Professional Liability Insurance
Application Note
Your application form and all other documentation pertaining to your policy will be available for viewing and printing at any time in your customer portal.
Personal Information
First Name
Last Name
Date of Birth
mm/dd/yyyy
DAN Member ID
Non-Member
Professional Status
Select Status...
Instructor
Assistant Instructor/Instructor in Training
Divemaster/Divemaster in Training
Skin Diving / Swimming Instructor
Retired (inactive) Instructor
Retired Divemaster/Skin Diving Instructor/ Assistant Instructor (Tail Coverage)
Previous Claims?
Select...
No previous claims
1 previous claim
2 previous claims
3 previous claims
4 previous claims
5 previous claims
6 previous claims
7 previous claims
8 previous claims
9 previous claims
10 previous claims
More than 10 previous claims
What activities do you currently participate in:
--Scuba Instruction
--Assistanting Scuba Instructors
--I'm an Instructor in Training
--Divemastering
--I'm a Divemaster in Training
--Skin Diving Instruction
--Free Diver Instruction
--Swimming Instruction
Contact Information
Email
Country
United States
Mailing Address
City
State
select state...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
----------
Armed Forces Europe
Armed Forces Americas
Armed Forces Pacific
Zip/Postal Code
Phone
Agency Affiliations
All agencies declared here will automatically be aded as Additional Insured on your final application.
Agency
Select Agency...
ACUC - American Canadian Underwater Certifications
AIDA - International Association for the Development of Apnea
American Red Cross - American Red Cross
ANDI - American Nitrox Divers International
BSAC - British Sub-Aqua Club
CMAS - World Confederation of Underwater Activities
COLA - County of Los Angeles
Diveheart - Diveheart
DP - The Dive Patrol, Inc
DRI - Dive Rescue International
ERDI - Emergency Response Diving
FII - Freediving Instructors International
GUE - Global Underwater Explorers
HSA - Handicapped Scuba Association
IANTD - International Association of Nitrox and Technical Divers
IDEA - International Diving Educators Association
MDEA - Multinational Diving Educators Association
MFE - Molchanovs Freediving Education
NACD - National Association for Cave Diving
NASE - National Academy of Scuba Educators
NAUI - National Association of Underwater Instructors
NSS-CDS - National Speleological Society Cave Diving Section
PADI - Professional Association of Diving Instructors
PDIC - Professional Diving Instructors Corporation
PFI - Performance Freediving International
PSAI - The Professional Scuba Association International
PSS - Professional Scuba Schools
PTRD - Professional Technical & Recreational Diving
RAID - RAID Dive
S.C.U.B.A. - Swiss Company for Underwater Breathing & Activities
SDI - Scuba Diving International
SEI - Scuba Educators International
SNSI - Scuba Nitrox Safety International
SSI - Scuba Schools International
TDI - Technical Diving International
UTD - Unified Team Diving
Agency ID
Primary Agency
Select Agency...
ACUC - American Canadian Underwater Certifications
AIDA - International Association for the Development of Apnea
American Red Cross - American Red Cross
ANDI - American Nitrox Divers International
BSAC - British Sub-Aqua Club
CMAS - World Confederation of Underwater Activities
COLA - County of Los Angeles
Diveheart - Diveheart
DP - The Dive Patrol, Inc
DRI - Dive Rescue International
ERDI - Emergency Response Diving
FII - Freediving Instructors International
GUE - Global Underwater Explorers
HSA - Handicapped Scuba Association
IANTD - International Association of Nitrox and Technical Divers
IDEA - International Diving Educators Association
MDEA - Multinational Diving Educators Association
MFE - Molchanovs Freediving Education
NACD - National Association for Cave Diving
NASE - National Academy of Scuba Educators
NAUI - National Association of Underwater Instructors
NSS-CDS - National Speleological Society Cave Diving Section
PADI - Professional Association of Diving Instructors
PDIC - Professional Diving Instructors Corporation
PFI - Performance Freediving International
PSAI - The Professional Scuba Association International
PSS - Professional Scuba Schools
PTRD - Professional Technical & Recreational Diving
RAID - RAID Dive
S.C.U.B.A. - Swiss Company for Underwater Breathing & Activities
SDI - Scuba Diving International
SEI - Scuba Educators International
SNSI - Scuba Nitrox Safety International
SSI - Scuba Schools International
TDI - Technical Diving International
UTD - Unified Team Diving
Agency ID
Coverage Options
Equipment Liability
US$285
Coverage for claims alleging defective or malfunctioning equipment. Provides coverage to instructors who provide equipment during training. Applies to equipment owned by the insured and used in the insured's classes.
