Professional Liability

Professional liability insures a person and/or an entity (corporation, LLC, LLP, partnership, etc.) against claims made by third parties (clients, patients, customers, etc.), alleging negligence in the rendering of, or the failure to render, professional services. Negligence can be defined as the failure to provide the degree of knowledge, care or skill of the average professional peer, in good standing, under similar circumstances. Essentially, anyone or any firm that holds themselves out as experts in a particular field can be held responsible for their work; their advice; their counsel. Professional liability is also referred to as "errors & omissions" ("E&O") or "malpractice" insurance.

 

Customer Information
Name of Business
Contact Name
Address
City
State
Zip
Business Phone
Fax
Best time to Call
A.M. P.M.
Contact Email Address

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Current Insurance Information
Company Name (not agency)
Policy Expiration Date
Premium Amount
$

About Your Business
# of full-time
employees
# of part-time
employees
How Long
in business
How many
locations
Annual Sales
years
Please give a brief description of your business and clientel (below)

Coverage Information
Please select the type of coverages you want
Bond

Commercial Auto

Commercial Liability

Commercial Property

Commercial Umbrella

D & O Liability

Disability

Group Health

Group Life

Professional Liability

Workers Compensation

Other

Additional Comments
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