It's time to renew!

Employment Practices Liability Confirmation of Material Information Form for Renewal Policies Only 

(to be completed, signed, and dated by the Insured.)


Every USLI policyholder is required to submit a Confirmation of Material Information Policy Renewal Form. If you received an email requesting this information, it must be received by our office before your coverage renews. Failure to complete this online form before your renewal date could result in a lapse in coverage. 

If any of the following questions are answered "YES," please submit complete details and note that the quoted terms may change.