Cyber Security Risk Assessment
Please complete the fields below and provide as many details as possible.
What is the nature of your request today?
I'm experiencing a cyber security incident or breach!
I'd like to request a full cyber security assessment for insurance purposes.
If you have an active incident occurring, please continue to complete the form below and call us on our priority response line immediately at: 517-940-6288
Organization Information
Please tell us a little more about your organization. The better we understand your organization the more customization we can provide you in order to maximize security while reducing expenses.
Organization Basics
*
Rows
Please provide details:
Full Legal Name of Organization
DBA or Trade Name(s)
Street Address
Street Address (2)
City
State
Zipcode
Primary Phone
Primary Email Address
Website
Organization Details
Rows
Please provide details:
Year Established
Primary Industry
Approximate # of Customers/Members/Users
Total # of Locations
Total # of Locations Outside of U.S.A.
Organization Financials
Rows
Please provide details:
Approximate Annual Revenue
Approximate Annual Operations Cost
Please use this section to provide us with any other relevant information or general notes related to the Organization:
Organization IT Environment
The following questions are required to understand the current IT Environment of your organization. Please answer each question and provide additional information as needed.
Organization IT Assets + Users
*
Rows
Please provide details:
Number of Workstations
Number of Laptops
Number of Servers (Physical)
Number of Servers (Virtual)
Total Number of Endpoints
Total Number of IT Assets
Approximate Number of Users Accessing Network(s)
Do you have an up-to-date IT Asset List?
Yes
No
Please use this section to provide us with any other relevant information or notes related to the IT Environment:
Organization Staff + Asset / Device Management
The following questions are required to understand the risk management in place for both your staff and digital assets + devices in use by your organization. Please answer each question and provide additional information as needed.
Total Number of Full Time Employees
*
Total Number of Part Time Employees
Total Number of Outside Contractors
Total Number of IT Staff (All Departments)
*
Total Number of Cyber Security Staff
*
Does any of your Staff work remotely?
Yes
No
Does your IT + Cyber Security Staff work remotely?
Yes
No
Where is your IT + Cyber Security Staff located?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are your employees subject to ongoing Background Checks?
Yes
Yes. But, only one time at initial hiring.
No
Which provider are you using for employee Background Checks?
Are your employees subject to ongoing Identity Screening + Monitoring?
Yes
Yes. But, only one time at initial hiring.
No
Which provider are you using for employee Identity Screening + Monitoring?
Do you have a written Employee Policy in place for employees to notify your organization of Identity Breaches?
Yes
No
Unsure
Please upload a copy of your Employee Identity Breach Notification Policy.
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Please tell us if any of the following Corporate Devices are issued to employees?
Cell Phone
Desktop (for remote access)
Laptop
Tablet
NONE
Other
Are your employees permitted to use their own Personal Devices?
Yes
No
Does your organization utilize any of the following Mobile Devices in the course of operations?
Cell Phone
Credit Card Reader
Laptop
Mobile Hotspot
Tablet
NONE
Other
Do you have a Mobile Device Management solution implemented for all related devices?
Yes
No
Unsure
Please tell us which Mobile Device Management solutions you currently have implemented and/or any related details:
Please indicate any Digital Assets that your organization owns:
Proprietary Software
Proprietary Hardware + Related IT
Digital Manuscripts / Learning Management Systems
Digital Audio / Video Assets
Metadata
Cryptocurrency / NFTs / Tokens
Social Media Accounts
Regulated / Official Security Tokens
NONE
Other
Do you have a Digital Asset Management Program?
Yes
No
Unsure
Please tell us more about the Digital Asset Management Program that you currently using and/or any related details:
Is your organization using any Web / Cloud Services?
Yes
No
Unsure
Are you using any Cloud Security solution that covers all cloud risks: spanning misconfigurations, vulnerabilities, identity risks, data security, API / PII / crown jewel asset exposure, and advanced threats?
Yes
No
Unsure
Which of the following Cloud Security solutions are you currently using?
Please Select
Orca Security
Other
Which other Cloud Security solution are you using?
Please tell us more about the Web / Cloud Services that you currently using and/or any related details:
Do you provide Remote Access of any kind to staff or customers / members?
Yes
No
Who is your current Remote Access Vendor?
Cyber Security Questionnaire
The following questions are required to diagnosis the current cyber security environment of your organization. Please answer each question and provide additional information as needed.
Do you have Endpoint Detection & Response (EDR)?
*
Yes
No
Unsure
Which of the following EDR solutions are you currently using?
Please Select
Crowd Strike Falcon EDR
Microsoft Defender
Sentinel One
Other
What other EDR solution are you using?
Do you have Next Generation Anti-Virus on all endpoints?
*
Yes
No
Unsure
Which of the following Next Generation Anti-Virus solutions are you currently using?
