Can the application be signed electronically?

Yes. Electronic signatures meet federal ESIGN requirements (15 U.S.C. ch. 96) and UETA where adopted, provided the platform captures intent, consent, attribution, and retains a reproducible record.

What if I discover an error after submission?

Promptly notify your broker or insurer in writing and request an amendment; timely correction reduces risk of material misrepresentation and may prevent coverage disputes.

Do I have to disclose old or minor incidents?

Disclose all known claims, circumstances, and incidents as requested on the application; omission of material incidents can lead to denial of coverage or rescission.

When is notarization or witnesses required?

Most E&O applications do not require notarization; some states or specific insurers may require notarized signatures or witnesses. Confirm with the insurer or regulatory requirements in the applicable state.

How should I provide supporting documents?

Attach prior policies, loss runs, contracts, and engagement letters in the formats requested (PDF/DOCX) and ensure file names clearly reference the applicant and document type for easy underwriting review.

What records should I keep after issuance?

Retain signed application, attachments, loss runs, and correspondence for the policy term plus several years; follow IRS, HIPAA, and state retention rules applicable to your industry.

Electronic Signature
Templates
Legal
Errors and Omissions Application

Errors and Omissions Application

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

ERRORS AND OMISSIONS APPLICATION

This Errors and Omissions Insurance Application (the "Application") is made as of by and between Applicant Name: (the "Applicant") and Producer Name: (the "Producer").

RECITALS

WHEREAS, the Applicant conducts professional services as described below and seeks coverage for claims alleging negligent acts, errors or omissions arising from the performance of such services;

WHEREAS, the Producer assists the Applicant in procuring professional liability insurance and submits this Application to the insurer for underwriting consideration;

WHEREAS, the Applicant acknowledges that statements made herein will form the basis of any policy issued and that the insurer will rely upon the representations contained in this Application;

NOW, THEREFORE, in consideration of the insurer's review and potential issuance of a policy, Applicant and Producer provide the following information and certify the truth of the statements made herein.

1. APPLICANT IDENTIFICATION

Business / Legal Name DBA (if any) Principal Office Address

Telephone

Email

State/Country of Formation

Entity Type (check all that apply) Individual Sole Proprietor Partnership Corporation LLC

Years in Business

Primary Professional Services Rendered

2. COVERAGE REQUESTED

Requested Effective Date:

Requested Retroactive Date

Limits of Liability (Per Claim)

Aggregate Limit

Retention / Deductible

3. PRIOR INSURANCE & CLAIMS HISTORY

Most Recent Professional Liability Carrier

Prior Policy Period From

Prior Policy Period To

Within the past five (5) years, has any claim, suit or demand been made against the Applicant or any predecessor, partner, officer or employee? Yes No

If yes, provide full details for each matter (date, parties, allegation, disposition, amount paid or reserved)

Are there any circumstances that may reasonably be expected to give rise to a claim? Yes No

4. RISK MANAGEMENT & OPERATIONS

Do you use written engagement letters, contracts or scopes of work with clients? Yes No Describe steps taken to minimize professional liability (training, peer review, QA procedures, etc.)

5. ADDITIONAL INFORMATION

Prior disciplinary actions, license suspensions or civil/criminal proceedings against Applicant or principals? Yes No

6. REPRESENTATIONS, AUTHORIZATIONS AND CERTIFICATIONS

The Applicant certifies that the statements contained in this Application are true and complete and are offered to induce the insurer to issue a policy. The Applicant understands that any material misrepresentation, omission, or concealment of fact may be a basis for denial of coverage or rescission of any policy issued. The Applicant further warrants that no facts or circumstances other than those disclosed in this Application are known to the Applicant that would increase the risk of loss.

The Applicant authorizes the release of claim and loss history, underwriting and disciplinary information to the insurer, and authorizes all prior insurers, attorneys, and regulatory bodies to release such information as may be requested. A photographic or electronic copy of this authorization shall be valid as the original.

Fraud Warning: Any person who knowingly submits false information or omits material information in order to obtain insurance may be guilty of insurance fraud and subject to criminal and civil penalties under applicable law.

