ZOLOFRA INSURANCE AGENCY

Ready to protect you today for what matters tomorrow.

EPLI- Employment Pract.

ABOUT EMPLOYMENT PRACTICES LIABILITY INSURANCE (EPLI)

EPLI coverage was created in response to major legal changes in the 1990's regarding the Civil Rights Act of 1991, Americans with Disabilities Act, and the Family Medical Leave Act, all of which provided employees with significantly more rights when dealing with their employers. This insurance is targeted to cover businesses against lawsuits by workers for sexual harassment, discrimination, wrongful termination, breach of employment and other employee legal right infractions.

No company is immune and the concern is that the number of lawsuits filed by employees against their employer is increasing.

In general, EPLI can provide protection against the following types of claims :

                                                                    sexual harassment
                                                                    breach of employment contract
                                                                    unfair demotion
                                                                    wrongful termination
                                                                     retaliation
                                                                    discrimination
                                                                    negligent evaluation
                                                                    wrongful discipline
                                                                    failure to promote
                                                                    wrongful infliction of emotional distress
                                                                    wrongful management employee benefits
                                                                     and more........

Please complete the form below to get your free quote now!

*Name of Business *Contact Name Company's Website Address *Physical Address *City, State and Zip Code *Contact Phone Number Fax Number *Contact Email Address *Services offered by the business: *Is your business currently covered by an Employment Practices Liability Insurance (EPLI) Policy?
Yes
No
Name of Current Carrier Expiration Date (mm/dd/yyyy) Current TOTAL number of Employees, including owners, partners, officers and directors. *Please provide a breakdown of the following:
*Total numner of persons employed in each of the last 3 years.
Estimated Gross Revenue for the next 12 months Actual Gross Revenue for the past 12 months *Total numbers of employess that were terminated by the business and the total nu,ber of employees that voluntarily left their employment in the past 3 years.
If applicable, list all additional locations by city and state and indicate the number of employees at each location.
*Any EEOC complaints, NLRB charges or lawsuits been made against you by any current or former employees within the past 5 years?
Yes
No
If yes, provide the date, description and total amount of each loss.
*Are you aware of any facts, incidents or circumstances which may result in any Employment Practices Liabilty losses, claims or suits being made against them?
Yes
No
If yes, please provide details.
*Are any plant, facility, branch, office closings or layoffs anticipated within the next 24 months?
Yes
No
If yes, please provide details.
*Desired Liimts (each Wrongul Employment Act / Aggregate)
$100,000 / $100,000
$250,000 / $250,000
$500,000 / $500,000
$500,000 / $1,000,000
$1,000,000 / $1,000,000
$2,000,000 / $2,000,000
*Desired Deductible
$2,500
$5,000
$7,500
$10,000
$15,000
$25,000
*Select which of the following are published and distributed to all employees:
Employee Manual
Sexual Harrassment Statement
Equal Opportunity and Discrimination Statement
Employee Grievance Procedures
Discipline Procedures
*Is there an employment application used for all applicants?
Yes
No
*Are annual written performance evaluations conducted for all employees?
Yes
No
*Would you like coverage for wrongful acts that take place outside the USA, it's territories and possessions, Puerto Rico or Canada and Coverage for claims made against you by leased workers and independent contractors?
Yes
No
if yes, what percentage of your workforce is comprised of leased workers? What percentage of your workforce is comprised of independent contractors? Additional Comments

* indicates a required field.

Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.

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