Please Select
CrowdStrike NGAV
SentinelOne NGAV
Other
What other Next Generation Anti-Virus solution are using?
Do you have Managed Detection & Response (MDR) in place for all sources of active detection?
*
Yes
No
Unsure
Which of the following MDR solutions are you currently using?
Please Select
Red Canary
CrowdStrike
Other
What other MDR solution are you using?
Which of the following Email Providers are you currently using?
Please Select
Apple
Google
Microsoft
Proton
Zoho
Other
Who is your current Email Provider?
Do you have Advanced Email Protection for O365/G-Suite as well as your cloud-based collaboration platforms including: pre and post delivery protection, URL and attachment sandboxing, anti-malware scanning, data loss prevention, and encryption?
*
Yes
No
Unsure
Which of the following Advanced Email Protection solutions are you currently using?
Please Select
Microsoft Defender
Barracuda
Huntress
Other
What other Advanced Email Protection solution are you using?
Do you have Multi-factor Authentication (MFA) implemented for all users?
*
Yes
No
Unsure
Do you have Multi-factor Authentication (MFA) implemented for all remote access and 3rd party applications?
*
Yes
No
Unsure
What MFA solution are you currently using?
Please Select
Azure
Duo
JumpCloud
Okta
RSA
Other
What other MFA solution are you using?
Do you have Application Safelisting (whitelisting / blacklisting) enabled for all workstations and servers?
*
Yes
No
Unsure
Do you have Zero Trust Segmentation implemented for all endpoints?
*
Yes
No
Unsure
Do you use a Zero Trust Network Access Solution to control remote access?
*
Yes
No
Unsure
Which of the following Zero Trust Network Access Solutions do you currently use?
Please Select
CloudFlare
Illumio
Splunk
Rubrik
Other
What other Zero Trust Network Access Solution are you using?
Do you have Privileged Access Management (PAM) implemented for all privileged accounts?
*
Yes
No
Unsure
Which Privileged Access Management (PAM) solution are you currently using?
Please Select
Delinea
ThreatLocker
Other
What other Privileged Access Management solution are you using?
Do you have a Password Manager implemented for all users?
*
Yes
No
Unsure
Do you currently have Segregation of Duties + Business Controls in place for all outgoing payments / funds transfers?
*
Yes
No
Unsure
Do you have Single Sign On (SSO) enabled and configured for all 3rd party applications?
*
Yes
No
Unsure
Do you have At-Rest Encryption enabled for all endpoints / devices?
*
Yes
No
Unsure
Do you have a formal Patch Management Program in place which is informed by critical security and vulnerability data within 30 days?
*
Yes
No
Unsure
Do you have an Immutable Backup Strategy (REQUIRES: 3+ backup sources covering all systems / data and 1+ offline / inaccessible from the network where the systems/data reside)?
*
Yes
Yes, we have a Backup Strategy. But, it does NOT meet these requirements.
No
Unsure
Do you have a Vulnerability Management Program which performs scans at least bi-weekly?
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Yes
No
Unsure
Do you have a Log Resilience/Centralization Platform (such as a SIEM)?
*
Yes
No
Unsure
Do you have Next Generation Firewalls at all locations (REQUIRES: inbound / outbound proxy, threat detection, DoS protection, etc)?
*
Yes
Yes, we have Firewalls. But, they are NOT Next Generation.
No
Unsure
Please use this section to provide us with any other relevant information or notes related to your current Cyber Security Controls + Environment:
Cyber Security Program
The following questions are required in order to better understand your written policies + procedures and response plans. Please answer each question and provide additional information as needed.
Do you have a Written Cyber Security Program in place which aligns with regulatory requirements and/or industry standards (NIST, CIS, etc)?
*
Yes
No
Unsure
Please upload a copy of your current Cyber Security Program.
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Is your organization (OR any of your customers) subject to additional regulatory requirements by any of the following regulated industries?
Financial Services
Government
Healthcare
Insurance
Security
Other
Do you have an Incident Response Plan in place currently?
Yes
No
Unsure
Is your Incident Response Plan approved by your insurance carrier?
Yes
No
Unsure
Do you have a dedicated Computer Security Incident Response Team (CSIRT)?
Yes (internal)
Yes (external)
No
Who is your external Computer Security Incident Response Team?
Is your Computer Security Incident Response Team (CSIRT) approved by and aligned with your insurance carrier?
Yes
No
Unsure
How often are you conducting Tabletop Exercises?
Please Select
At Least 1X Per Year
At Least 4X Per Year
At Least 6X Per Year
At Least 12X Per Year
More than 12X Per Year
NEVER
Please tell us more about your current Incident Response Plan:
Please use this section to provide us with any other relevant information or notes related to your current Cyber Security Program and planning:
Cyber Liability Insurance
The following questions are required to establish and understanding of your current cyber insurance in force (or desired coverage). Please provide as many details as known related to the coverage.
