Mortgage Field Services


Application 1



Dear Prospective Insured, we are pleased to offer the following:

 COMBINED LIMIT PER EVENT
Commercial General Liability$1,000,000 per claim/2,000,000 aggregate
Care, Custody and Control for
Mortgagors Personal Property		$50,000 Occurrence/ $100,000 aggregate
Deductible$1000
Fire Damage to premises you lease$50,000
Medical Payments$ 5,000
Errors & Omissions$1,000,000 Claims Made
Deductible$ 2,500

Please send us the premium and completed application ONLY if you understand what we are providing and meet the coverage restrictions outlined below:

  1. Only work you perform for members of NAMFS (National Association of Mortgage Field Services) will be covered by this policy.
  2. Your gross income for all your mortgage field service work for NAMFS and Non-NAMFS members cannot exceed $25,000 for the past 12 months.
  3. If you purchase this policy and your gross income exceeds $25,000 during the policy year you must contact us so we can cancel and rewrite you into the larger program.
  4. You must provide proof of income which must accompany your application and a check. (1099 or tax return is acceptable documentation)
  5. Call us at 800-392-6958 ext. 304, 323, 324 or 314 if you have any questions or Email: jrumbaugh@york-jersey.com - llea@york-jersey.com -
    ncocchi@york-jersey.com or swassong@york-jersey.com.
THIS POLICY IS NOT AVAILABLE IN NEW YORK, OHIO, KENTUCKY OR ILLINOIS. Please contact us for other products that are available in these states.

NATIONAL ASSOCIATION OF MORTGAGE FIELD SERVICES, INC.
"SMALL INSURED" LIABILITY INSURANCE PROGRAM APPLICATION

Make sure you complete all fields before submitting.
Click on Submit when ready to send.

  • Name of Applicant:
  • Email Address:
  • D/B/A:
  • Address:
  • Address 2:
  • City, State, Zip:
  • Phone:
  • Fax:
  • Number of years Experience:
  • Prior Claims History (please advise details of any prior claims including date of loss and amount paid)
  • Does the applicant or employee have knowledge or information of any act, error or omission which may reasonably be expected to give rise to a claim in the future? If yes, please explain:
  • List by name companies that send you work:
  • Annual income from Mortgage Field Services:
    Past Year: US$
    Current Year:US$
    Next Year:US$
  • Current Insurance Company:
  • Retroactive Date:
  • Current Premium:
  • If no prior coverage, check here:
IMPORTANT: READ AND UNDERSTAND BEFORE SIGNING UP FOR COVERAGE


ANY PERSON WHO INCLUDES ANY FALSE OR MISLEADING INFORMATION ON AN APPLICATION FOR AN INSURANCE POLICY IS SUBJECT TO CIVIL ANS CRIMINAL PENALTIES.

The undersigned understands that if their gross income from Mortgage Field Service operations exceeds US$25,000 annually, before deducting expenses, they are not eligible for this insurance.

The undersigned warrants that their gross income from all their Mortgage Field Service operations is US$25,000 or less per year.

The Insurance Company providing the coverage reserves the right to audit this policy by requesting tax returns and/or 1099's for the past 24 months. This policy is subject to audit. If you go over the 25,000 you will be charged an additional premium based on the standard rate of $19.93 + Surplus Lines Tax.

If your income exceeds US$25,000 please contact York-Jersey Underwriters at 800-392-6958 ext. 304, 314, 323 or 324 to discuss other products available.

Coverage provided under this insurance is on a Claims Made basis and is renewable annually at each 1st January.

Premium Schedules by sign up date:
January-June: US$771.00 includes 3% tax & $50.00 fee
July-September: US$513.50 includes 3% tax & $50.00 fee
October- December: US$359.00 includes 3% tax & $50.00 fee

Premiums are Minimum Premiums and not refundable. Service fee is non-refundable.

A 1099 or other proof of income for the preceding 12 months must accompany this application.

Please mail proof of income and payment to:

York-Jersey Underwriters, Inc.
P.O. Box 810
Red Bank, New Jersey 07701

This policy insures work performed for NAMFS members only. (National Association of Mortgage Field Services)

This policy contains a $50 service fee which is included in the premium.

By digitally signing this application you are acknowledging and accepting the service fee.

NOTE: The insurance company or agent providing this coverage reserves the right to contact the companies for whom you provide services in order to verify the income indicated on this application. By applying for this policy and signing the application you are authorizing the insurer to contact your clients to verify your income.
  • Applicant’s Digital Signature:

THIS POLICY IS NOT AVAILABLE IN THE STATES OF NEW YORK, OHIO, KENTUCKY AND ILLINOIS. PLEASE CONTACT OUR OFFICE FOR INFORMATION ON OTHER COVERAGE AVAILABLE IN THESE STATES.

Contact Us

Other Key Services

Auto/Home

York-Jersey Underwriters represents 15 auto and homeowner insurers. We always provide multiple quotes from a variety of companies to ensure you are receiving the best service and highest value. You can be assured that your independent agent has your best interests in mind.

Business

From Wall Street to Main Street, we insure businesses of all sizes. Whether you are a retailer, wholesaler, contractor or manufacturer, we have the expertise to tailor your coverage plans to meet your particular needs. By representing many of the leading national and regional insurance companies, we can design a comprehensive protection plan that works for your bottom line.

Life/Health Employee Benefits

York Jersey Underwriters also specializes in employee benefits. Our organization has a team of employee benefit specialists who have over 30 years of combined experience with group benefits. Our employee benefit specialists focus on reducing employer cost without decreasing employee benefits.

Mortgage Field Services

York-Jersey Underwriters has insured the mortgage field service industry since 1983 and has the endorsement of the National Association of Mortgage Field Services (NAMFS). This is the oldest, largest and only not-for-profit field service association in the country.