CPH Liability Insurance
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CPH Liability Insurance

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CPH Liability Insurance

{{Insurance.Description}}

  • {{s}}
{{currentWizard.Name}} Complete Purchase Complete Finance Agreement

{{item.Title}}

Coverage Type Limit of Liability Retention Premium
Directors and Officers {{Variables.limit | currency:"$"}} {{Variables.selectedretention| currency:"$"}} {{Variables.DOPremium | currency:"$"}}
Employment Practices {{Variables.limit | currency:"$"}} {{Variables.selectedretention| currency:"$"}} {{Variables.EPLIPremium | currency:"$"}}
Fiduciary {{Variables.limit | currency:"$"}} {{Variables.selectedretention | currency:"$"}} {{Variables.FLIPremium | currency:"$"}}
{{discount.OnlineDescription}} {{discount.OnlineDiscount}}% {{ Variables.Discounts | currency:"$ "}}
Premium Subtotal {{ Variables.SubTotal | currency:"$ "}}
Taxes {{Variables.StateTaxDescription}} {{Variables.StateTaxRate*100 | number :2}}% {{Variables.SubTotal*Variables.StateTaxRate | number :2 | currency:"$"}}
Taxes {{Variables.CityTaxDescription}} {{Variables.CityTaxRate*100 | number :2}}% {{Variables.SubTotal*Variables.CityTaxRate | currency:"$"}}
Total {{ Variables.Total | currency:"$"}}
VISA Accepted Mastercard Accepted Discover Accepted
Shopping is always safe and secure
Security Transaction

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

Named Insured: {{Variables.orgName}}
{{Purchase.Valids.CardType.message}}
{{Purchase.Valids.NumberCard.message}}
{{Purchase.Valids.CardName.message}}
{{Purchase.Valids.Month.message}}
{{Purchase.Valids.Year.message}}
{{Purchase.Valids.SecurityCode.message}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

{{Lang == "es" ? 'Dirección' : 'Address'}} {{Lang == "es" ? 'Ciudad' : 'City'}} {{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}} {{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Variables.address}} {{Variables.address2}} {{Variables.city}} {{Variables.zipcode}} {{Variables.state}} {{Variables.Province}}
{{Lang == "es" ? 'Dirección' : 'Address'}} {{Lang == "es" ? 'Ciudad' : 'City'}} {{Lang == "es" ? 'Código Postal' : 'Zipcode'}} {{Lang == "es" ? 'Código Postal' : 'Postal Code'}} {{Lang == "es" ? 'Estado' : 'State'}} {{Lang == "es" ? 'Provincia' : 'Province'}}
{{Purchase.Valids.Address1.message}} {{Purchase.Valids.City.message}} {{Purchase.Valids.Zip.message}} {{Purchase.Valids.State.message}}

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{c.Title}} Total

{{c.Value | currency}}

{{SpecialPurchaseSummary.Total | currency}}

{{SpecialPurchaseSummary.Message}}

Total: $ {{SpecialPurchaseSummary.Total | number:2}}

{{Lang == "es" ? 'Importante' : 'Important'}}

{{Lang == "es" ? 'IMPORTANTE SABER' : 'IMPORTANT TO KNOW'}}:

{{Lang == "es" ? 'Enviar' : 'Submit'}}
Message:{{Purchase.Result.Message}}
Message:{{Purchase.Result.Message}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

Named Insured: {{Variables.orgName}}
VISA Accepted Mastercard Accepted Discover Accepted

{{Purchase.Valids.CardType.message}}
{{Purchase.Valids.NumberCard.message}}
{{Purchase.Valids.Month.message}}
{{Purchase.Valids.Year.message}}
{{Purchase.Valids.SecurityCode.message}}
{{Purchase.Valids.CardName.message}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Your credit card was not able to be processed, please confirm your address below.

