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Applications

E-mail your submissions to usz_zip@zurichna.com or fax to (866) 240-0155.

 

To help us best meet your needs, please include this information with your submissions:

  • The 'date needed' for quotes
  • The predominant SIC or NAICS code
  • Available loss information for the past five years
  • For core property & casualty lines, safety program details
  • For automobile, drivers' names, dates of birth and license numbers
  • For workers' compensation, total payrolls for each of the past three years
  • We accept current editions of the ACORD applications for core property & casualty lines

Accident & Health

We will provide a quote with the following information:*

  • The insured's address and contact information
  • Desired coverage (business travel only or business and pleasure)
  • The amount of coverage desired (may vary by employee classes)
  • Employee count
  • Payroll information (if coverage is desired as a multiple of salary)
  • Estimated travel days (For business travel coverage only)

 

*Additional information may be required based on the exposure

Please complete these Zurich applications for the following coverages:

Crime

pdf Crime Application

Directors & Officers Liability

pdf D&O for Non-Profits

pdf D&O for Private Companies

To include Employment Practices Liability, please also complete the EPL application.

Employment Practices Liability

pdf Employment Practices Liability

Environmental

pdf Contractor's Pollution Liability and Environmental Services

pdf Z Choice

pdf Z Link

Errors & Omissions

pdf Errors and Omissions - Specified Professions

For consultants, please also include the E&O Consultants Supplemental Application.

pdf Errors and Omissions - Consultants

For Information Technology Professionals, please use our ZTEC Application.

pdf ZTEC