7. NOTICES

All notices, communications or requests regarding this Application shall be in writing and sent to the address set forth below for the Applicant or Producer, as applicable; such notices shall be effective upon receipt.

Notice Address for Applicant

8. GENERAL PROVISIONS

Governing Law: This Application and any policy issued in reliance hereon shall be governed by and construed in accordance with the laws of the state specified by the insurer in the policy declarations, without regard to conflict of law principles.

Entire Agreement: This Application, and any attachments hereto, constitute the entire agreement between the parties with respect to the subject matter hereof and supersede all prior oral or written statements, representations, or promises.

Severability: If any provision of this Application is held invalid or unenforceable, the remainder of this Application shall remain in full force and effect.

Amendments and Waiver: No amendment, modification or waiver of any provision of this Application shall be effective unless made in writing and signed by the Applicant and an authorized representative of the Producer or insurer. No waiver shall constitute a waiver of any other provision or future breach.

Counterparts: This Application may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

9. ATTACHMENTS

The Applicant shall attach all required schedules, prior loss runs for the last five (5) years, sample engagement letters, and any other documents specified by the Producer or insurer. The undersigned certifies that the attached documents form part of this Application.

Applicant Printed Name:

By:

Title:

Date:

Producer Printed Name:

By:

Title:

Date:

What the Errors and Omissions Application Is and why it matters

An Errors and Omissions Application is the formal insurance submission used to request professional liability coverage that protects professionals and firms from claims alleging negligent acts, errors, or omissions in the performance of professional services. The form collects applicant identity, business operations, limits requested, prior claims and incidents, retroactive dates, loss controls, and contractual risk-transfer arrangements. Insurers use the application to underwrite coverage, set premiums, and evaluate exclusions; accurate answers determine coverage scope and claims defensibility under the policy terms.

Why completing the application carefully benefits you

A complete, accurate Errors and Omissions Application reduces underwriting delays, lowers misrepresentation risk, and helps ensure requested coverage matches your exposures. Precise disclosure of claims history and business activities shortens review time and reduces the chance of coverage disputes later.

Who typically completes this application

The application is completed by the insured or an authorized representative, including brokers or risk managers, to secure professional liability insurance.

Individual professionals completing initial coverage for their practice.
Business owners or compliance officers managing firm-level policies.
Insurance brokers or agents submitting applications to underwriters.

Ensure the person signing is authorized to make representations about the business and its prior acts; inaccurate signatories increase audit risk.

Primary sections you will find on the application

Most Errors and Omissions Applications follow a consistent structure that organizes corporate, operational, claim, and coverage details for underwriting review.

Applicant Details

Legal entity name, DBA if applicable, EIN or SSN, business address, and contact details; used to bind and issue policy documents to the correct legal party.

Business Activities

Detailed description of services performed, percentage revenue by service line, jurisdictions served, and target clients; insurers evaluate operations to identify excluded activities or needed endorsements.

Prior Claims

Full claims and circumstances history for a specified prior period (typically five to ten years), including reserves, payments, and open matter status; critical for underwriting and pricing.

Risk Management

Policies, procedures, supervision, employee training, and quality controls; documented loss prevention reduces premium and may qualify for favorable terms.

Coverage Requested

Limit selections, deductible preferences, retroactive date requests, and any extensions such as breach response or cyber-related professional liability coverage.

Declarations & Signature

Authorized signature, date, authorization statement, and disclosure of any material misrepresentations; signature attests to accuracy and triggers insurer reliance.

Step-by-step: completing an Errors and Omissions Application

Follow these steps in order to prepare and submit a complete application to the insurer or broker.

01

Gather documents: Collect prior policies, loss runs, and client contracts.
02

Describe operations: Draft clear, revenue-weighted service descriptions.
03

Report claims: Provide full details for each matter and associated payments.
04

Review and sign: Confirm accuracy, sign as authorized, and retain a copy.

Configuring an online application workflow

Set these fields and settings when building an online Errors and Omissions Application form for electronic submission and routing.

