• Real Estate Professional Errors and Omissions Insurance
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  • EXPRESS APPLICATION FOR FLORIDA

    For effective dates on or after 10/1/2026

  • To be eligible for this application you must be able to answer "true" to statements 1-9 below. Please contact our office if you are not eligible for this program or need coverage for services not offered under the Express program.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Entity Type:*
  • NEW BUSINESS ACCOUNTS: Desired Effective Date*
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    2 digit month, 2 digit day, 4 digit year
  • Retroactive Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • If you have a policy in force, you will need prior acts coverage. Attach a copy of your current Declarations page.

  • To be eligible for the premium options shown below, your responses to statements 1-9 must all be "True."

  • 1. No owner, agent or member of the Applicant company has had their license revoked, been investigated or been subject to any disciplinary action by any licensing board, real estate association or other regulatory body within the last 5 years.*
  • 2. No owner, agent or member of the Applicant company has been cancelled, refused insurance or declined by an insurance carrier during the last 5 years (except due to loss of market or non payment of premium).*
  • 3. No owner, agent or member of the company is involved in business brokering, mortgage brokering, appraisals, commercial real estate sales, escrow services, property manager services, development or construction.*
  • 4. No owner or agent of the company has an exclusive listing agreement with any builder/developer.*
  • 5. The Applicant's total gross revenues did not exceed $500,000 for the past 36 months. (Gross revenues are defined as all fees and commissions received by the insured entity before expenses are paid to any employees, agents, or independent contractors.)*
  • 6. The Applicant and anyone to whom this insurance will apply is not aware of any professional liability claim or any acts, errors, omission or Personal Injuries which might reasonably be expected to be the basis of a claim made against them within the past 5 years.*
  • 7. No owner, agent or member of the Applicant has provided services related to properties that included involvement in any eviction procedures, delivering or negotiating cash for keys offers or property rehabilitation.*
  • 8. No more than 50% of the Applicant's transactions are dual agency.*
  • 9. No more than 50% of the Applicant's transactions are from agent-owned property sales.*
  • Did you answer "True" to all True/False Eligibility Statements 1-9 above?*

  • STOP!

    Do not continue this application. DO NOT PAY on the next screen.

    If you answered "False" to any of the True/False Eligibility Statements 1 through 9 on the previous page, then you are NOT eligible for the Express Program and you must apply using the Standard Application.

  • SELECT YOUR DESIRED PREMIUM OPTION

    PREMIUM / LIMITS OF LIABILITY / DEDUCTIBLE
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  • CHOOSE YOUR PREMIUM OPTION*

  • DISCLAIMER

    COMPLETION OF THIS FORM DOES NOT BIND COVERAGE. 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.

  • I, the undersigned, certify that I have no knowledge of any claims, legal, or otherwise, which have been or may be made, against any entity or individual for which insurance is requested, which has not been reported previously to you or another insurance company. In addition, after making reasonable inquiries, I am not aware of any act, error or omission, or allegations of any act, error or omissions, or any other circumstances or incidents which could give rise to a claim as a result of the Company's operations or any individual's activities on behalf of the Company.
  • I understand that the insurance Company's willingness to provide coverage was based on the understanding that there are no known unreported claims or incidents. I also understand that all such unreported claims or incidents which later result in a claim will not be covered by the Company's policy.
  • 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 agrees that this application shall be the basis of, and becomes part of, the Applicant's professional liability coverage.
  • Date:*
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    2 digit month, 2 digit day, 4 digit year

  • Click the green button below to complete application

    ATTENTION! Payment and completion of this form does NOT bind coverage. Coverage is not bound until the application is reviewed and accepted by underwriting. Please note: ACH/Credit Card fees are charged by the payment processor and fully earned. IF YOU DID NOT ANSWER "TRUE" TO ALL ELIGIBILITY STATEMENTS 1-9, DO NOT PAY ON THE NEXT PAGE!

  • REMEMBER YOUR PREMIUM!

    (copy or remember your preimum amount to use on the payment screen)

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