1. Forms
NAICS 621512

Diagnostic Imaging Centers

Forms written for this kind of business. Core coverage forms and general endorsements apply to every account and are not listed here.

Businessowners (ISO BP)

15 forms
Form CodeTitleTypeWho needs it
BP 04 02Additional Insured - Managers Or Lessors Of PremisesEndorsementTenants whose lease requires the landlord or property manager to be an additional insured.
BP 04 16Additional Insured - Lessor Of Leased EquipmentEndorsementBOP accounts that lease equipment (copiers, kitchen equipment, forklifts, medical devices) under agreements requiring the lessor to be an additional insured.
BP 04 98Employee Benefits Liability CoverageEndorsementBOP accounts with employees enrolled in health, retirement or other benefit plans the employer administers.
BP 05 89Employment-Related Practices Liability EndorsementEndorsementSmall employers on a BOP that want EPL bundled with their package.
BP 05 95Electronic Data Liability - Limited Coverage Subject To Cyber Incident ExclusionEndorsementAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 15 04Exclusion - Access Or Disclosure Of Confidential Or Personal Material Or InformationExclusionAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 15 05Exclusion - Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability - Limited Bodily Injury Exception Not Included WithdrawnExclusionAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 15 06Exclusion - Access Or Disclosure Of Confidential Or Personal Material Or Information (Personal And Advertising Injury Only)ExclusionAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 15 07Information Security Protection EndorsementEndorsementAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 15 60Cyber Incident ExclusionExclusionAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 16 39Broad Abuse Or Molestation ExclusionExclusionBOP accounts with exposure to children, vulnerable adults or close personal contact: fitness studios, tutoring, personal care, daycare-adjacent retail, healthcare offices.
BP 17 02Condominium Commercial Unit-Owners CoverageEndorsementBusinesses that own a commercial condominium unit (office, retail or medical condo) and insure their unit and contents on a BOP.
BP 17 03Condominium Commercial Unit-Owners Optional CoveragesEndorsementOwners of commercial condominium units insured under BP 17 02.
BP 18 03Cyber Incident Liability ExclusionExclusionAny BOP account that stores customer, employee or payment data or relies on computer systems.
BP 18 05Electronic Data Liability - Limited Coverage Subject To Cyber Incident Exclusion, Deletion Of Bodily Injury ExceptionEndorsementAny BOP account that stores customer, employee or payment data or relies on computer systems.

Commercial General Liability (ISO CG)

3 forms
Form CodeTitleTypeWho needs it
CG 21 16Exclusion – Designated Professional ServicesExclusionBusinesses that perform professional services (consulting, design, inspection, IT, health and others) where the carrier wants professional exposures handled by an E&O policy.
CG 21 59Exclusion – Diagnostic Testing LaboratoriesExclusionDiagnostic and medical testing laboratories.
CG 22 44Exclusion – Services Furnished By Health Care ProvidersExclusionHealthcare facilities, clinics, senior living, schools and other organizations that employ or use health care providers.

Commercial Inland Marine (ISO CM)

1 forms
Form CodeTitleTypeWho needs it
CM 26 03Artificially Generated Electric, Magnetic Or Electromagnetic Energy CoverageEndorsementMedical and dental practices with electronic diagnostic, imaging and treatment equipment.

Commercial Property (ISO CP)

5 forms
Form CodeTitleTypeWho needs it
CP 00 18Condominium Commercial Unit-Owners Coverage FormCoverageBusinesses that own a commercial condominium unit (office, medical, retail or warehouse condominiums) and need contents and unit-improvement coverage alongside the association's master policy.
CP 00 50Extra Expense Coverage FormCoverageOrganizations that must keep operating at almost any cost after a loss but whose income would not drop much: banks, insurance agencies, medical and professional offices, newspapers, utilities, public entities and non-profits.
CP 04 18Condominium Commercial Unit-Owners Optional CoveragesEndorsementOwners of commercial condominium units: medical and professional offices, retail and light-industrial condo units.
CP 04 26Ordinance Or Law Coverage For Tenant's Interest In Improvements And Betterments (Tenant's Policy)EndorsementTenants that have invested heavily in build-outs they cannot remove: restaurants, medical and dental offices, retail stores, salons, fitness centers, labs.
CP 15 06Off-Premises Interruption Of Business – Vehicles And Mobile EquipmentEndorsementBusinesses that depend on specific vehicles or mobile equipment to earn revenue: mobile food vendors, mobile medical or imaging units, mobile shredding, specialty contractors, equipment-based service companies.

Commercial Liability Umbrella (ISO CU)

3 forms
Form CodeTitleTypeWho needs it
CU 04 44Sexual Abuse Or Sexual Molestation Liability CoverageCoverageOrganizations that care for or supervise children, students or vulnerable adults.
CU 34 44Broad Abuse Or Molestation ExclusionExclusionOrganizations that care for or supervise children, patients, students or vulnerable adults.
CU 34 45Sexual Abuse Or Sexual Molestation ExclusionExclusionOrganizations that care for or supervise children, patients, students or vulnerable adults.

Commercial Excess Liability (ISO CX)

2 forms
Form CodeTitleTypeWho needs it
CX 21 93Broad Abuse Or Molestation ExclusionExclusionOrganizations that care for or supervise children, patients, students or vulnerable adults.
CX 21 94Sexual Abuse Or Sexual Molestation ExclusionExclusionOrganizations that care for or supervise children, patients, students or vulnerable adults.

