Professionals’ Best Application for Appraiser E&O

Name

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Instructions

This policy applies only to claims first made against the insured during the policy period or discovery period. The limit of liability available to pay judgements or settlements shall be reduced by payment of defense costs. Defense costs are subject to the applicable retention. Please read and review the policy carefully.

Instructions: this self-rating application is for an individual appraiser who performs 100% real estate appraisals work. Please note that coverage will only apply to services rendered by the applicant.

The term "Applicant" shall mean all natural persons proposed for coverage.

Section A: General Information

Name of Applicant*

First Name Last Name

Official Business Name*

Official Business Address*

City*

State*

Zip*

Primary Email Address*

Primary Phone*

Current/ Desired Effective Date

Alternative Information about the Applicant

Please describe any alternative business names, mailing/billing addresses or administrative contact information related to business activities other than the official ones listed above. If none, please enter “none”.

In lieu of mailing my Policy, please Email the Policy to the address above. I agree to accept an electronic copy of my Application with my Policy.

In lieu of completing multiple applications, I agree for this application to be used to place coverage with an alternative insurance company offering better coverage or lower rates for a comparable product.

Section B. Confirm Eligibility for the “Self-Rated” Program

1. The applicant holds a valid state license or certification in each state in which he/she provides appraisal services. If you are a Trainee, you have passed the initial exam (if required) or any other state requirements.*

True

False

2. The applicant does not appraise any real estate in which he/she has an ownership interest.*

True

False

3. The applicant has not been disciplined or investigated by any state licensing, administrative or regulatory board as a result of appraisal activities within the past 5 years.*

True

False

4. There have been no claims reported and/or pending circumstances which could result in a claim made against the applicant within the past 5 years.*

True

False

Qualification

I'm sorry, but you no longer qualify for the Self Rating E&O Program.

Please call the ALIA Service Team at 1-800-882-4410 Extension 1 so we can renew your coverage in the Standard E&O Program.

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Calculate Your Premium

5. In the last fiscal year, 80% or more of the Applicant’s revenues have been derived from residential appraisals.*

True

False

6. Within the last fiscal year, the Applicant has not appraised any properties valued at greater than $3,000,000.*

True

False

7. The Applicant’s combined total gross revenues for the last three (3) years did not exceed $500,000.*

True

False

Additional Coverage Options (for a charge)

Appraiser Trainee Coverage is availible for 50% of the premium chosen from the table above

Appraisal Management Company Extension (return completed application to your agent for final premium)

Select Your Premium

Calculating Your Rates

Please select your limits*

Premium*

Summary

Your State: {state:83}

Your Selected Limits: {Please select your limits:43}

Premium

Additional Coverages

ALIA Subscription ($10 a month billed annually)

Total Due

Please Read

This proposal is based on your enrollment in the ALIA Professional Education Subscription as itemized above. As a benefit to this subscription, your standard Deductible of $500 is reduced to $0 and additional coverage enhancements are provided. The premiums listed above are subject to change based on carrier fillings and should not considered final until written confirmation is obtained from the carrier.