Request A Quote – Cyber Cover Plus

Use this proposal if your estimated total revenue for the coming 12 months is $75m or less.

Segregation of Operations

Your Details

Name*

First Last

Contact Number*

Email*

Address*

Street Address Suburb State Postal Code

Policyholder/Business Name*

Business Activity, Industry or Profession*

Australian Business No. (ABN)*

Policyholder’s Principal Address*

Street Address Suburb State Postal Code

Trading Names*

Websites

Segregation of Operations

Please provide your estimated Revenue for the coming 12 month period by region, and indicate in which territories you are located.

Are you located in Australia/NZ?*

Revenue in Australia/NZ ($)*

Are you located in EU/UK*

Revenue in EU/UK ($)*

Are you located in the USA?*

Revenue in the USA ($)*

Are you located in the Rest of World?*

Revenue in the Rest of World ($)*

Total Revenue ($)*

Estimated annual total number of transactions*

Combined number of client/customer records*

Please provide the total number*

Do you comply with your relevant PCI DSS obligations?*

What percentage of your Total Revenue is from online or e-commerce activities?*

Number of full time employees*

Please provide the total number*

Do you have a Notifiable Data Breach plan in place and otherwise comply with The Privacy Act 1988?*

Do you have a Data Protection/Privacy policy?*

Do you have firewalls protecting your own and customer/client data?*

Do you protect all Personally Identifiable Information and other sensitive data through Encryption?*

Do you outsource the handling of any Personally Indentifiable Information?*

Do you use up-to date antivirus/spyware and malware software?*

Are all mission/business critical systems and data information assets backed up and stored at another location?*

Has an independent party completed an audit of your system/data security?*

If your IT network failed, which of the following would best describe the impact to your operations and revenues?*

Do you have written data security policies and procedures communicated to all employees, and do employees receive annual security awareness training?*

Are you aware of any claims, circumstances, privacy breaches, viruses, DoS / DDoS, or hacking incidents which have impacted, or could adversely impact your business?*

Please provide details including costs incurred and any remedial action taken*

Is your Estimated Revenue Is >$25m*

Describe the type of information in records held by you: Select all that apply*

Customer info (e.g., Name, Address, E-Mail Address, Phone, etc.)

Credit card details

Personal Identity info (e.g., Drivers License, TFN, Passport #, Gov’t ID)

Confidential 3rd party trade secrets or IP (Intellectual Property)

Banking or Financial details

Medical or Healthcare data

Do you have a dedicated person responsible for your IT infrastructure, data security and privacy?*

Do you have a Disaster Recovery Plan (DRP) and/or Business Continuity Plan (BCP) in place and has this been tested in the last 18 months?*

Does your network include contingency / redundancy / resilience of any description, to mitigate system interruptions or failures (such as mirrored infrastructure, failover mechanisms, warm or hot replicated sites or similar)?*

Do you control / limit / monitor your employees’ ability to remove data or information from your network / office (examples include USB drive security)?*

Does your website use Web Apps?*

Do you use monitored Intrusion Detection or Intrusion Prevention Systems (IDS/IPS)?*

Are you aware of any evidence of network intrusion or vulnerabilities highlighted in an IT Security audit or Penetration test which have not yet been resolved?*

Please provide details*

Have you had any unforeseen down time to your website or IT network of more than 12 hours?*

Please provide details*

Segregation of Operations

Cyber Event Protection Optional Covers

OPTIONAL COVER - Contingent Business Interruption

Do you want Optional Cover for Contingent Business Interruption?*

Tell us about your critical components, service providers and supplies.

OPTIONAL COVER - Criminal Financial Loss

Do you want Optional Cover for Criminal Financial Loss?*

Includes Cyber Theft, Telephone Phreaking, Identity-based Theft and Cryptojacking. Does not include Socially Engineered Theft unless selected specifically.

Aggregate Limit for Criminal Financial Loss*

Please specify the value*

Do you want to include cover for Socially Engineered Theft?

Sublimit for Socially Engineered Theft

The sublimit for Socially Engineered Theft cannot be greater than the aggregate limit for Criminal Financial Loss.

Do you require passwords to be changed regularly (at least quarterly)?

Do you allow remote access to your internal network?

Are all new payees, and changes to existing payees’ banking details, double authenticated with the payee?

Do transfers > $10,000 require dual signature or supervisor / manager sign off?

Are you entrusted with or in control of funds from a 3rd party, or do you provide any of the following services for others? Tick all that apply

Collection or payment processing?

Asset, investment or trust management services?

Cash management or other treasury functions?

Other office functions?

Please provide details

Have you ever been declined for Crime, Fidelity or Computer Crime insurance, or had such insurance cancelled?

Please provide details

Have you ever suffered a Crime, Fidelity or Computer Crime loss?

Please provide details

OPTIONAL COVER - Tangible Property

Do you want Optional Cover for Tangible Property?*

Aggregate Limit for Tangible Property*

Please specify the amount*

OPTIONAL COVER - Joint Venture and Consortium Cover

Do you want Optional Cover for your liability from Joint Ventures or Consortia?*

Name(s) of the Joint Venture or Consortium

Your share of revenue from the JV or consortium for the coming 12 months in your Estimated Total Revenue.

