The Insurance Marketplace ® Questionnaire

2012 EDITION, DECEMBER 2012

Name of Company, Underwriting Group, Risk Retention Group, Specialty Broker, or Program Administrator (as you wish your listing to appear)
Company:
Address:
City: State/Province: Zip: Country:
Telephone: Toll Free: Fax:    
Email:     URL:    
This is your questionnaire for coverage listings in the 2012 National Market Directory.
As you complete your questionnaire, please check the appropriate column - Program Administrator/Underwriting Manager or Other Market Sources - for each coverage that you want to appear under. We will make the distinction when we list you.
Except for ADVERTISERS, whose LISTINGS ARE FREE, there is a charge based on the number of categories. Please consult the fee schedule on page 8.
If you choose to advertise, even regionally, you are eligible to appear with your coverages in the National Market Directory, even though you might not otherwise qualify for such listings. For details, please call our advertising department at 1-800-428-4384 or 317-582-1600, FAX 317-816-1000 or e-mail Eric Hall at ehall@roughnotes.com or Dick Schoeninger at dick@roughnotes.com

Listing Criteria and Marketing Information

The criteria for listing an insurer, managing underwriter, managing general agent or excess and surplus lines broker in the 2011 edition of The Insurance Marketplace® are:

Insurors - licensed in one or more states with net premiums (2010) of $2 million (U.S.) or more.

Managing Underwriters - represent one or more companies for specific classes or for all property and casualty classes and operate in all states in which the company operates.

Managing General Agents - represent companies and operate in one of The Insurance Marketplace® geographical territories.

Excess and Surplus Lines Brokers - have binding contracts with Lloyd's or domestic and alien non-admitted insurers.

1. Indicate the category which best describes your organization:
     
       
     
2. Please answer the following questions related to marketing:
  A. List any additional nonstandard or unusual forms of insurance (not listed in the questionnaire) which your organization writes:
 
  B. List all states in which your organization is operating through agents on an admitted basis:
 
  C. List all states in which you are operating on a non-admitted basis:
 
  D. Countries:
 
3. If you are an Insurance Company, how are your special facilities marketed:
       
         
4. If you operate as a Program Administrator, Risk Retention Group, Managing Underwriter, MGA or E&S Broker, are your facilities available to:

On the following seven pages, please check each type of insurance your company writes and whether you offer the coverage as a program administrator/ underwriting manager, or as another market source. Before returning this questionnaire please answer the marketing questions on page one. We also request that a company or individual in charge of the Excess and Surplus or Specialty Lines Department sign the questionnaire on page 8. Return to : The Insurance Marketplace, c/o The Rough Notes Company, Carolyn Pringle, Project Coordinator, P.O. Box 1990, Carmel, Indiana 46032-4990. Fax: 317-816-1000.

