Apply for Firearms Instructor Plus
Liability Insurance

Insured Information

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Billing Information

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Insured Information

(Name that will appear on your policy)

Select Your Coverage Limit

General Liability & Professional Liability:

General Liability Only (Professional Liability Excluded)

Applicant Information

* Unfortunately, we will not be able to provide you with coverage at this time due to established underwriting guidelines. If you have questions or if we can be of assistance, please contact one of our Client Solutions representatives at 877-NRA-3006 (option 3).


(Note: there is no professional coverage offered on any reloading instruction.)

Additional Insured Information

This policy includes naming one range and/or one classroom facility as an additional insured for claims arising out of your instruction at that range or classroom. There is an additional charge for naming another range or classroom or substituting the range or classroom originally named.

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If you need to add another Facility, you may do so after adding this one.

Terms and Conditions

I understand coverage is excess over any other applicable insurance. All information is true and accurate to the best of my knowledge and no pertinent information has been withheld.

For your protection various state laws require the following notice:

GENERAL FRAUD STATEMENT (not applicable in CA, CO, HI, NE, OH, OK, OR, UT, and VT)

Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and [NY: substantial] civil penalties." In the District of Columbia, Louisiana, Maine, Tennessee and Virginia, insurance benefits may also be denied.

STATE SPECIFIC FRAUD STATEMENTS

COLORADO law requires the following notice: It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance company for the purposes of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information to a policy holder or claimant for the purpose of defrauding or attempting to defraud the policy holder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.

HAWAII law requires you be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment or both.

OHIO law requires you be informed that any person with intent to defraud or knowing that he / she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

OKLAHOMA law requires the following notice: Any person who knowingly and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy, containing any false, incomplete or misleading information is guilty of a felony.

This policy is not subject to the protection of any guaranty association in the event of liquidation or receivership of the insurer.

Client acknowledges that:
  1. Lockton Affinity, LLC (hereinafter "Lockton"), as the insurance agent and administrator for this program, will receive certain compensation, including standard commission, from an insurer, intermediary or other third party as a result of the sale of insurance to you. In addition, Lockton, in its role as administrator of the program, will charge the Program Administrator Service Charge as listed above which compensates Lockton for services performed, and related costs incurred, for the program participants. This charge is not part of any premium paid to any carrier and is non-refundable in the event of cancellation.
  2. The compensation received by Lockton may differ depending on the product, insurer, intermediary or other third party.
  3. Lockton may also receive certain incentive compensation, including contingency payments and bonuses as a result of being the insurance agent for this program, from an insurer, intermediary or other third party based upon factors such as premium volume placed with a particular insurer or through a particular intermediary and loss or claims experience. By submission of payment pursuant to this invoice, Client consents and agrees to Lockton's ability to receive the compensation outlined herein under all circumstances.

By agreeing to pay the quoted premium and directing Lockton to bind coverage on your behalf, you also consent and agree to receive your insurance policy/coverage documents in an electronic format.IMPORTANT INFORMATION FOR NEW YORK CLIENTS

Certain Underwriters at Lloyd's London is rated "A, Excellent" by A.M. Best indicating the company's strength and ability to meet its ongoing insurance policy and contract obligations. More detailed information about A.M. Best Company and their rating methodology can be found at www.ambest.com

Certain Underwriters at Lloyd's London is an approved, non-admitted carrier. Approved, non-admitted insurance carriers are neither licensed by nor under the supervision of the state department of insurance. If an approved, non-admitted carrier is found insolvent, the State Insurance Guaranty Fund will not respond. Also, all premiums are taxable. Lockton Affinity, LLC has not performed an independent financial analysis, and, as such, cannot guarantee or make any representations in regard to the financial condition of Certain Underwriters at Lloyd's London or any other insurance companies with which we place business.


NRA Voice of Freedom Campaign

Help the NRA energize and activate Americans on Second Amendment issues.Yes, I want to support the NRA Voice of Freedom Campaign.

* Gifts to 501(c)(4) entities are not deductible as charitable contributions. To learn more about this and other opportunities to support NRA programs, visit www.nragive.com or call 1 (877) NRA-GIVE.

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