Excess Liability($2 million / $4 million)
US$454
Optional coverage increases policy limits from $1,000,000 per claim/ $2,000,000 aggregate to $2,000,000 per claim/$4,000,000 aggregate.
Technical Dive Training
US$0
Coverage for teaching and supervising recreational technical diving activities. Must be an active Technical Instructor.
Rebreather Endorsement
US$0
Coverage for claims for Bodily Injury or Property Damage resulting from a covered occurrence which occurs during the supervision of, instruction in, and orientation to the designated rebreather.
Rebreather #
Manufacturer Name
Model
Certification #
Training Agency
Select Agency...
ACUC - American Canadian Underwater Certifications
AIDA - International Association for the Development of Apnea
American Red Cross - American Red Cross
ANDI - American Nitrox Divers International
BSAC - British Sub-Aqua Club
CMAS - World Confederation of Underwater Activities
COLA - County of Los Angeles
Diveheart - Diveheart
DP - The Dive Patrol, Inc
DRI - Dive Rescue International
ERDI - Emergency Response Diving
FII - Freediving Instructors International
GUE - Global Underwater Explorers
HSA - Handicapped Scuba Association
IANTD - International Association of Nitrox and Technical Divers
IDEA - International Diving Educators Association
MDEA - Multinational Diving Educators Association
MFE - Molchanovs Freediving Education
NACD - National Association for Cave Diving
NASE - National Academy of Scuba Educators
NAUI - National Association of Underwater Instructors
NSS-CDS - National Speleological Society Cave Diving Section
PADI - Professional Association of Diving Instructors
PDIC - Professional Diving Instructors Corporation
PFI - Performance Freediving International
PSAI - The Professional Scuba Association International
PSS - Professional Scuba Schools
PTRD - Professional Technical & Recreational Diving
RAID - RAID Dive
S.C.U.B.A. - Swiss Company for Underwater Breathing & Activities
SDI - Scuba Diving International
SEI - Scuba Educators International
SNSI - Scuba Nitrox Safety International
SSI - Scuba Schools International
TDI - Technical Diving International
UTD - Unified Team Diving
Rebreather #1
Manufacturer Name
Model
Certification #
Training Agency
Select Agency...
ACUC - American Canadian Underwater Certifications
AIDA - International Association for the Development of Apnea
American Red Cross - American Red Cross
ANDI - American Nitrox Divers International
BSAC - British Sub-Aqua Club
CMAS - World Confederation of Underwater Activities
COLA - County of Los Angeles
Diveheart - Diveheart
DP - The Dive Patrol, Inc
DRI - Dive Rescue International
ERDI - Emergency Response Diving
FII - Freediving Instructors International
GUE - Global Underwater Explorers
HSA - Handicapped Scuba Association
IANTD - International Association of Nitrox and Technical Divers
IDEA - International Diving Educators Association
MDEA - Multinational Diving Educators Association
MFE - Molchanovs Freediving Education
NACD - National Association for Cave Diving
NASE - National Academy of Scuba Educators
NAUI - National Association of Underwater Instructors
NSS-CDS - National Speleological Society Cave Diving Section
PADI - Professional Association of Diving Instructors
PDIC - Professional Diving Instructors Corporation
PFI - Performance Freediving International
PSAI - The Professional Scuba Association International
PSS - Professional Scuba Schools
PTRD - Professional Technical & Recreational Diving
RAID - RAID Dive
S.C.U.B.A. - Swiss Company for Underwater Breathing & Activities
SDI - Scuba Diving International
SEI - Scuba Educators International
SNSI - Scuba Nitrox Safety International
SSI - Scuba Schools International
TDI - Technical Diving International
UTD - Unified Team Diving
Effective Date
Select Start Date for Your Coverage
12:01AM EST
format: mm/dd/yyyy
Coverage effective date begins at 12:01AM EST on the date selected. Coverage ends 1 year later at 12:01AM EST.
Next