Total: $ {{Variables.Total | number:2}} $ {{Variables.TotalPaid | number:2}} $ {{Variables.TotalPr | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

{{Lang == "es" ? 'IMPORTANTE SABER' : 'IMPORTANT TO KNOW'}}:

Message:{{Purchase.Result.Message}}
Message:{{Purchase.Result.Message}}
Named Insured: {{Client.ClientName}}

{{Lang == "es" ? 'Información de Pago con Pagos Mensuales' : 'Purchase Policy with Monthly Payment'}}

VISA Accepted Mastercard Accepted Discover Accepted

{{Purchase.Valids.CardType.message}}
{{Purchase.Valids.NumberCard.message}}
{{Purchase.Valids.CardName.message}}
{{Purchase.Valids.Month.message}}
{{Purchase.Valids.Year.message}}
{{Purchase.Valids.SecurityCode.message}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Credit Information

Professional Liability Premium {{FinProperties.TotalPremium | currency}}
{{FinProperties.NumberOfInstallments}} Installments {{FinProperties.InstallmentAmount | currency}} / Month
APR {{FinProperties.APR}}%
Finance Charge {{FinProperties.FinanceCharge | currency}}
Down Payment (15%) {{FinProperties.DownPayment | currency}}
Total with Financing Charge {{FinProperties.TotalPremium + FinProperties.FinanceCharge | currency}}

Down Payment: $ {{FinProperties.DownPayment | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

Accept Your Premium Financing Agreement
  • Submit the required down payment above.
  • You will receive an email from Input 1 (do-not-reply@pbsnetaccess.com) with the subject line "Your Premium Financing Agreement Quote is Ready for Your Approval".
  • Click the link in the email to view the financing agreement.
  • Accept the agreement and complete additional steps to set up your monthly payments to Input 1, the financing company.

If payment is not paid to the finance company, your policy will be cancelled for non-payment.

{{Lang == "es" ? 'Enviar' : 'Submit'}}
Message:{{Purchase.Result.Message}}
Message:{{Purchase.Result.Message}}
Named Insured: {{Client.ClientName}}

{{Lang == "es" ? 'Información de Pago' : 'Payment Information'}}

VISA Accepted Mastercard Accepted Discover Accepted

{{Purchase.Valids.CardType.message}}
{{Purchase.Valids.NumberCard.message}}
{{Purchase.Valids.CardName.message}}
{{Purchase.Valids.Month.message}}
{{Purchase.Valids.Year.message}}
{{Purchase.Valids.SecurityCode.message}}

{{Lang == "es" ? 'Dirección de Facturación' : 'Billing Address'}}

Premium Summary

Annual Policy Premium {{wfDefault.Invoice.Subtotal | currency}}
Taxes 2022-1 FIGA Assessment Surcharge {{wfDefault.Invoice.Taxes | currency}}
Administrative Fee {{wfDefault.Invoice.Fees | currency}}
{{c.Name}} {{c.Amount | currency}}

Total: $ {{wfDefault.Invoice.Total | number:2}}

Total: $ {{wfDefault.Invoice.TotalProrated | number:2}}

{{Lang == "es" ? 'Términos y Condiciones' : 'Terms and Conditions'}}

{{Lang == "es" ? 'Enviar' : 'Submit'}}
Message:{{Purchase.Result.Message}}
Message:{{Purchase.Result.Message}}
Premium 1 Premium 2 Premium 3
{{Variables.Premium01 | currency:"$"}} {{Variables.Premium02 | currency:"$"}} {{Variables.Premium03 | currency:"$"}}
Premium Subtotal {{ Variables.SubTotal | currency:"$ "}}
Taxes {{Variables.StateTaxDescription}} {{Variables.StateTaxRate*100 | number :2}}% {{Variables.StateTaxTotal | number :2 | currency:"$"}}
Taxes {{Variables.CityTaxDescription}} {{Variables.CityTaxRate*100 | number :2}}% {{Variables.CityTaxTotal | currency:"$"}}
Total {{ Variables.Total | currency:"$"}}

Check Payment Info

Uncheck the "Apply Payment in Nexsure box" if this is a partial payment or a split of two payment methods (credit card and check or 2 checks). For all PHLY Special event manual payments (American Express and Wires) uncheck the Apply Payment in Nexsure box).

