Get a Quote — Franklin Insurance Solutions

Franklin Insurance Solutions

We make it our business
to get into your business.

Tell us what you need covered and a bit about how you operate. We turn your answers straight into a complete, underwriter-ready submission — so you're not filling out the same information five more times.

Grab a coffee — this takes about 15 minutes. Your progress saves as you go, and nothing is submitted until the very end.

We found a saved draft from your last visit.

What do you want to quote?

Pick everything you'd like priced. You can select more than one — we'll only ask the questions that apply to what you choose.

Choose at least one coverage so we know what to quote.

Your submission packet

Nothing selected yet

The general business application is included on every submission, whatever you select.

Business Information

Basic identifying information for the applicant business.

Legal Business Name

Entity Type

FEIN (Federal Tax ID)

NAICS Code (if you know it)

Website (optional)

Year Business Started (under current ownership)

Mailing Address & Primary Contact

Where correspondence should go, and who underwriters can reach directly.

Mailing Address Line 1

City

State

ZIP

Contact Full Name

Preferred Phone

Contact Email

Premises Information

Add every location the business operates from.

The main application holds four locations. We'll attach a supplemental schedule for the rest — just tell us in the notes at the end how many more there are.

Prior Insurance History

Your current policy plus the two years before it.

Any losses or claims in the past 3 years?

No Yes

General Liability Coverage Desired

Requested limits for the new policy. The defaults are the most commonly requested — change them if your contracts require something different.

Proposed Effective Date

Each Occurrence Limit

General Aggregate Limit

Medical Expense Limit

Contractor Details

How your operation is structured, split and staffed.

Years of Experience (owner/management)

Currently Licensed?

Yes No

License #

Kind of License

Radius of Operations from Main Location

States Worked In

Percentage of Operations — these should total 100%

General Contractor %

Subcontractor %

Developer %

Construction Manager %

These currently add up to 0%. Underwriters will send it back if it isn't 100.

Annual Payroll Breakdown

Payroll — Owners / Officers / Partners at Job Sites ($)

Payroll — Other Employees (excluding owners and clerical) ($)

Cost of Leased / Temp / Staffing / Casual Labor ($)

Total Payroll ($)

Underwriting Questions — Operations

Standard yes/no questions on every contractor submission. Answer honestly — a "yes" just prompts a quick explanation, it doesn't disqualify anything.

Underwriting Questions — Site Conditions & Work Type

Equipment, hazardous materials, specialized work, and claims history.

Professional Liability Details

The services you're insuring, how the work is contracted, and the limits you'd like quoted.

Describe the professional services you want covered

Underwriters price straight off this description — the more specific, the better the quote.

Revenue From These Services — Last 12 Months ($)

Projected — Next 12 Months ($)

Owners & Professional Staff Doing the Work

Support / Administrative Staff

Limit of Liability Requested

Deductible You'd Like Quoted (carriers call this the retention)

How Often Do You Use a Written Client Contract?

Share of Revenue From Your Largest Client (%)

Work Subcontracted Out to Others (%)

Licenses, Designations or Associations (optional)

Current Professional Liability Policy — leave blank if this would be your first

Carrier

Limits

Retroactive Date

The date your continuous coverage began.

Cyber & Data Breach Details

Your size, the data you hold, and the security controls carriers now require before they'll quote.

Gross Revenue — Current 12 Months ($)

Gross Revenue — Projected Next 12 Months ($)

How Many Personal Records Do You Hold? (record count)

Customers, patients and employees — names tied to any identifying or financial detail. An estimate is fine.

Number of Employees

NAICS Code or Industry Description

Website and Email Domains

List every domain you send mail from.

Main Cloud or Hosting Provider (optional)

Whoever holds the largest share of your sensitive records.

How Often Do Your Backups Run?

Crime & Employee Theft Details

Who touches your money, and the checks you have in place. Separation of duties is what carriers price on.

Limit Requested

Deductible You'd Like Quoted

U.S. Locations

Locations Outside the U.S.

Independent Contractors (people)

Employees Who Handle Money, Checks or Transfers

Largest Single Payment or Transfer You Typically Make ($)

How Often Do You Count Stock and Equipment?

Who Reconciles Your Bank Statements?

Directors & Officers Details

Ownership, the shape of your balance sheet, and anything changing at the top. This coverage is underwritten on financial health.

Limit Requested

Deductible You'd Like Quoted

State of Incorporation

Total Employees

Directors & Officers

Revenue, Most Recent Fiscal Year ($)

Total Assets ($)

Net Income ($)

Use a negative number for a loss.

Owners Holding 20% or More

Outside Investors or Lenders (optional)

Technology E&O Details

What you build or run for clients, how your contracts protect you, and who looks after your own security.

Describe the technology products and services you provide

Revenue — Current Fiscal Year ($)

Projected — Next 12 Months ($)

Total Employees

Your Network Security Is

Who Is Responsible for Your Network Security?

Rough Split of Your Revenue by Type of Work

Percentages don't have to be exact — carriers just need the shape of the business.

Limit of Liability Requested

Deductible You'd Like Quoted

You Use a Written Client Contract

Your Contracts Cap Your Liability (limitation of liability)

Roughly how many personal records do you hold or process?

Count both your own and your clients' records.

Staffing Agency Details

Who you place, where they work, and how you screen and supervise them. Class code accuracy here drives your whole submission.

Types of Temporary Workers You Place

List everything that applies, with a rough share of your placements for each.

Industries You Serve

All States Where You Place Employees

Workers on Assignment at Peak

Average Number on Assignment

Gross Annual Revenue ($)

Annual Payroll — Placed Workers ($)

Annual Payroll — Internal Staff ($)

Current Experience Modifier (e-mod)

Main NCCI Class Codes You Report (if you know them)

What Supervision Do You Provide at Client Worksites?

The Rest of What You Asked For

You selected coverages that need a few details we'll gather with you directly rather than in this form. Everything you've entered so far still applies to them.

Anything we should know about these before we reach out? (optional)

Review & Submit

Here's what we have. Go back to change anything, or submit and we'll take it from here.

Your submission packet

These are the standard industry application forms your carriers require. We complete them from your answers — you don't fill out anything twice.

All set — thank you.

Your information is on its way to our team. We'll review it and follow up with you shortly. Keep a copy for your records if you'd like.

We make it our businessto get into your business.

What do you want to quote?

Your submission packet

Business Information

Mailing Address & Primary Contact

Premises Information

Prior Insurance History

General Liability Coverage Desired

Contractor Details

Underwriting Questions — Operations

Underwriting Questions — Site Conditions & Work Type

Professional Liability Details

Cyber & Data Breach Details

Crime & Employee Theft Details

Directors & Officers Details

Technology E&O Details

Staffing Agency Details

The Rest of What You Asked For

Review & Submit

Your submission packet

All set — thank you.

We make it our business
to get into your business.