E-commerce Store Cyber Liability Insurance Application
Business Details
Business Name
Website URL
Year Established
Business Address
Contact Information
Contact Name
Email
Phone
E-commerce Operation Information
E-commerce Platform(s) Used
Annual Online Sales Revenue
Countries Served
Customer Payment Methods Accepted
Average Monthly Transaction Volume
Types of Customer Data Collected/Stored
Cyber Security Measures
Current Security Measures (e.g., Firewalls, Encryption, Two-Factor Authentication)
GDPR/CCPA Compliance
Yes
No
Have you experienced any cyber incidents in the past 5 years?
Yes
No
If yes, please describe:
Coverage Information
Requested Insurance Coverage Limit
Additional Coverage Requested