TOTAL $ Payment Amount Apply Payment in Nexsure

$ {{Variables.Total}}

$ {{Variables.TotalPr}}


Client Info

Policy Effective Date E-mail Policy Documents to Client Client E-mail
{{Variables.EffDate | date}}
{{Variables.Email}}
{{Purchase.Valids.CheckAmount.message}}

Premium Summary

Professional Liability Premium {{OperationCoverages.PL.Premium | currency}}
Additional Insured Premium {{OperationCoverages.AdditionalInsured.Premium | currency}}
Additional Occupation Premium {{OperationCoverages.AdditionalOccupation.Premium | currency}}
General Liability Premium {{OperationCoverages.GL.Premium|currency}}
Premium Subtotal {{wfDefault.Invoice.Subtotal | currency}}
Taxes 2022-1 FIGA Assessment Surcharge {{wfDefault.Invoice.Taxes | currency}}
Administrative Fee {{wfDefault.Invoice.Fees | currency}}

Total:
$ {{wfDefault.Invoice.Total | number:2}}

{{Lang == "es" ? 'Información de Pago con Cheque' : 'Check Payment Information'}}

Uncheck the "Apply Payment in Nexsure box" if this is a partial payment or a split of two payment methods (credit card and check or 2 checks). For all PHLY Special event manual payments (American Express and Wires) uncheck the Apply Payment in Nexsure box).

Payment Amount Apply Payment in Nexsure
{{Purchase.Valids.CheckAmount.message}}

{{Lang == "es" ? 'Importante' : 'Important'}}

If you prefer, you can include additional attachments to this invoice

{{GetOtherInsuranceFiles()}}
Policy Effective Date Change Effective Date Send Email Has binding conditions?
{{Variables.EffDate | date}} {{Variables.EndorsementEffectiveDate | date:'MM/dd/yyyy'}}


Policy Effective Date E-mail pending reason to client
{{Variables.EffDate | date}}

Rates Table

Showing 6 of 10 levels. Click here for show all levels.

Coverage / Level 1 2 3 4 5 6 7 8 9 10
{{level.NewColumn}} ${{level.Level1}} ${{level.Level2}} ${{level.Level3}} ${{level.Level4}} ${{level.Level5}} ${{level.Level6}} ${{level.Level7}} ${{level.Level8}} ${{level.Level9}} ${{level.Level10}}
Please select your desired coverage level by clicking one of the following radio buttons.

Renewing Customers

Do you have a current Professional Liability Insurance Policy for Life Coaches with Philadelphia Insurance Company?

Yes No

Please enter your policy number or email address

Searching...

Your entry does match a record in our system:

  • Policy Number: {{userFound.PolicyNumber}}
  • Email address: {{userFound.Email}}
  • Current Retroactive date: {{userFound.RetroactiveDate}}
  • Current Effective date: {{userFound.EffectiveDate}}
Please proceed to complete remaining information in order to renew your policy.

We’re sorry, but your entry does not match a record in our system.
Please contact us at 800-875-1911 to retrieve your policy information.

Searching...

We’re sorry, but your entry does not match a record in our system.
Please contact us at 800-875-1911 to retrieve your policy information.

Payment Information

*Card Type: {{Purchase.Valids.CardType.message}}
*Card Number: {{Purchase.Valids.NumberCard.message}}
Security Code Shopping is always safe and secure
*Expires On:
{{Purchase.Valids.Year.message}} {{Purchase.Valids.Year.message}}
*Security Code: What is this? Security Code {{Purchase.Valids.SecurityCode.message}}
*Name on Card: {{Purchase.Valids.CardName.message}}
Gross Payment
Net Payment
Total: {{(!Variables.IsGrossPayment ? 0.80*Variables.TotalPremium + Variables.TotalTax + (Variables.Fee ? Variables.Fee : 0) : Variables.Total) | currency}}

Billing Address

Same as Insured:

{{Variables.orgName}}
{{Variables.address + ","}} {{Variables.address2}}
{{Variables.city + ","}} {{Variables.state}} {{Variables.zipcode}}

*Street Address 1: {{Purchase.Valids.Address1.message}} Street Address 2:
*City: {{Purchase.Valids.City.message}} *State: {{Purchase.Valids.State.message}}
*Zip Code: {{Purchase.Valids.Zip.message}}

Message:{{Purchase.Result.Message}}
Message:{{Purchase.Result.Message}}
Policy Effective Date E-mail Policy Documents To Client
{{Variables.EffDate | date}}
Policy Effective Date E-mail decline reason to client
{{Variables.EffDate | date}}

In order to Bind Coverage you must generate a proposal
and accept the terms and conditions of the policy.

Effective Date Send Email
{{Variables.EffDate | date}}

{{question.ErrorMessage}}


{{SubmitConfirmation.Header}}

Policy Number: {{SubmitConfirmation.PolicyNumber}}

Thank you for choosing us.

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