Cyber One Questionnaire - Cyber Level Ins

Smart Application Form

Cyber One Insurance Policy

"*" indicates required fields

1Your business

2Your insurance

3Your cyber history

4Your cybersecurity

5Your attack surface

Name of applicant*

Company name*

Email address*

Company industry*

Phone number*

Company UIC/ID number*

Company website

Company VAT number

Year of establishment*

Company registered address*

Street Address City State / Province ZIP / Postal code Country

Do you require cover for any related entity?

Number of employees*

Total turnover (EUR)*

Turnover - EU/EEA/Switzerland (%)*

Turnover - USA/Canada (%)*

Turnover - The rest of World (%)*

Turnover - Online or supported via websites (%)

Which online payment service provider do you use?

Choose your PCI DSS certification level

Date of your last PCI DSS assessment

DD slash MM slash YYYY

Coverage Limit*

EUR

Business interruption

Cyber Extortion (Ransomware)

Legal and Regulatory fines and expenses

Free extension of cover included:

Cyber Terrorism sublimit

Executives PR sublimit

Automatic Extended Reporting Period

Would you like to add cover extensions for an additional premium? Select one or more additional covers:

Improvement Costs

Computer Hardware (Bricking)

Criminal Apprehension Reward Fund

Cybercrime

Telecommunications Fraud

Invoice Fraud

Extended Retroactivity

Improvement costs

Computer harware (Bricking)

Criminal apprehension reward fund

Cybercrime sublimit

EUR

Telecommunications fraud sublimit

EUR

Invoice fraud sublimit

Extended retroactivity period

years

How soon would you start to incur Business Interruption after a critical system is down or not functional?*

How long would it take You to fully restore from your backup?*

Select Deductible (your own participation to the risk)*

Select your Business Interruption Deductible*

Policy start date*

DD slash MM slash YYYY

Did you have a Cyber loss in the past 5 years?*

When did the claim occur?

DD slash MM slash YYYY

Detailed information about previous Cyber incidents

Please, specify all the security certificates that you currently have*

ISO 27001

ISO 27002

ISO 17799

ISO 20000

ISO 21827

NIST 800-53

NIST 800-171

IEC 62443

ANSI/ISA 62443

I don't know

None

You use a Security Information and Event Management (SIEM) system.*

True

False

You have a Network Intrusion Detection System (NIDS) implemented in your infrastructure.*

True

False

You have a Host Intrusion Detection System (HIDS) implemented in your infrastructure.*

True

False

You have a Data Leakage/Loss Protection (DLP) solution implemented in your infrastructure.*

True

False

You use a Secure email gateway (SEG) or any additional email filtering/security solution.*

True

False

You have implemented WEB Application Firewall (WAF) in your infrastructure.*

True

False

You have implemented Network Firewall (NF) in your infrastructure.*

True

False

You have Anti-virus software on most of your computer endpoints.*

True

False

You have Endpoint Detection and Response (EDR) software on most of your computers.*

True

False

You have a written Policy that addresses information security awareness which is communicated to all employees, including but not limited to legal liability issues, social engineering, phishing and data protection.*

True

False

You operate commercially licensed and purchased firewalls to prevent, detect and monitor intrusions across your network and regularly apply patches and updates in accordance with the suppliers’ recommendations.*

True

False

You operate licensed anti-virus software across your network and regularly apply patches and updates in accordance with the vendor’s release policy.*

True

False

You encrypt all sensitive and confidential data that is stored on, processed and transmitted from your computer system.*

True

False

You backup your critical data at least weekly to a different location.*

True

False

The backup of Your Critical Data is stored in a secure location with physical access control and allowance for authorized personnel only.*

True

False

You have a formalized data destruction procedure in place for personally identifiable information that is no longer needed by your company.*

True

False

You secure remote access (access control procedures to prevent unauthorized access) to Your network and Your data.*

True

False

You enforce a policy of auditing of managing computer and user accounts*

True

False

You have a Business Continuity Plan or Disaster Response plan which includes Cyber Incident Response Plan (including but not limited to data breaches, network security breaches, Denial of service attacks and Cyber Extortion).*

True

False

Number of employees using the corporate network*

employees

Number of home working employees (using other networks)*

employees

Number of server nodes (On-premise and Cloud)*

servers

Number of root domains*

domains

Number of sub-domains*

subdomains

Number of VPN clients*

VPN users

Number of email aliases (accounts)*

email accounts

Number of WEB and Desktop applications*

applications

Degree of WEB and Desktop apps centralization*

Number of Mobile applications*

mobile apps

Email marketing consent

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