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What is your legal name?

Please fill in your first and last name.

We need your legal name to verify your identity and ensure your insurance policy is properly issued in your name. This must match your government-issued ID.

What is your date of birth?

Please fill in your complete date of birth.

Your date of birth is required for identity verification and to determine eligibility for our insurance products.

How can we reach you?

Please enter a valid email and phone number.

Enter a valid email address.
We use your contact information to send policy documents, claim updates, and important security notifications about your coverage.

When is the best time we could reach out to you?

Please select a valid time.

We want to make sure we contact you at a convenient time. Your preferred time helps our specialists schedule a call that works best for you.

What types of crypto assets do you hold?

Please select at least one asset type.

Bitcoin (BTC)
Ethereum (ETH)
Stablecoins (USDT, USDC, DAI)
Other altcoins
NFTs / Digital collectibles
DeFi positions (staking, liquidity pools)

How do you store your crypto assets?

Please select at least one storage method.

Hardware wallet (Ledger, Trezor, etc.)
Software / Hot wallet (MetaMask, Trust Wallet)
Centralized exchange (Coinbase, Binance, Crypto.com, Kraken)
Institutional custodian (Fireblocks, BitGo)
Multi-signature setup
DeFi protocols / Smart contracts

What coverage are you interested in?

Please select at least one coverage type.

Wallet & device protection
Exchange & custodian coverage
Social engineering & fraud defense
In-person & physical threat coverage
Comprehensive coverage (all of the above)

How much coverage do you need?

Please enter an exact coverage amount between $1 and $1,000,000.

$
Type the exact dollar amount, from $1 to $1,000,000.

Review your application

We could not submit your application. Please try again.

Application submitted!

Thank you for choosing TrustChain. One of our crypto insurance specialists will reach out to you within 24 hours to build a custom coverage plan for your portfolio.

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