Field	Configuration
Applicant Name	Required text field; auto-validate against EIN
Claims Section	Repeatable block with date and description fields
Attachment Upload	Allow PDF or DOCX uploads up to 20 MB
Signature	Signer email + date stamp; store audit trail

Where and how to submit the completed application

After finalizing the application, route it to the insurer, broker, or underwriting portal using one of these destination methods.

Broker submission: Email or portal upload to your broker for presentation to insurers.
Direct to insurer: Submit through insurer underwriting portal or email address.
Agency management system: Upload into agency AMS for tracking and renewal reminders.
Cloud storage: Store in secure document repository with access controls.

Digital signing and eSubmission considerations

Electronic submission is common for E&O applications, but platforms must meet authentication, audit, and retention requirements.

Authentication: Email or SMS code verification
Audit Trail: Timestamps, IP, and signer events
File formats: PDF, DOCX accepted

Use a platform that provides robust audit records and secure storage; many integrate with systems such as Salesforce, NetSuite, Google Workspace, and document repositories for streamlined workflows.

Typical timelines and processing expectations

Processing times vary by insurer and submission method; plan for these standard timelines when preparing or renewing coverage.

Initial underwriting review:

3–10 business days depending on complexity

Supplemental information request:

2–7 business days to respond typically

Binding decision:

Often within 7–21 business days after full submission

Policy issuance:

1–5 business days after premium payment

Renewal cycle:

Start 60–90 days before policy expiration

Common mistakes to avoid when preparing the application

Omitting prior incidents or near-misses that insurers treat as material information and may investigate later.
Using vague service descriptions such as 'consulting' without specifying specialties, revenue split, or standard contracts.
Failing to attach prior policies or loss runs, which delays underwriting and can result in higher provisional premiums.
Allowing unauthorized personnel to sign or submit the application, creating representation and binding issues.

Consequences of inaccuracies or omissions

Coverage denial: Claims may be declined for material misrepresentation

Policy rescission: Insurer may rescind the policy ab initio

Premium adjustments: Insurer may retroactively adjust premiums

Legal exposure: Insured may face contractual disputes

Regulatory risk: State regulators may investigate material omissions

Reputation harm: Client trust may be impaired

Where state rules commonly differ for E&O applications

Several jurisdictions impose unique notarization, witness, or RON requirements that can affect application execution and proof of signature.

Requirement	Typical	Variation
Notarization	not typical	fl: some forms require notarization
Witnesses	usually none	fl: two witnesses common
RON availability	most states allow ron	ca: limited pathways
Form attachments	permitted electronically	some states require original

eSignature vendor comparison for submitting an Errors and Omissions Application

Platform choices affect authentication, audit trail, and integration. The table below compares starting pricing and key features among common eSignature vendors.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	Yes, 7-day trial	No	No	No	No
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently asked questions about the Errors and Omissions Application

Answers to common questions about signing, submitting, correcting, and preserving E&O application materials.

Need help? Contact support

Can the application be signed electronically?
Yes. Electronic signatures meet federal ESIGN requirements (15 U.S.C. ch. 96) and UETA where adopted, provided the platform captures intent, consent, attribution, and retains a reproducible record.
What if I discover an error after submission?
Promptly notify your broker or insurer in writing and request an amendment; timely correction reduces risk of material misrepresentation and may prevent coverage disputes.
Do I have to disclose old or minor incidents?
Disclose all known claims, circumstances, and incidents as requested on the application; omission of material incidents can lead to denial of coverage or rescission.
When is notarization or witnesses required?
Most E&O applications do not require notarization; some states or specific insurers may require notarized signatures or witnesses. Confirm with the insurer or regulatory requirements in the applicable state.
How should I provide supporting documents?
Attach prior policies, loss runs, contracts, and engagement letters in the formats requested (PDF/DOCX) and ensure file names clearly reference the applicant and document type for easy underwriting review.
What records should I keep after issuance?
Retain signed application, attachments, loss runs, and correspondence for the policy term plus several years; follow IRS, HIPAA, and state retention rules applicable to your industry.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now