Please check only one, Program Administrator or Other Market Sources.
For Office Use: Written by     Written by
COVERAGES Prg. Adm.
/Undwrtg. Mgr 		  Other Mkt. Sources   COVERAGES Prg. Adm.
/Undwrtg. Mgr 		  Other Mkt. Sources
Abortion Clinics Professional Liability 1   Auto Service Centers 679
Abstracters Professional Liability 2   Automatic Car Wash Services 47
Accountants Professional Liability 3   Automobile and Snowmobile Racing Liability (Spectator) 48
Accreditation Programs Errors and Omissions 4   Automobile and Truck Rental – Daily 49
Actuaries Professional 5   Automobile Dealers 50
Acupuncture Specialists Liability 6   Automobile Excess Liability 51
Adjusters Errors and Omissions 7   Automobile Insurance Plans Excess Liability 52
Adoption Agencies Errors and Omissions 602   Automobile Insurance Plans Physical Damage 53
Adult Book Stores 570   Automobile Leasing Contingent Liability 54
Adult Entertainment Film Production 768   Automobile Leasing Contingent Physical Damage 55
Advertising Agency Liability 8   Automobile Nonstandard Liability 56
Air Cargo Insurance 10   Automobile Nonstandard Physical Damage 57
Aircraft Hull and Liability 11   Automobile Physical Damage (Kits/Replicas/Custom Cars) 58
Aircraft Products Liability 12   Automobile Repossessors Liability 59
Aircraft Spare Parts 13   Automobiles – Sport and High Performance Cars 60
Airport Owners/Operators Liability 14   Bailees Customers Insurance 61
Airport Property And Aviation–Related Risks 665   Bankers Blanket Bond – High Limits 62
Alcohol and Drug Rehabilitation Centers Liability 15   Barber Shop Liability 63
All–Terrain Vehicles 16   Bars 64
Alternative Energy Plants 17   Battered Persons Facilities 65
Amateur Athletic Programs (Colleges and Clubs) 18   Beauty Shop Liability 66
Ambulance Service Malpractice 19   Bed and Breakfast Inns 67
Ambulatory Surgery Centers 686   Bicycle Dealers 691
American Expatriates 73   Bicycle Manufacturers 692
Amusement Devices – Coin Operated 20   Billiard Parlors 572
Amusement Parks and Fairgrounds 21   Bingo Halls 573
Amusement Rides 22   Biotechnology Liability 693
Anesthetists Professional Liability 23   Birds (Exotic) 69
Anhydrous Ammonia Dealers Liability 24   Birth Centers Liability 70
Animal Farms (Exotic) 25   Blood Banks Professional Liability 71
Animal Mortality 26   Bloodstock Insurance 72
Animal Rides 28   Boat Dealers 694
Answering Services Errors and Omissions 29   Boat Manufacturers 695
Antique Aircraft Insurance 30   Boatyards or Boat Repair and Servicing Operations 696
Antique and Classic Automobile Insurance 31   Bobtail or Deadheading Liability (Truckers) 75
Antique and Classic Boats 32   Body Piercing Liability 76
Apartment Complexes 622   Boiler and Machinery Coverage aka Equipment Breakdown Coverage 697
Appraisers Errors and Omissions 33          
Aquaculture Operations 34   Bowling Centers 77
Archery Clubs 35   Bridge, Tunnel, and Elevated Highway Construction 698
Architects and Engineers Professional 36   Broadcast Stations 603
Armored Car Services 37   Brownfields Development Sites 604
Art Collections 687   Buffer Layer Liability 214
Art Galleries 688   Builders Risk 79
Asbestos Abatement Consultants Professional Liability 40   Builders Risk – including Design Error 80
Asbestos Abatement Contractors 41   Building Equipment Erection and Installation 699
Asbestos and Lead Paint Abatement Bonds 42   Bumbershoot Liability 81
Assisted Living Facilities 620   Bungee Jumping Events 82
Associations Professional Liability 43   Burglar, Fire Alarm and Safety Equipment Company Liability 83
Association–Sponsored Mass Marketing Programs 44   Bus Conversions 100
Athletic Event Cancellation Insurance 689   Buses 84
Auction Houses 45   Business Legal Expense Insurance 85
Auctioneers Errors and Omissions 46   Business Travel Accident 86
Auto Dismantlers/Auto Recyclers 655   Cable TV Liability 700
Auto Salvage Yards 690   Campers and Camper Vans 87
Campground Owners Liability 88   Crop Dusting and Spraying 141
Canoe Trips/River Rafting 89   Custom Harvesting Operations 143
Capacity or Excess Property Insurance 90   Customized Vans 144
Caribbean Property 568   Customs Bonds 145
Carnivals and Circuses 92   Customs Brokers and Freight Forwarders 142
Carpentry Work Contractors 701   Cyber Liability 362
Casino/Gaming Risks 93   Dance Schools 146
Catered Affair Cancellation Insurance 94   Dangerous Dog Liability Insurance 773
Caterers Errors and Omissions 95   Day Care Centers – Adult 705
Celebrity Protection Insurance 103   Day Care Centers – Children 149
Cemetery Professional Liability 96   Demolition Contractors Liability 150
