Cyber Insurance Questionnaire

By filling out this questionnaire SeCAP Inc. will provide your company with a no-cost external discovery as mapped to NIST 2.0 ($15,000.00 value). The information provided also allows for SeCAP Inc. to provide an initial quote for the insurance coverage and policies you desire without going through an interview process. SeCAP Inc. understands by requesting this information we are held to high degree of security and we take that obligation seriously. In order to further protect your information, SeCAP Inc. has expressly taken out any requests for information that bad actors may deem profitable; while, at the same time allowing for a framework to establish coverage quoting.

  • Section 1 - General Information

  • Section 2 - Corporate Structure

  • Section 3 - Information About Your Business

  • Section 4

    Please complete the following table for each current property and casualty insurance policy purchased by your business in the standard insurance market.
  • Worker Compensation

  • General Liability

  • Auto Liability

  • Property

  • Personal Liability

  • Cyber Liability

  • Directors & Officers Liability

  • Employment Practices Liability

  • Section 5 - Additional information about employer Sponsored health and/or Benefit Plans

  • Number of Employees Enrolled or Employer Sponsored Health Plan:

  • Approximate Anual Premiums Paid by Company

  • Section 6

    Additional Information About Your Warranty and/or Extended Service Contract (ESC) Program(s):
  • Should be Empty: