Legal Malpractice Insurance Application

Download, fill out, and return this one-page premium estimate form.

It will give the insurers enough information about your practice to provide you with “ballpark” terms, without your having to complete a full application.

We’ll send your form to all suitable insurers, and contact you as they respond. If you like any of the estimates that we obtain, then you can complete a full application and provide any other information that the insurer needs to offer you a firm, final proposal. The premium of the final proposal usually matches or is very close to the estimate.

NOTES:

        •   If you filled out a full renewal application for your current insurer (not a one
or two page form that asks if your practice has changed in the last year), then send us that, instead of filling out the premium estimate form.

       •   The premium estimate form contains a grid that requires you to allocate your   firm’s last 12 months’ billings among its practice areas.

Securities law, Tax law, and other practice areas that the insurers consider higher risk, require completion of a supplement.

Attached to the premium estimate form is a page that contains the supplemental questions for Plaintiff’s Litigation, Real Estate law, Collections, and Mergers & Acquisitions.

Download the supplement for other practice areas below, or send us the most recent supplement(s) that your firm completed for its current malpractice insurer.       

        •   If you’d rather submit a complete application, download it below, along with any necessary supplements, and a roster, if your firm has two or more attorneys.   

The forms below are in portable document format (PDF), for which you must have  Adobe Reader. You can download it here: Get.Adobe.com/Reader

MAIN APPLICATION

Legal Malpractice Insurance Application (Solo Practitioner)

Legal Malpractice Insurance Application (2 or more attorneys)
Attorney Roster (2 or more attorneys)

PRACTICE AREA SUPPLEMENTAL APPLICATIONS bbbbbbbb

If 1% or more of your practice is in any of the following areas, please complete the supplemental application below.

Supplemental Application – Banking/Financial Institutions

Supplemental Application – Business Transactions (Word document)

Supplemental Application – Class Actions/Mass Torts/MDL

Supplemental Application – Entertainment

Supplemental Application – Family Law  (Word document)
Allocate your Family Law billables among Divorce, Guardianship, etc. Ignore the rest of the form. 

Supplemental Application – Intellectual Property

Supplemental Application – Plaintiffs’ Personal Injury

Supplemental Application – Real Estate

Supplemental Application – Securities

Supplemental Application – Tax (scroll down to p.3)

Supplemental Application – Title Agency

Supplemental Application – Trusts & Estates

OTHER SUPPLEMENTAL APPLICATIONS
If you’ve been involved in any malpractice claim or suit in the last five years, or are aware of an incident which may give rise to a claim, please complete the form below for each claim or incident.

Supplemental Application – Malpractice Claim Information

If any lawyer in your firm currently serves as director, officer, trustee or partner of any entity which is a client of the firm, or has held an equity or financial interest in a client in the last five years, please complete the Outside Interests supplement below.

Supplemental Application – Outside Interests

If you have more than one office, please complete the Additional Locations supplement below.

Supplemental Application – Additional Locations

If you share office space with one or more attorneys who aren’t affiliated with your firm, please complete the Office-Sharing supplement below.

Supplemental Application – Office Sharing

OTHER REQUIRED DOCUMENTS

If your firm currently has malpractice insurance, then addition to the application, please send us the following documents, as we must provide them to insurers to obtain pro-posals for you:

*A copy of the Declarations page from your firm’s current policy, which is the first page (it says “Declarations” on it). 

*The Individual Prior Acts Retroactive Date Endorsement from the firm’s current policy. It lists each attorney and his/her retroactive date, which is how far back their coverage extends (it’s usually the same as the attorney’s date of hire, or for the founding attorney(s), the date the firm opened). If there’s a separate Prior Acts endorsement for the firm, please provide that as well.

You can either print, scan, and email these documents to us, or email us the entire policy, which will entail less effort. (After the Declarations page are the endorsements, most of which are common to every policy, and the “boilerplate” contract language that’s in all of the insurer’s legal malpractice policies).  

OTHER REQUIRED DOCUMENTS IF YOUR FIRM’S MALPRACTICE COVERAGE HAS BEEN NON-RENEWED

We’ll also need these documents to obtain quotes for you:

*A copy of the non-renewal notice that the current insurer sent to your firm.

*A loss run, which is a summary of the firm’s claims activity printed on the insurer’s letterhead. It lists all claims that the firm has reported to that insurer, the total dollars the insurer has paid to resolve each closed claim, and the amounts it has both paid to date and posted in reserve for each open claim.

You can obtain it by emailing either your insurer’s customer service department or the person who sent you the non-renewal notice; be sure to include your firm’s policy number.

WHERE TO SEND COMPLETED APPLICATIONS

Please email completed applications to Curt Cooper: ccooper “at” lawyersinsurer.com. If you have any questions, send an email, or call 202-802-6415.

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