Charter Boats 97   Dental Hygienists Professional Liability 151
Charter Buses 98   Dentists Professional Liability 152
Check Cashing Services 101   Developmental Disabilities Facilities 435
Chemical Manufacturers and Distributors 102   Dieticians and Nutritionists Professional Liability 153
Chiropractors Professional Liability 104   Difference in Conditions Insurance 154
Christmas Tree Lots 105   Directors and Officers Liability 155
Churches 106   Directors and Officers Liability–Financial Institutions 156
Clergy Professional Liability 108   Directors and Officers Liability–Nonprofit Organizations 157
Clinical Laboratory Malpractice 109   Dive Shops/Instructors 579
Coal Mining Operations 110   Document Destruction Professional Liability 671
Coal Trucks Physical Damage 111   Dog Kennels 158
Coastal Properties 702   Drag Strip Liability (Spectators) 159
Coatings and Adhesives Manufacturers 605   Dredging Contractors 642
Coin and Stamp Dealers "All Risk" Insurance 112   Driving Schools 160
Coin–Operated Dry Cleaners and Laundries 113   Drug Testing Liability 581
Coinsurance Deficiency Coverage 114   Dump Trucks (Liability and Physical Damage) 161
Collateral Protection Insurance 115   Ear Piercing Liability 162
Collectibles 232   Earthquake and Earth Movement Insurance 163
Collection Agents Errors and Omissions 116   Educational Institutions 662
Commercial Autos–Miscellaneous and Special Purpose 117   Educators Professional Liability 164
Commercial Credit Insurance 118   Electric/Hybrid Vehicles 774
Commercial Fishing Boats 119   Electricians 706
Community Resort Associations 606   Electronic Data Processing Equipment 707
Community Service Agencies 121   Electronic Data Processors Errors and Omissions 708
Community Theaters 122   Elevator Maintenance Contractors 165
Computer Software Designers Errors and Omissions 123   Emergency Medical Technicians Errors and Omissions 166
Concrete Work Contractors 703   Emergency Service Organizations 167
Condominium Directors and Officers Liability 124   Employed Counsel Professional Liability 168
Condominiums 125   Employee Benefit Plans Liability 169
Construction 762   Employee Staffing Services 608
Construction/Environmental Testing Laboratories 269   Employers Liability Coverage or Stop Gap Liability 636
Consultants Professional Liability 127   Employment Agencies Errors and Omissions 170
Contractor Controlled Insurance Plan (CCIP) aka Contractor’s Wrap–Up 704   Employment Temporary Services Agencies 172
          Employment–Related Practices Liability 171
Contractors Design and Build (Project Managers) 128   Engineers Professional aka Architects and Engineers Professional Liability 173
Contractors Equipment Insurance 129          
Contractors Pollution Liability 130   Environmental Consultants Errors and Omissions 174
Contractual Bonus Insurance 675   Environmental Contractor Bonds 175
Convenience Stores 638   Environmental Impairment Liability 176
Convention and Trade Show Insurance 132   Environmental Remediation Contractors 609
Corporate or Employed Counsel Professional Liability 134   Environmental Site Assessment 177
Cosmetic Manufacturers and Dealers 135   Equestrian Risks 178
Country Club Insurance 136   Equipment and Tool Rental Services 179
Country Inns 682   Equipment Breakdown Coverage aka Boiler and Machinery Coverage 445
County Clerks and Recorders Errors and Omissions 137          
Courier and Messenger Services 138   Equipment Leasing–Lessor Protection 180
Crane and Rigging Contractors 139   Equity Protection Plan 764
Escrow Agents Errors and Omissions 181   General Contractor–Nonresidential Buildings – Not Industrial or Warehouse 717
Event Cancellation Insurance 483          
Event Coordinators Errors and Omissions 709   Geothermal Energy Projects 220
Excavation Contractors 182   Glass and Glazing Work Contractors 718
Excess and Surplus Lines Brokers and Managing General Agents Errors and Omissions 183   Global Medical Insurance 612
          Golf Carts and Low Speed Vehicles (LSV) 776
Excess FDIC Insurance 184   Golf Course Architects 569
Excess Fidelity Bonds 185   Golf Courses 222
Excess Flood Insurance 672   Golf Driving Ranges 223
Excess Liability (Commercial) 186   Grain Elevators 224
Excess Liability (Over Self–insured Retention) 187   Green Building–Commercial 719
Excess Liability (Personal) 188   Green Building–Personal 720
Excess Malpractice and Professional Liability 189   Gun Collection Floaters 225
Excess Marine Liability 190   Gymnastics Liability 226
Excess Maritime Employers Liability 191   Hail Insurance on Growing Crops 227
