Wellness PRO – Permanent Makeup and Body Art Insurance
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Wellness PRO – Permanent Makeup and Body Art Insurance
  • Home
  • Application
  • Program Details
  • FAQs
  • Contact Us

Application

Fill out your information below for a free no-obligation tattoo insurance quote.
1Your Details
2General Information
3Equipment and Procedures
4Coverages
5History
Mailing Address:*
Business operated as:

Unfortunately you are not eligible for the program at this time, however you can complete the application to qualify for coverage outside of the program.

If a piercer has a year experience, they are limited to what body parts they can pierce.

Are you required to name any other person or entity as an Additional Insured on your Policy?*
b. What is the interest of the Additional Insured?

Do you sell products not related to tattooing or body piercing for this business?
Do you have operations or services other than tattooing or body piercing for this business?
Are you in compliance with all city, county, state ordinances and work in a licensed business location?
Do you have formal training and/or have completed apprenticeships in Tattooing and/or Body Piercing?
Do you use a Consent and After Care form on every client?
Is all your equipment either a.) pre-sterile, one time use or b.) heat sterilized prior to use?
Do you provide any of the following? Separate application may be required.

Equipment and Procedures – Tattooing

Are all pigments you use from US or Canada manufacturers and/or EU/UK standards?
Do you EVER re-use needles?

Equipment and Procedures – Piercing

Are all your jewelry and needles either a.) pre-sterile, one time use or b.) heat sterilized prior to use
Is all jewelry you use made within US guidelines and/or meets EU/UK standards?
For new piercings, do you use jewelry specifically made for that purpose?
IMPORTANT NOTE: Piercers under 1 Year Experience are limited to the following: Eyebrow, Earlobe, Outer Rim Ear cartilage, Lower Lip-Sides and Center, Nostrils – Thin or Hyaline Cartilage Only, Navel, Nipples, Surface Piercing/Surface Anchors and/or use of “O” or “Chamfer” Needles require Piercers to have at least 2 Years of Experience.
Do you want coverage for work on minors?
If Yes, indicate type:

Limitations to work on Minors:
MINOR PIERCING: Ear, Nose, Navel, Lips, Tongue (midline only) & Eyebrow piercings on minors age 13 years or over with written parental consent (ear lobes children age 3 months and older) – if state law specifies an older age, you must follow state law.
MINOR TATTOOING: In states where legal, age 16 or over with written parent consent.

Are you in compliance with the above limitations to work on minors guidelines?
Do you offer any of the following?

Note – ALL questions must be answered. Failure to disclose claims history could invalidate coverage:

Do you Currently have Insurance coverage
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Do you have any past Professional, or General Liability Claims, whether or not insured?
Do you have knowledge of an event, circumstance or occurrence (other than listed above) prior to the effective date of the proposed policy, or are you aware that a claim may be brought as a result of said event, circumstance or occurrence?

ATTESTATION

I understand and agree this Application and any supplements attached hereto will be relied upon for issuance of any policy. I further understand and agree that failure to provide a true and accurate response to the foregoing questions may, at the option of the company, result in the voiding of the insurance issued in reliance on this application and/or denial of claims under any policy issued. I authorize and consent to investigations of information bearing upon moral character, professional reputation, and fitness to engage in the activities of my business including authorization to every person or entity, public or private, to release the Company, any documents, records, or other information bearing upon the foregoing. I understand and agree these investigations shall not be confined to information submitted in this application, but shall include any other sources of information deemed relevant by the Company as may be authorized by law. Furthermore, I understand that the policy applied for will apply only to CLAIMS FIRST MADE and REPORTED to the Company in writing within the period of coverage shown on the certificate of insurance issued with the policy or certificate on the date the policy is canceled or terminated, whichever comes first or as otherwise provided by the policy. I understand this insurance is being provided through a surplus lines company and the insurer is not subject to all the insurance laws and rules in my state and the risk is not protected by the State Insurance Insolvency Fund.

THIS APPLICATION MUST BE SIGNED BY APPLICANT WITHIN 30 DAYS OF BINDING. SIGNING THIS FORM DOES NOT BIND THE COMPANY TO COMPLETE THE INSURANCE. COVERAGE BECOMES EFFECTIVE WHEN ACCEPTED BY THE INSURANCE COMPANY.

I, the above indicated, hereby warrant and confirm that I, while operating under my business, will follow the guidelines and procedures that I indicate I follow on the insurance application, including use of proper sterilization on all equipment, no reuse of needles, registration of clients and providing each client instructions on how to care for their tattoo and/or piercing.

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LIABILITY LIMIT REQUESTED
Are higher limits required?

POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM INSURANCE COVERAGE

You are hereby notified that under the Terrorism Risk Insurance Act of 2002, as amended ("TRIA"), that you now have a right to purchase insurance coverage for losses arising out of acts of terrorism, as defined in Section 102(1) of the Act, as amended: The term "act of terrorism” means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security and the Attorney General of the United States, to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of an air carrier or vessel or the premises of a United States mission; and to have been committed by an individual or individuals, as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Any coverage you purchase for "acts of terrorism" shall expire at 12:00 midnight December 31, 2027, the date on which the TRIA Program is scheduled to terminate, or the expiry date of the policy whichever occurs first, and shall not cover any losses or events which arise after the earlier of these dates.

YOU SHOULD KNOW THAT COVERAGE PROVIDED BY THIS POLICY FOR LOSSES CAUSED BY CERTIFIED ACTS OF TERRORISM IS PARTIALLY REIMBURSED BY THE UNITED STATES UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THIS FORMULA, THE UNITED STATES PAYS 80% OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURER(S) PROVIDING THE COVERAGE. YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A USD100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS USD100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED USD100 BILLION, YOUR COVERAGE MAY BE REDUCED. THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT.

Consent
I hereby elect to have coverage for acts of terrorism excluded from my policy. I understand that I will have no coverage for losses arising from acts of terrorism.
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