Please fill out the form below to apply for Vitamins, Supplements & Nutraceuticals Liability Insurance.
Aristolochia spp., Aristolochia, Aristolochic acids, Aristolochia fanghi, Aristolochia spp., Asarum [ ] spp., Bragantia spp., Clematis spp., Akebia spp., Cocculus spp., Diploclisia spp., Menispernum spp., Sinomenium spp., Mu Tong, Fang Ji, Guang Fang Ji, Fang Chi, Kan-Mokutsu, and any adulterated botanicals, botanical derivatives, or other products that contain aristolochic acid, aristolochic acid derivatives, or aristolochic acid extracts.
Ephedra Sinica, Ephedra. E. equisetina, Ma Huang, Ephedra Alkaloid, Pseudoephedrine, Ephedrine or any other Ephedra derivatives or extracts.
Stephania, Stephania spp, or any adulterated botanicals, botanical derivatives, or any other products that contain Stephanie, or any Stephanie derivatives or extracts.
Magnolia, or any adulterated botanicals, botanical derivatives, or any other products that contain Magnolia, or any Magnolia derivatives or extracts.
Kava, ava, ava pepper, awa, kava root, kava-kava, kawa, Piper methysticum Forst. f, Piper Methysticum G. Forst, rauschpfeffer, intoxicating pepper, kava kava, kava pepper, kawa kawa, kawa-kawa, kew, Piper methysticum, sakau, wurzelstock, yangona.
If yes, provide 5 year loss history for all claims, including any predecessor. Attach a description of any loss greater than $5,000.
If yes, please attach Tank schedule.