Excess Medical Stop Loss Coverage–Self–Insured Risks 192   Halfway Houses 228
Excess Property 652   Haunted Houses 229
Exercise and Physical Fitness Centers 193   Hazardous Industries Monoline Workers Compensation Insurance 649
Exterminators Liability 194          
Farm Feed, Fertilizer, Seed and Supplies 711   Hazardous Material Haulers 230
Farm Implement Dealers 710   Hazardous Waste Storage and Disposal Facilities 231
Farm Labor Contractors 775   Health Foods Industry 576
Farmers Markets 712   Hearing Aid Service Errors and Omissions Liability 233
Farms and Ranch Properties 196   Heavy Construction Contractors 721
Ferry Flight Insurance 763   Helicopters 234
Film and TV Producers Errors and Omissions 197   High Limit Disability 722
Film and TV Producers Indemnity (Cast Insurance) 198   High Performance Boats 587
Film Schools Student Productions 769   High Technology Exposures 235
Film/Movie Production Insurance 669   High–Valued Commercial Property 653
Financial Institutions 199   High–Valued Personal Property 723
Financial Planners Errors and Omissions 200   Highway and Street Construction Contractors 724
Fine Arts Floaters (High Values) 201   Historic Home Insurance 236
Fire Protection Industry 574   Hole–in–One Coverage 237
Firearms Dealers and Distributors 202   Home Business Insurance 725
Firefighters Accident, Death and Disability Coverage 203   Home Health Care Agencies 238
Fireworks Displays–Contractors Risks 204   Home Inspection Errors and Omissions 621
Fishing Contests 205   Home Sellers Liability 588
Flea Markets and Antique Shows 206   Homebuilders Coverage 666
Floor Laying and Other Floor Work Contractors 713   Homeowners Associations 589
Food Rejection Insurance 207   Homeowners Policies–Low–Value and Nonstandard 239
Food Street Vendors 575   Horse (Livestock) Major Medical and Surgery Insurance 243
Food–Borne Illness–Loss of Income 451   Horse and Carriage Risks 240
Force Majeure Insurance 208   Horse Breeders/Boarders 241
Forced–placed Foreclosure Property Insurance 209   Horse Farms 242
Foreign Film Production 770   Horticultural Risks 244
Forensic and Expert Witness Errors and Omissions 210   Hospice 777
Foresters Errors and Omissions 586   Hospital Professional Liability 245
Foundries 714   Hot Air Balloons (Liability and Physical Damage) 246
Franchise Sponsored Mass Marketing Programs 211   Hotels 247
Fraternal Organizations 610   Houseboats 248
Fumigators 212   Hunting and Fishing Clubs 250
Furriers Coverages 213   Identity Theft Liability 778
GAP Insurance 611   Independent Pay Telephone Operators 627
Garage Liability–Repair and Service Operations 215   Industrial Hygienists Errors and Omissions 251
Garagekeepers Legal Liability 216   Industry/Vendor Service Provider 726
Garbage and Waste Haulers 217   Installation Floaters – High–Value 252
General Contractor–Apartments and Condominiums 715   Installment Sales Floater 253
General Contractor–Industrial and Warehousing 716   Insurance Agents and Brokers Errors and Omissions 254
          Insurance Company Professional Liability 255
Insurance Investigators Errors and Omissions 256   Massage Therapists Professional Liability 729
Intellectual Property (Patents, Copyright) Enforcement Coverage 257   Material Handling Contractors 314
          Media Liability 730
Interior Designers Professional Liability 258   Media Promotions 634
International Insurance 259   Mediators/Arbitrators Errors and Omissions 315
Internet Home (Web) Page Designers Errors and Omissions 614   Medical and Radiology Laboratories Professional Liability 316
Internet Liability 727   Medical Billing Companies Errors and Omissions 615
Internet Promotions 632   Medical Diagnostic Centers Errors and Omissions 317
Investment Counselors Errors and Omissions 260   Medical Equipment Dealers 318
IRA or Keogh Plan Errors and Omissions 262   Medical Equipment Manufacturers 319
Irrigation Designers Errors and Omissions 263   Medical Marijuana Crop Insurance 767
Janitorial Services 264   Medical Marijuana Dispensaries 766
Jewelers Block 267   Medical Personnel Service Agencies Professional Liability 320
Jewelry and Fur Floaters (High Values) 268   Medical/Physical Rehabilitation Therapy 654
Kart (Go–Kart) Liability 270   MediSpas 677
Kidnap/Ransom Insurance 271   Mental Health Clinics Professional Liability 321
Kidney Dialysis Centers 272   Mergers and Acquisitions 640
Labor Unions Errors and Omissions 273   Mexico Coverage 592
Land Improvement Contractors 274   Micro Brewery/Brew Pubs 324
Land Surveyors Professional Liability 275   Military Housing Property Managers 674
Landfill Closure Performance Bonds 276   Miniature Golf 323
