• STANDARD APPLICATION FOR CALIFORNIA

    STANDARD APPLICATION FOR CALIFORNIA

    Real Estate Professionals Errors and Omissions Insurance Application

  • NOTICE: This is an application for a “Claims-made” policy. Coverage for prior acts and claims made after termination of this policy may be restricted. Please read the policy carefully.

  • California Association of REALTORS® member:*
  • 2.a. Date firm was established:*
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  • Entity Type*

  • Professionals are defined as: Owners, Partners, Officers, Real Estate Brokers/Agents/Salespersons, Appraisers, Property Managers, Consultants or Auctioneers including independent contractors.

  • 5. Does the applicant have a formalized training program for all professionals and staff?*
  • 7. Do at least 15% of all professionals hold a professional designation?(i.e. GRI, CRS, CRE, ABR, MAI, SRA)*
  • 8. Is the applicant owned, associated, or controlled by any business, investment group or syndication?*
  • 9. a. Has any member of your firm engaged in property construction or development (including renovations)?*
  • If any member of the firm has engaged in property construction, development, or renovations, check all that apply and complete 9b:*

  • If you checked #3, you must complete the Construction/Development Ownership section of the Other Services Supplement. 

  • 10. Provide your gross revenues for the last 12 months and projected next 12 months. If newly established, please provide an estimate of revenues for the current annual period. (Gross revenues are defined as all fees and commissions before expenses, including fees, commissions and bonuses payable to employees and independent contractors.)

    Please note: Your revenue should make sense mathematically with your other numbers. (Average home value X average commission percentage X number of transactions = total gross commissions)

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  • *If Applicant has revenue derived from Residential Appraisals, please complete the Other Services Supplemental Application.

  • Does the Applicant have any past or projected Commercial transactions? (ie: Sales, Leasing, Land, Appraisals)*
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  • *If Applicant has revenue derived from Commercial Appraisals, please complete the Other Services Supplemental Application.

  • Does the Applicant have any past or projected transactions involving Property Management, Business Brokering, Mortgage Brokering, Auctioneering, Short-term Escrow, Consulting, or other services?*
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  • *If Applicant has revenue derived from Property Management, Business Brokering, Mortgage Brokering, or Auctioneering, please complete the Other Services Supplemental Application.

  • 11. Does the applicant have documented procedures which include instructions on how to handle complaints and compliance with Federal, State and Local statutes?*
  • 12. Does the applicant use approved board of REALTORS or state association of REALTORS standard contract forms for the listing?*
  • 14. Has the applicant ever had a transaction valued at $10,000,000 or more?*

  • 15. What percentage of residential transactions included a: 

  • 16. a. What percentage of transactions involve acting as a:

  • b. When acting as a dual agent, is dual agency disclosed to all parties in writing?*
  • 17. Has any member of your firm been involved in asset or property preservation services including any incidental repair work on bank owned properties within the last 3 year period?*
  • If Yes to #17, were all such repairs contracted by you done by a licensed contractor?*

  • If your firm was involved in asset or property preservation services on bank owned properties, indicate if all such repairs (contracted by you) were done by a licensed contractor.

  • 18. Has any member of your firm been involved in property rehabilitation services on bank owned properties within the last 3 year period?*
  • If Yes to #18, were all such repairs contracted by you done by a licensed contractor?*

  • If your firm was involved in property rehabilitation services on bank owned properties, indicate if all such repairs (contracted by you) were done by a licensed contractor.

  • 19. For any bank owned properties where you represent the buyer, do you advise the buyer in writing to have the property inspected by a licensed and insured home inspector prior to purchase?*
  • 20. Has any member of your firm directly acquired the properties or deeds of financially distressed homeowners, including sale–leaseback agreements within the last 3 year period?*
  • 21. Has the applicant engaged in any eviction services on pre-foreclosed or bank owned properties within the last 3 years?*
  • If Yes to #21, was the preparation, filing and service of the eviction complaint and obtaining the eviction judgment handled by an attorney?*

  • If your firm has engaged in evictions, indicate if the preparation, filing, service, and judgment was handled by an attorney.

