Yes, on all users
Some, but not all users
No
Unsure

Do you implement Multi-Factor Authentication (MFA) on your Remote Access services (Virtual Private Network (VPN), Remote Desktop Protocol (RDP), RDWeb, RD Gateway or other)?*

Yes
No
We do not allow remote access
Unsure

Do you implement Multi-Factor Authentication (MFA) on Network and / or Cloud Administration accounts or other Privileged user accounts?*

Yes always
Sometimes
No
On all administrative accounts and all cloud services where supported
Unsure

Do you require a secondary means of communication to validate the authenticity of funds transfer requests before processing a request in excess of $5,000?*

Yes
No
Unsure

Do you require a secondary means of communication to validate the authenticity of any request to change banking details?*

Yes
No
Unsure

Limits of Cover Required

Level of cover required?*

$250,000
$500,000
$1,000,000
$2,000,000
$5,000,000
$10,000,000
Other
Unsure, please provide more details

If other, please advise*

Claims Experience

The term YOU in the questions below relates to your Firm, Company or you as a Sole Practitioner including present or former Partners, Directors, Principals, Consultants, or Employees.

Have YOU experienced any actual or potential Data Breaches or Cyber Incidents, whether insured or not, in the past three years?*

Yes
No