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Strong Tower Specialty Risk Evaluation Request

Thank you for your interest in Strong Tower Specialty.

This Evaluation Request is intended for licensed retail insurance agents and brokers seeking a preliminary review of a risk or opportunity. Submission of this request does not establish a brokerage relationship, guarantee appointment, guarantee market access, or guarantee coverage availability.
 
Please complete the form below and provide any supporting documentation that may assist in our evaluation.
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Agency Information

Please provide information about your agency and primary contact.
Primary Contact
Email Address

Risk Information

Please provide basic information regarding the risk or opportunity to be evaluated.

Coverage Information

Please identify the coverage types associated with the evaluation request.
Coverage Type(s) Requested

Industry Classification

Please identify the primary industry or operational classification of the risk being submitted.
Industry Class
Has this risk been submitted to other wholesale brokers?
Opportunity Type

Relationship Information

Current Relationship with Named Insured

Supporting Documentation

Insured Authorization Status
Strong Tower Specialty is willing to conduct preliminary risk evaluations for licensed retail agents and brokers. However, market exploration, submissions, quotations, and placement activities may require appropriate authorization from the insured.
Click or drag files to this area to upload.You can upload up to 10 files.
Attach any ACORD applications, supplemental applications, loss runs, experience modification worksheets, schedules, narratives, or other supporting documentation that may assist Strong Tower Specialty in conducting a preliminary evaluation.

Strong Tower Specialty is a licensed wholesale insurance brokerage and does not conduct business directly with the public. Evaluation requests are available exclusively to licensed retail insurance agents and brokers. Submission of an Evaluation Request does not authorize Strong Tower Specialty to market, quote, negotiate, bind, or otherwise pursue insurance coverage on behalf of any insured unless and until all required authorization, documentation, appointment, and brokerage requirements have been satisfied.

If you have questions regarding this Evaluation Request, please email us at riskeval@strongtowerspecialty.com.