Does your organization currently have Cyber Liability Insurance?
Yes
No
Unsure
Who is your current Insurance Carrier?
What type of insurance policy is in force?
Please Select
Stand Alone Cyber Liability Insurance
Cyber Liability Rider (included with BOP)
Cyber Liability Rider (included with General Liability)
Other
Is the insurance policy part of a Group/Membership Plan or your own coverage?
Our Organization's Own Insurance Policy
Part of a Membership Plan Policy
Part of a Group Policy
Unsure
What is the existing coverage limit Per Incident?
What is the existing coverage limit Policy Maximum?
When is the Renewal Date for this policy?
-
Month
-
Day
Year
Date
Have you received an Offer for Renewal?
Yes
No
Unsure
Please list the dates and provide details (ransomware, business email compromise, data loss, etc) of any incidents or cyber insurance claims which occurred in the last 5 years:
Is Cyber Liability Insurance desired?
Yes
No
What is the amount of cover desired/required?
When would you like coverage to begin?
-
Month
-
Day
Year
Date
Please indicate if you would like recommendations for any additional coverage:
Comprehensive Commercial Liability Insurance
Tech E+O Insurance
Device + Hardware Insurance
Directors + Officers Insurance
Workers' Compensation Insurance
Digital Asset Insurance
Social Media Account Insurance
Identity Theft
Please use this section to provide us with any other relevant information or notes related to your current Cyber Insurance or desired / required coverage:
Scope of Project/Request
Rows
Please provide details:
Industry Sector
Reason for Initial Outreach
Success Criteria for Project/Scope/Opportunity
DFIR Questionnaire - Insurance Information
Rows
Please provide details:
Insurance Carrier
Claim ID#
Claim Manager Name
Claim Manager Email Address
Claim Manager Phone Number
DFIR Questionnaire - Company Background
Rows
Please provide details:
High Level Details
General Description of Environment
Headquarters Location
Office + Datacenter Locations
Number of Employees
Number of IT Staff
Where is the IT Staff Located
DFIR Questionnaire - Incident Background
Rows
Please provide details:
Ransomware Variant?
Ransome Note Found?
Has there been any communication with the threat actor?
Initial Ransom Demand?
Earliest Known Date of Impact?
What is the earliest evidence of compromise identified so far (if known)?
Has the decryption utility been acquired?
Any knowledge of exfiltration?
What is the scope of the infection/ransom?
Any previous knowledge of the infection (Ransomware, Malware/BEC/etc)?
DFIR Questionnaire - Timeline
Rows
Please provide details:
Please provide a detailed timeline of events:
DFIR Questionnaire - Assets
Rows
Please provide details:
Do you have an IT asset list?
Any web services or cloud services to be aware of?
Business critical servers and applications?
Any legacy operating systems?
What kind of network devices are in the environment?
Are systems bootable?
What technologies are used for managing assets and pushing out software/patches/etc?
Are all devices patched and up to date?
Do employees work remotely?
Do employees utilize their own devices?
Who is your firewall vendor?
Any logs being retained and for how long?
Is there an existing XDR/MDR or AV solution in place?
DFIR Questionnaire - Priorities
Rows
Please provide details:
What are your current priorities for restoration of business applications (provide an ordered list if possible)?
DFIR Questionnaire - Backups
Rows
Please provide details:
Do you have any backups?
Backup Vendor Name?
Type of backups (tape, cloud, on premise)?
Full image/system backups?
Is the backup server domain joined?
How far back do they go?
When was the last time you restored and tested backups?
SAN Solution (Nimble, HPE, Dell EMC, NetApp):
Were snapshots enabled and if so have they been disabled?
Is Active Directory working?
AD Architecture (forests, domains, trusts, Azure AD):
If Azure AD is in play, what is in Azure vs. on-premise and is writeback enabled to keep Azure AD passwords sync'd with on premise AD?
Number of Domain Controllers:
Domain Controller Server Name(s):
DFIR Questionnaire - Email
Rows
Please provide details:
Email Vendor:
Where does email authenticate?
MFA required?
DFIR Questionnaire - Remote Access
Rows
Please provide details:
Remote Access Vendor:
MFA required?
Are authentication logs available?
How far back?
DFIR Questionnaire - Actions Taken
Rows
Please provide details:
What has been done so far?
Is Cyber Liability Insurance currently in place?
Yes (Cyber Liability Insurance Policy)
Yes (Cyber Liability Rider ONLY)
No
Unsure
Submitter Name
*
First Name
Last Name
Submitter Email
*
example@example.com
Date Submitted
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
e-Signature
*
Submit
Submit
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