Errors & Omissions Application

Templates

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Insurance

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Datapoint

Description

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Proposed Effective & Expiration Dates

Captures the requested start and end dates for the E&O insurance policy period.

Requested Retroactive Date

Identifies the earliest date from which coverage is requested for prior acts, based on continuous professional services.

Named Insured / Applicant Name

Returns the legal name of the individual or business entity applying for E&O coverage.

Mailing Address

Captures the full mailing address of the applicant, including street, city, state, and ZIP code.

Primary Contact Information

Includes the name, phone number, and email address of the person responsible for completing the application.

Business Structure / Entity Type

Identifies the legal structure of the applicant (e.g., Sole Proprietor, LLC, Corporation).

FEIN / SSN

Returns the applicant's Federal Employer Identification Number or Social Security Number for identification purposes.

Description of Professional Services

Outlines the specific professional services or activities performed by the applicant that require E&O coverage.

Number of Employees / Professionals

Returns the total number of staff performing or supporting professional services.

Licensing & State Operations

Identifies applicable professional licenses and the states in which services are provided.

Use of Subcontractors

Indicates whether subcontractors are used in service delivery and whether they maintain their own E&O coverage.

Per Claim Limit Requested

Specifies the limit of liability requested for any single claim.

Aggregate Limit Requested

Captures the total limit of liability requested for all claims during the policy term.

Self-Insured Retention / Deductible Requested

Identifies the amount the applicant agrees to pay per claim before insurer contribution.

Requested Prior Acts Coverage

Indicates whether the applicant is seeking coverage for acts occurring before the policy period.

Current or Prior E&O Coverage

Returns details of any previous or current E&O policies, including insurer, effective dates, limits, and retroactive date.

Coverage Gaps

Indicates whether there have been any lapses in E&O coverage and provides explanation if applicable.

Past Claims or Incidents

Discloses any prior professional liability claims, including status, date, and outcome.

Disciplinary or Regulatory Actions

Captures any past or ongoing investigations, fines, or actions by licensing or regulatory bodies.

Knowledge of Potential Claims

Indicates whether the applicant is aware of any incidents that could lead to a future claim.

Estimated Annual Gross Revenue

Returns the applicant's total expected or most recent annual revenue from professional services.

An errors and omissions (E&O) insurance application gathers detailed business and coverage information to assess professional liability risk and issue policies. Feathery’s AI automatically extracts structured data including applicant and business details, requested effective and retroactive dates, entity type, and licensing information. It also captures descriptions of professional services, employee counts, subcontractor usage, and requested liability limits with corresponding deductibles or retentions. The system reviews prior coverage, identifies any lapses, and discloses claims history, disciplinary actions, and awareness of potential future claims.

By digitizing financial details such as annual gross revenue and aligning prior acts coverage with risk history, Feathery streamlines underwriting, reduces manual review, and ensures accurate risk evaluation. This automation helps insurers and brokers deliver faster quotes, improve compliance, and provide comprehensive professional liability coverage for businesses across industries.

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Related templates

ACORD 25

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