Adult Short Term Production Insurance

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DICE/Short Term Productions Adult Entertainment Application

  • If you have any questions about how to fill in this form call (818) 788-1911 to speak to one of our friendly advisors.

  • This application is used to insure a single adult entertainment production with a maximum budget of $1,000,000 and a maximum duration of 60 days within a 60 day consecutive period.

  • Required Documents

    The following documents are required to apply for coverage:
    • This application
    • Fraud Statement
    • Estimated Schedule of Productions
    • Stunt Schedule (if any stunts/hazardous activities)
    • Cast Schedule (if cast coverage is required)
    • Cast Medical Certificates (for cast members that require sickness coverage)
    • Animal Schedule (if animal death/injury coverage required)
  • Applicant Information

  • Underwriting Qualification Questions

  • Insurance History

    if Yes, provide details below
  • Policy 1

  • Policy 2

    If yes, provide details below
  • Policy 1

  • Policy 2

  • Key Personnel

    Enter the key personnel: executive producer, producer, director, etc. (at a minimum, either the executive producer or producer must be listed)
  • Executive Producer

  • Producer

  • Director

  • Other Key Personnel 1

  • Other Key Personnel 2

  • Other Key Personnel 3

  • Other Key Personnel 4

  • Production Details

  • Coverages

  • Dates of Coverage

  • (12 month coverage term)
  • General Liability Coverage

  • Coverage Limit

  • Additional Comments


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