Landfills (Sanitary) 277   Mining Operations and Equipment 326
Landscape Architects Professional Liability 278   Mobile Home Dealers–Physical Damage and Liability 327
Law Enforcement Officers Liability 279   Mobile Home Parks–Owners Liability 329
Lawn Care Services 280   Mobilehome Personal Lines Coverage 731
Lawyers Professional Liability 281   Mortgage Bankers and Servicing Agents Errors and Omissions 331
Lead Paint Contamination 282          
Lead Paint Removal Contractors 283   Mortgage Brokers Errors and Omissions 593
Lead-based Paint Renovation, Repair and Painting Coverage 765   Mortgage Impairment Insurance 332
Legal Expense Insurance 284   Morticians Professional Liability 333
Lenders Environmental Liability Insurance 285   Motor Home Rentals 577
Libraries 286   Motor Home/Travel Trailers (Commercial Use) 594
Limited Partnership Liability–Partnership Managers 288   Motor Homes 334
Limousine Services 289   Motor Scooter and Moped Rental Insurance 619
Liquefied Petroleum Gas Dealers 290   Motor Sports Liability 335
Liquor Dealers and Stores 291   Motor Truck Cargo Insurance 336
Liquor Liability (Host Coverage) 292   Motorcycle Custom Manufacturing and Fabricating 667
Liquor Liability and Dram Shop Act Liability 293   Motorcycle Dealers 338
Livestock Haulers 294   Motorcycle Insurance 337
Livestock Mortality 295   Motorcycle Rental Insurance 629
Livestock–Auction Market Form 296   Mountain Bikes/Dirt Bikes 339
Livestock–Commercial Feedlot Reporting Form 297   Mountain Climbing/Mountaineering 340
Loggers Broad Form Property Damage Liability 298   Movie Boats 771
Logging Operations 299   Moving Companies 578
Long Haul Trucking Insurance 300   Multiple Peril Crop Insurance 341
Managed Care Errors and Omissions 591   Municipal and Public Entities Liability 342
Manicurists Liability 301   Museums 343
Manufactured Home Haulers 302   Musical Instrument Floaters 344
Marina Operations 304   Musicians 779
Marine Cargo Insurance 305   Mutual Fund Managers Errors and Omissions 733
Marine Hull Insurance 306   Mutual Funds Directors and Officers Coverage 732
Marine–related Professional Liability and Errors and Omissions Coverage 307   Natural Gas Utilities 661
          Negative Film Insurance 346
Maritime Liability 308   Nightclubs 660
Marketing and Public Relations Firms Errors and Omissions 309   Notary Public Errors and Omissions 349
Marketing Consultants Errors and Omissions 310   Nurse Practitioners 780
Marriage and Family Counselors Professional Liability 311   Nurse–Midwives Professional Liability 350
Martial Arts Liability 312   Nurseries 351
Masonry, Stone Setting and Other Stonework Contractors 728          
Nurses Professional Liability 352   Poultry Insurance 396
Nursing Homes Professional Liability 353   Power Distribution–Electric Utilities 670
Nutriceuticals 734   Precious Metal Dealers 397
Oceanography Risks 354   Premium Finance Companies Errors and Omissions 398
Off–Course and Storage Coverage 630   Printers Errors and Omissions 399
Offshore Oil Drilling and Service Risks 355   Privacy Insurance 678
Oil and Gas Deficiency Insurance–Guaranteed Performance 356   Private Corrections Industry 400
Oil Drilling Equipment 357   Prize Indemnification Insurance 401
Oil Drilling Rigs and Well Servicing Equipment 358   Product Tampering Insurance 402
Oil Jobbers/Petroleum Distributors 359   Product Warranty Inefficacy Coverage 403
Oil Landmen and Lease Brokers Errors and Omissions 360   Product Warranty Insurance 404
Oil Lease Property (Oil Field Equipment) 361   Products Liability–Hazardous or New Products 407
Oil Well Liability 363   Products Liability–Retroactive 406
Operators Extra Expense–Oil and Gas 364   Products Recall Expense Insurance 408
Ophthalmologists Professional Liability 365   Professional Athletes 409
Opticians Professional Liability 366   Professional Employers Organizations (PEOs) 637
Optometrists Professional Liability 367   Professional Insurance Industry Organizations 676
Osteopaths Professional Liability 368   Property Management Errors and Omissions 410
Outdoor Recreational Facilities 616   Prosthetic and Orthotic Patient Care Errors and Omissions 617
Outfitters and Guides Liability 369   Protection and Indemnity Insurance (Marine) 411
Outpatient Clinics 370   Psychiatrists Professional Liability 412
Owner Controlled Insurance Plan (OCIP) aka Owner’s Wrap Up 735   Psychologists Professional Liability 413
          Public Housing Authorities Liability 415
Owners and Contractors Protective Liability (Monoline) 668   Public Officials Liability 416
Paint Ball Game Centers 371   Public Utilities Insurance 417