Chartis Specialty Insurance Company

Transcription

1 Chartis Specialty Insurance Company AIU Insurance Company American Home Assurance Company American International Pacific Insurance Company American International South Insurance Company Birmingham Fire Insurance Company of Pennsylvania Granite State Insurance Company Illinois National Insurance Co. National Union Fire Insurance Company of Pittsburgh, Pa. National Union Fire Insurance Company of Louisiana New Hampshire Insurance Company (each of the above being a capital stock company) (herein called the Company) WebMerchantGuard Card Not Present Application NOTICE: THE POLICY DOES NOT PROVIDE FOR ANY LEGAL DEFENSE IN ANY MATTER. THE POLICY DOES NOT PROVIDE ANY LIABILITY COVERAGE FOR ANY REASON OR MATTER THAT MAY ARISE DURING THE POLICY PERIOD. PAYMENTS MADE UNDER THIS POLICY WILL REDUCE THE AMOUNTS AVAILABLE TO PAY LOSS DURING THE POLICY PERIOD. I. COMPANY INFORMATION 1. Full Name of Applicant _ Individual Corporation Partnership Other Address Names of Subsidiaries (or attach list) _ 2. Web site Home Page Address(es) including subsidiaries Mailing Address (if different) 3. Chief Financial Officer 4. Date Established _ Place of Incorporation 5. No. of Employees 1

2 6. Description of all Merchant activities, products & services: Are there merchant activities, products or services planned for next year that are different from those described above? Do you have any products or services that are delivered over the internet for example downloadable music, software, games etc.,? Yes No If yes, please describe in detail the product and service sold: 7. Name of Your Financial Institution(s) Address Account Number(s) for all accounts on which you want coverage _ II. LIMITS REQUESTED LIMIT DEDUCTIBLE* COINSURANCE** _ 2

3 * Choose a percent from 1% to 15% which will be applied to your sales volume ** Choose a percent from 5% to 50% which will be applied to your covered loss (usually the amount of your chargebacks after application of the deductible). III. WEBMERCHANT INFORMATION 8. Description of products/services offered (i.e. small electronics 50% computers 10% software 40%.,) Use separate sheet if necessary. Products % of sales 9. During the past 3 years have you a. Experienced any uncollectible chargeback losses exceeding $5000 from any individual cardholder Yes No b. Experienced any acts of dishonesty by other ISO/MSP or bank employee that lead to an uncollectible charge back Yes No c. Experienced any sales of 50% or more during a certain period of time i.e. Easter, 4 th of July, Halloween, Thanksgiving, Christmas or other period Yes No d. Taken longer than 180 days to resolve a fraudulent charge back dispute Yes No 3

4 Please provide a copy of your merchant processing agreement, third party merchant service agreements if applicable, sample merchant statement, and the credit card processing codes for the processor or cards that you will accept ATTACHED IV. BUSINESS REVENUES 11. List the total credit card sales/total chargebacks for card not present (mail order, telephone order, internet order) transactions for each 12 month period year for the past three 12- month periods ending on the last day of the month immediately prior to the date of this application(list data for all accounts to be covered). Example: If the application date is March 12, 2001, information should be provided for February 2000 February 2001 (current), February 1999 February 2000 (1 st Prior period), February 1998-February 1999(2 nd Prior period) and February 1997 February 1998 (3rd Prior period). Current 12 month period SALES/TRANSACTION INFORMATION Total Revenues $ 1st Prior 12 month period 2nd Prior 12 month period 3 rd Prior 12 month period Total # of CNP transactions Total $ amount of CNP sales % of CNP sales that are internet sales Average # of visitors per day CHARGEBACK INFORMATION Total # of CNP chargebacks Total $ amount of CNP chargebacks Total # of internet CNP chargebacks Total $ amount of internet CNP chargebacks # $ % Estimated next 12 month Total $ amount of CNP sales $ Average $ amount of each sale $ 4

5 12. What are the fees you pay for processing for each card accepted; Card Name Basis Point Charged Transaction Fee Charged Average Reserve V. FRAUD DETECTION 13. What minimum level of Fraud Detection methods do you perform? Check all that apply AVS CVVC Neural net program (i.e. Efalcon, Surefire, Brighterion etc.) Data Mining within your data base of customers Data Mining within a merchant network of data bases Other (please explain) NONE If NONE do you plan to add this to your card not present processing within the next year? _ Yes. Select type from the list above and give an approximate date of implementation. (Attach separate sheet) _ No 5

6 14. Do you utilize any of the following prior to shipping items in a card not present transaction? Check all that apply. Waiting period. Number of days Ship only to billing address of credit card used in purchase Phone call verification of order. Negative credit file check with other merchant or ISO. Limit maximum amount of card not present transaction to no greater than $. Other. Please explain. 15. Has any similar insurance policy or program to the insurance applied for here been cancelled or revoked? (If Yes please attach details.) VI. NETWORK SECURITY 16. Do You use firewalls to prevent unauthorized access connections from internal networks and computer systems to external networks? No Implementation required Partial Implementation required Full Implementation required 17. Do You have remote users authenticated before being allowed to connect to internal networks and computer systems? No Implementation required Partial Implementation required Full Implementation required 18. Do You have anti-virus procedures used on desktops and mission critical servers? No Implementation required Partial Implementation required Full Implementation required If implemented, how often do You update the procedures? 19. Do You have in place a written policy and procedures for card present and card not present transactions? 20. Do You require that all Your employees provide written confirmation acknowledging that they have received, read and understood the card processing policy and procedures and that failure to follow card processing policies and procedures will result in disciplinary action, up to and including termination? 6

7 VII. AUDIT/INTERNAL CONTROL PROCEDURES 21. How often do perform audits of cash & credit card accounts? 22. Do You require that bank accounts are reconciled by someone not authorized to deposit or withdraw there from at all locations? Yes No 23. Do You have an internal audit department? Yes No 24. Do have a system in place that allows for the reporting of suspicious or fraudulent activity confidentially? If yes please explain in an attachment providing information on the policy and the procedure and the persons responsible for the reporting and actions taken thereafter VIII. CREDIT CARD PROCESSING 25. Have any of Your credit card privileges ever been suspended? If yes, please attach explanation including dates, length of suspensions, reasons and resolutions if any 26. How often do You perform a reconciliation on card not present transactions? 27. Have You had any unresolved charge back disputes in the past three years? If yes, please attach explanation including number of disputes, dates, amounts, reasons and resolutions if any 7

8 The Insured represents that the information furnished in this application is complete, true and correct. Any misrepresentation, omission, concealment or incorrect statement of a material fact, in this application or otherwise, shall be grounds for the rescission of any policy issued. Dated at _ this day of _ By Print Name Print Title _ Signature 8