High Limit Excess Liability Questionnaire
1. Please provide specific details of the insured's occupation and their spouses.
2. All drivers in the household will need to be listed:
A. Need occupation/employer on each driver
B. Date of Birth
C. MVR information and CLUE reports
3. All losses for the home and the auto within the last 5 years with details.
4. Totals - *Note: If not insured with Chubb, who is the current carrier? Provide
the underlying dec pages.
A. Vehicles
B. Residences/Locations
C. Watercraft
D. Number of recreational vehicles
E. Number of employees in the household
5. Do we write all the primary coverage? If not, we need to know why we do not
currently have this business.