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NFP Cyber Insurance

Application Form

Please complete all the questions in the application form below and a member of our dedicated NFP Team will be in contact shortly thereafter with a quote and will be able to answer any further questions you may have about the policy.



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STATEMENT OF FACT FOR CYBER & PRIVACY LIABILITY COVERAGE

1. You have a privacy policy in place governing your collection of private data.
2. You have an IT security policy in place that governs the handling of sensitive personally identifiable information.
3. You have anti-virus software installed and enabled on all desktops, laptops and servers (excluding database servers) and it is updated on a regular basis.
4. You have firewalls installed on all external gateways.
5. You take regular back-ups (at least weekly) of all critical data and store the same offsite or in a fire-proof safe, or your outsourced service provider meets this requirement.
6. If you store medical records or patient data, you ensure that all patient data transmitted over open networks and/or stored on portable devices is encrypted.
7. If you process or store credit card information (where this is not outsourced to a third party that accepts full responsibility for PCI compliance), you have been certified as being PCI compliant within the last 12 months, or have successfully completed a self-assessment audit.:
CLAIMS INFORMATION

1. After full inquiry, you are not aware of any circumstances, complaints, claims, loss, or penalties/fines levied against you in the last five years, in relation to the risks that this application relates to.
2. You are not aware of any circumstances or complaints against you in relation to data protection or security, or any actual security violations or security breaches either currently or in the past five years.:
DECLARATION
PRIVACY
  1. Aon is committed to protecting your personal information in accordance with the Australian Privacy Principles under the Privacy Act 1988 (Cth). We collect, use and disclose personal information to offer, promote, provide, manage and administer the many financial services and products we and our group of companies are involved in as set out in the Aon Privacy Notice.

  2. If you are disclosing personal or sensitive information about any other person to Aon, you confirm that you have obtained the consent of that person to disclose to Aon their personal or sensitive information and you have made them aware that Aon will or may disclose their information to third parties that are reasonably necessary to assist in the provision of the relevant services or products. If you have not obtained consent from this other person to disclose their personal or sensitive information to Aon, you will inform us before providing the relevant information to us.
By submitting this form, you acknowledge that you have read the Aon Privacy Notice and agree that we can handle any personal information you have provided to us in the manner set out above.:

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