Cyber Liability Insurance Coverage

Name*

First Last

Title*

Company*

Phone Number*

Email*

Address*

City*

Zip*

I've worked with the following SBAM cyber partners*

RiskAware Cyber Scanning Tool
SensCy Score & Cyber Concierge Services
I haven’t worked with either of these partners

Number of Employees*

Are you an SBAM Member?*

Elite Member
VIP Member
Premium Member
Basic Member
Free Starter Member
I’m not sure. Can you check for me?

Do you have an existing, standalone cyber policy?*

Yes
No

Please list the name of the insurance agency who enrolled you in the current cyber policy.*

If you don’t have a current cyber policy and are not working with an agency, enter ‘NONE’

Multi-factor authentication (MFA) – Do you have multi-factor authentication enabled on email access, remote access and network administration?*

Yes
No
I don’t know

i. Multi-Factor Authentication is a security method that requires the user to provide two or more verification methods to access a given resources. For example, requiring a user to enter the correct password and a 6 digit unique code received via text message.

How many PII, PHI or PCI records does the applicant collect, process, store, transmit or have access to?*

PII – Personally Identifiable Information – information that (i) directly identifies an individual (e.g., name, address, social security number or other identifying number or code, telephone number, email address, etc.) or (ii) by which an agency intends to identify specific individuals in conjunction with other data elements, i.e., indirect identification. (These data elements may include a combination of gender, race, birth date, geographic indicator, and other descriptors). PHI – Protected Health Information – past, present and future physical and mental health data and the condition of an individual created, received, stored or transmitted by HIPAA-covered entities and their business associates. PCI – Payment Card Information Data – data related to cardholders names, credit card numbers, or other credit card or financial information protected by state and/or federal law.

How many biometric information records or data (i.e. fingerprints, retinal scans etc) do you collect, process, store, transmit, or have access to that can be used to uniquely identify a person?*

Do you keep offline backups for all critical data that are disconnected from its network or store backups with a cloud service provider?*

Yes, continuously
Yes, daily
Yes, weekly
Yes, monthly
Yes, more than monthly
I don’t know

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

Yes
No
I don’t know

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

Are you or your outsourced payment processor PCI-DSS compliant?*

Yes, outsourced payment processor is compliant
We don’t use an outsourced payment processor
No, outsourced payment is not compliant
I don’t know

Do you require a secondary means of communication to validate the authenticity of funds transfers (ACH, wire) requests by at least 2 employees before processing request in excess of $25,000?*

Yes
No
I don’t know

Do you enforce procedures to remove content (including 3rd party content) that may infringe or violate any intellectual property or privacy right?*

Yes
No
I don’t know

In the past 5 years, have you filed a cyber insurance claim or suffered any event or situation that could result in a future cyber insurance claim?*

Yes
No
I don’t know

Amount of Annual Revenue*

* Indicates Required Fields

Comments

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Cyber Liability Insurance Coverage

Obtain insurance from a top cyber insurance carrier.