Please specify your preferred Excess, Indemnity Period and Aggregate Limit

Excess Limit*

Please specify the limit*

Section A Indemnity Period

Policy Aggregate Limit

Please specify the limit

Consent*

I agree

Claims made notice
Section B – loss to others of this policy is issued on a ‘claims made and notified’ basis. This means that Section B – loss to others responds to:
a. claims first made against you during the policy period and notified to us during the policy period, provided that you were not aware at any time prior to the commencement of the policy of circumstances which would have put a reasonable person in your position on notice that a claim may be made against him/her; and:
b. written notification of facts pursuant to Section 40(3) of the
Insurance Contracts Act 1984 (Cth). Effectively, the facts
that you may decide to notify are those which might give rise to a claim against you even if a claim has not yet been
made against you. Such notification must be given as soon as reasonably practicable after you become aware of the facts and prior to the expiry of the policy period. If you give written notification of facts the policy will respond even though a claim arising from those facts is not made against you until after the policy has expired. When the policy period expires, no new notification of facts can be made to us on the expired policy for a cyber event first discovered or identified by you during the policy period.

Your Duty of Disclosure
Before you enter into an insurance contract, you have a duty to tell us anything that you know, or could reasonably be expected to know, may affect our decision to insure you and on what terms. You have this duty until we agree to insure you.
You have the same duty before you renew, extend, vary, continue under similar insurance or reinstate an insurance policy.
You do not need to tell us anything that:
– reduces the risk we insure you for; or
– is common knowledge; or
– we know or should know as an insurer; or
– we waive your duty to tell us about.
If you do not tell us anything you are required to, we may cancel your policy or reduce the amount we will pay you if you make a claim, or both
If your failure to tell us is fraudulent, we may refuse to pay a claim and treat the policy as if it never existed.

About IMC Insurance Pty Ltd
IMC Insurance Pty Ltd (ABN 73 063 511 740,
AFSL 229344) (‘IMC) acts under a binding authority given to it by the insurer to administer and issue policies, alterations and renewals. In all aspects of arranging this policy, IMC acts as an agent for the insurer and not for you.

Contact details are:
Email: insure@imcinsurance.com.au
Telephone: +61 3 9825 6333
Postal address: Level 1/251-253 Malvern Road, South Yarra VIC 3141

Privacy
In this Privacy Notice the use of “we”, “our” or “us” means the insurer and IMC, unless specified otherwise.
We are committed to protecting your privacy.
We need to collect, use and disclose your personal information (which may include sensitive information) in order to consider your application for insurance and to provide the cover you have chosen, administer the insurance and assess any claim. You can choose not to provide us with some of the details or all of your personal information, but this may affect our ability
to provide the cover, administer the insurance or assess a claim.
The primary purpose for our collection and use of your personal information is to enable us to provide insurance services to you.
Personal information will be obtained from individuals directly where possible and practicable to do so. Sometimes it may be collected indirectly (e.g. from your insurance intermediary or co- insureds). If you provide personal information for another person you represent to us that:
–
you have the authority from them to do so and it is as if they provided it to us;
–
you have made them aware that you will or may provide their personal information to us, the types of third parties we may provide it to, the relevant purposes we and the third parties we disclose it to will use it for, and how they can access it.
If it is sensitive information we rely on you to have obtained their consent on these matters. If you have not done or will not do either of these things, you must tell us before you provide the relevant information.
We may disclose the personal information we collect to third parties who assist us in providing the above services, such as related entities, distributors, agents, insurers, reinsurers and service providers. Some of these third parties may be located outside of Australia. In all instances where personal information may be disclosed to third parties who may be located
overseas, we will take reasonable measures to ensure that the overseas recipient holds and uses your personal information in accordance with the consent provided by you and in accordance with our obligations under The Privacy Act 1988 (Cth).
In dealing with us, you consent to us using and disclosing your personal information as set out in this statement. This consent remains valid unless you alter or revoke it by giving written notice to IMC’s Privacy Officer. However, should you choose to withdraw your consent, we may not be able to provide insurance services to you.
The IMC Privacy Policy available at www.imcinsurance.com.au or by calling IMC, sets out how:
–
IMC protects your personal information;
–
you may access your personal information;
–
you may correct your personal information held by us;
–
you may complain about a breach of The Privacy Act 1988 (Cth) or Australian Privacy Principles and how IMC will deal with such a complaint.
If you would like additional information about privacy or would like to obtain a copy of the Privacy Policy, please contact the IMC Privacy Officer by:
Postal Address: Level 1/251-253 Malvern Road, South Yarra VIC 3141
Phone: +61 3 9825 6333
Fax: +61 3 9825 6333
Email: insure@imcinsurance.com.au
You can download a copy of the IMC Privacy Policy by visiting www.imcinsurance.com.au.

I/we acknowledge that:
1.
I/We have read and understood the important information provided on the last page of this document in the Important Information section.
2.
I/We are authorised by all those seeking insurance to make this Proposal, and declare all information on this Proposal and any attachment is true and correct.
3.
I/We authorise the underwriter to give to, or obtain from, other insurers or any credit reference service, any information relating to insurance held by me/us or any claim in relation thereto.
4.
I/We acknowledge that, where answers are provided in the proposal are not in my/our handwriting, I/We have checked and certify that the answers are true and correct.

Please sign your name*

Name

Date

Unlock peace of mind with a personalised quote tailored just for you

Reach out to our dedicated team of cyber insurance specialists for comprehensive protection against digital risks – Your security is our priority.

Use this proposal if your estimated total revenue for the coming 12 months is $75m or less.

OPTIONAL COVER - Contingent Business Interruption

OPTIONAL COVER - Criminal Financial Loss

OPTIONAL COVER - Tangible Property

OPTIONAL COVER - Joint Venture and Consortium Cover

Please specify your preferred Excess, Indemnity Period and Aggregate Limit