  • 22. Has the applicant engaged in any services which involved delivering or negotiating cash-for-keys offers or property rehabilitation?*
  • 23. Is any client responsible for more than 25% of the applicant’s annual income?*

  • (Does 25% or more of your annual income come from a single client?)

  • 24. Does the firm perform or intend to perform professional services for REITs or property syndications?*
  • 25. a. During the past 5 years, has the applicant been involved in any merger, acquisition, or consolidation?*
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  • 25b. During the past 5 years, has any principal, partner, director, officer, or professional of the applicant performed professional services for any other business which the applicant has any ownership or managerial interest?*
  • 26. Does any applicant transact business in multiple states or outside of the United States?*

  • 27. After inquiry, is the applicant, or anyone to whom this insurance will apply, aware of any:

  • a. Professional Liability claim made against them in the past 5 years?*
  • b. Act or omissions in the performance of professional service for others which might reasonably be expected to be the basis of a claim or suit against them?*
  • c. Changes in any claims previously reported on past applications?*
  • d. License revoked by any licensing board, real estate association, or other regulatory body in the past 5 years?*
  • e. License suspension by any licensing board, real estate association, or regulatory body in past 3 years?*
  • f. Fines of more than $10,000 (in the aggregate) by any licensing board, real estate association, or other regulatory body in the past 3 years?*

  • *If Yes to 27. a, b, or c, you will need to complete a Claim Supplement. 

  • IMPORTANT NOTE: The applicant’s non disclosure of claim information does not indicate nor imply, in any way, that any act or omission is covered by this policy. In addition, circumstances or incidents that might reasonably be expected to be the basis of a claim MUST be reported to the applicant’s current insurer before the claim reporting period expires.

  • Is the applicant's expiring E&O policy from RealCare?*

  • NEW BUSINESS APPLICANTS ONLY #28-30

    Questions 28-30 are only required if the Applicant is new to RealCare
  • 28. During the past 5 years has any insurance carrier declined, canceled or refused renewal of similar insurance on behalf of this applicant or anyone to whom this insurance will apply (other than due to loss of market)? *Notice: This question does not apply to Missouri residents**
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  • 30. Has the applicant ever purchased an extended reporting period endorsement?*

  • 31. Coverage Selection:

  • Claims Expenses
  • c. Desired Policy Effective Date:
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  • d. Current Policy Retroactive Date:
     / /
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  • FRAUD WARNING: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to crimina l and civil penalties.

    The undersigned is authorized by, and acting on behalf of, the Applicant and represents that all statements and particulars herein are true, complete and accurate and that there has been no suppression or misstatements of fact and agreesthat this application shall be the basis of, and becomes part of, the Applicant’s professional liabilitycoverage.

    COMPLETION OF THIS FORM DOES NOT BIND COVERAGE. APPLICANT’S ACCEPTANCE OF COMPANY’S QUOTATION IS REQUIRED PRIOR TO BINDING COVERAGE AND POLICY ISSUANCE. THE APPLICANT AND FIRM ACCEPTS NOTICE THAT ANY POLICY ISSUED WILL APPLY ON A “CLAIMS-MADE” BASIS. THE APPLICANT AND FIRM ACCEPTS NOTICE THAT THEY ARE REQUIRED TO PROVIDE WRITTEN NOTIFICATION TO THE COMPANY OF ANY CHANGES TO THIS APPLICATION THAT MAY HAPPEN BETWEEN THE SIGNATURE DATE BELOW AND ANY PROPOSED EFFECTIVE DATE. THE APPLICATION MUST BE SIGNED BY AN ACTIVE OWNER, PARTNER, PRINCIPAL, OFFICER, OR MEMBER OF THE APPLICANT.

  • Date
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  • After signing, you must click the SUBMIT APPLICATION button to submit your application.

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