Cyber (ISO CY)

27 forms
Form CodeTitleTypeWho needs it
CY 00 01Commercial Cyber Insurance Policy WithdrawnCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 00 02Commercial Cyber Insurance PolicyCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 00 03Information Security Protection Cyber PolicyCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 00 10Information Security Protection Cyber Policy WithdrawnCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 00 11Financial Institutions Information Security Protection Cyber Policy WithdrawnCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 00 12Media And Information Security Protection Cyber Policy WithdrawnCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 00 13Media And Information Security Protection Cyber Policy WithdrawnCoverageAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 10 03Nonbinding ArbitrationConditionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 10 04Binding ArbitrationConditionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 01Additional Extended Reporting Period - ElectedEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 05Agreed Value For Business IncomeEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 09Amend Defense And Settlement Provision - SettlementConditionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 10Provide Coverage For Dishonest, Malicious Or Fraudulent Acts Committed By Employees HistoricalEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 13Computer And Funds Transfer Fraud EndorsementEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 14Computer Fraud EndorsementEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 15Telephone Toll Fraud EndorsementEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 16Exclusion - Social MediaExclusionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 17Exclusion - Software InfringementExclusionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 28Payment Card Industry Liability CoverageEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 29Payment Card Industry Liability Coverage - Defense Costs Coverage OnlyEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 31Include Retroactive Date - First Party Insuring AgreementsEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 36Amend Retention - Business Income And Extra Expense - Waiting Period (ISP)EndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 40Amend Replacement Or Restoration Of Electronic Data Insuring Agreement - Betterment And Bricking ExpensesEndorsementAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 46Exclusion - Fraudulent InstructionExclusionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 83Exclusion - WarExclusionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 84Condition - Litigation Funding Mutual DisclosureConditionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.
CY 20 85Exclusion - Generative Artificial IntelligenceExclusionAny business that stores personal or payment data, depends on computer systems or transfers funds electronically.

Employment-Related Practices Liability (ISO EP)

21 forms
Form CodeTitleTypeWho needs it
EP 00 01Employment-Related Practices Liability Coverage FormCoverageAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 00 02Employment-Related Practices Liability Coverage Form (Separate Limits For Defense And Indemnity)CoverageAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 12Who Is An Insured - Restricted Coverage For EmployeesEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 13Who Is An Insured - Outside Director, Trustee, Officer Or MemberEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 14Counsel SelectionEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 15Named Employee(s) ExclusionExclusionAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 17Liability To Your Customers And ClientsEndorsementCustomer-facing employers such as restaurants, retailers, hotels, healthcare and service businesses.
EP 01 18Liability To Independent ContractorsEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 20Liability To Non-EmployeesEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 21Nuclear Energy Liability Exclusion Endorsement (Broad Form)ExclusionAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 33Amendment Of Consent To SettleEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 34Amendment Of Coverage Territory - Worldwide CoverageEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 35Amendment Of Coverage Territory - Worldwide Coverage Except For Specified CountriesEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 01 36Amendment Of Coverage Territory - Additional Scheduled CountriesEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 03 01Co-Payment Liability InsuranceEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 03 02Deductible And Co-Payment Liability InsuranceEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 20 01Additional Insured - Designated Person Or OrganizationEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 20 04Additional Insured - Independent Contractor(s)EndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 21 01Exclusion - Designated Ongoing Operation(s)ExclusionAny employer buying stand-alone employment practices liability on the ISO EP program.
EP 28 01Extended Reporting Period EndorsementEndorsementAny employer buying stand-alone employment practices liability on the ISO EP program.
EP DS 01Employment-Related Practices Liability DeclarationsDeclarationAny employer buying stand-alone employment practices liability on the ISO EP program.

Commercial Inland Marine – ISO IH Series Forms

2 forms
Form CodeTitleTypeWho needs it
IH 00 89Scientific And Medical Diagnostic Equipment Coverage FormCoverageHospitals, imaging centers, laboratories, clinics, universities and research facilities with high-value diagnostic or scientific equipment.
IH DS 89Scientific And Medical Diagnostic Equipment DeclarationsDeclarationAccounts insured under the ISO Scientific And Medical Diagnostic Equipment Coverage Form.

Professional Liability - Medical and Allied Health (ISO PR)

10 forms
Form CodeTitleTypeWho needs it
PR 00 09Diagnostic Testing Laboratories Professional Liability Coverage FormCoverageMedical and diagnostic laboratories and imaging centers.
PR 00 10Diagnostic Testing Laboratories Professional Liability Coverage Form (Claims-Made Version)CoverageMedical and diagnostic laboratories and imaging centers.
PR 02 00Earlier Notice Of Cancellation Provided By UsEndorsementMedical professionals and facilities whose hospital privileges, contracts or lenders require longer cancellation notice.
PR 03 01Deductible Liability Insurance (For Use With Diagnostic Testing Laboratories Policies)EndorsementInsureds on PR 00 09 or PR 00 10 that accept a deductible.
PR 04 00Products Liability Coverage For Diagnostic Testing LaboratoriesEndorsementDiagnostic testing laboratories that supply products (test kits, specimens, reagents) as part of their operations.
PR 21 01Exclusion - Employees As InsuredsExclusionMedical practices and facilities whose employees carry their own professional liability or are insured elsewhere.
PR 24 00Consent To SettleConditionPhysicians and other professionals who want a say before the insurer settles a malpractice claim.
PR 24 01Non-Binding ArbitrationConditionInsureds on ISO PR forms where the carrier uses arbitration provisions.
PR 24 02Binding ArbitrationConditionInsureds on ISO PR forms in states where the carrier uses arbitration provisions.
PR DS 05Diagnostic Testing Laboratories Professional Liability DeclarationsDeclarationInsureds written on PR 00 09 or PR 00 10.