Hendrickson Insurance
Hendrickson Insurance · Sarasota, Florida

Product liability supplement.

For Gulf Coast sellers of homeopathic, supplement, and non-prescription products, this supplement pairs with the commercial application so we can prepare a product-liability quote, and estimates are fine where you are not sure.

This supplement pairs with the Commercial / Business application. Please complete that first so we can pair them.

A. Applicant & Role in the Supply Chain

Required.
Role(s) in the supply chain

B. Product Categories

Product categories sold (check all that apply)

C. Ingredients of Concern

Insurers and the FDA flag the ingredients below. Any "Yes" requires the product name(s), supplier, and any adverse events, and these may be excluded or separately rated.

Do any products contain the following?

D. Regulatory & Quality Compliance

E. Advice, Claims & Professional Exposure

This account has NO licensed pharmacist or licensed health practitioner on staff, and the questions below assess advice-related and health-claim exposure.

F. Product Liability Controls

G. Sales & Distribution

Sales channels (check all that apply)

H. Product Loss History

I. Acknowledgement

I certify that the information above is true and complete to the best of my knowledge. Submitting this form does not bind coverage; coverage is subject to underwriting approval and payment of premium.

Required.
Required.
Please confirm to submit.
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Thank you — application received

Dennis will review it and follow up shortly with your quote. Questions? Call or text 941-952-7991.

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