First Name
Last Name
Email
Company
Job Title
Job Function
Actuarial/Risk
Business Management
Claims
Customer Experience
Data & Analytics
Investment Management
IT
Marketing
Operations
Product Development
Research & Development
Sales
Strategy
Technology & Innovation
Transformation
Underwriting
Other
What is your business type?
Academia/Education
Accelerator/Incubator/Innovation Lab
Association
Banking/Financial Services
Broker/Agency
Government/Regulator
Insurer
Insurtech (Digital-first insurance provider)
Investment Bank/Other Financial Services
Investment/Asset Management
Law Firm
MGA/Wholesaler
PR Agency
Press/Media
Reinsurer
Solutions Provider
Startup
TPA/Third Party Administrator
Technology Provider
Technology Startup
What insurance lines of business do you offer?
Commercial Lines – D&O
Commercial Lines – Fleet
Commercial Lines – Property
Commercial Lines – Small Commercial
Commercial Lines – Workers Comp
Embedded Insurance
Health/Wellness/Benefits
Life & Annuities
Personal Lines – Auto
Personal Lines – Home
Personal Lines – Pet
Personal Lines – Renters
Personal Lines - Personal Devices
Personal Lines - Travel
Specialty Lines – Crop/Agriculture
Specialty Lines – E&S
Specialty Lines – Marine/Aviation
Specialty Lines - Cyber
Supplemental Health/Voluntary Benefits
What is your investment stage?
Seed and early stage
Series A
Series B+
What purchasing authority do you have?
Sole responsibility
Joint responsibility
Advisory influence only
No influence
Not Applicable. I am not procuring products/service
Phone
Country
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire sint eustatius and saba
Bosnia and Herzegovina
Botswana
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (keeling) Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-bissau
Guyana
Haiti
Holy See (vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French Part)
Saint Pierre and Miquelon
Saint Vincent and The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maartin (Dutch Part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vietnam
Virgin Islands, British
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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