Lawyers Professional Liability Insurance

Quick Quote Form

Firm Information

Areas of Practice

Please provide percentages of time devoted during the previous year in each area of parctice (MUST TOTAL 100%).

  • Plaintiff Lit - Class Actions
  • Business Formation
  • Environmental Regulatory
  • Plaintiff Lit - Legal Malpractice
  • Business Transactions - General
  • Estate & Probate - General
  • Plaintiff Lit - Medical Malpractice
  • Civil Lit - General
  • Estate Planning and Trust Admin
  • Plaintiff Lit - Personal or Bodily Injury
  • Com. & Corp. General Lit - Defense
  • Family Law / Juvenile Rights
  • Plaintiff Lit - Social Security, Workers Comp.
  • Com. & Corp. General Lit - Plaintiff
  • Immigration
  • Public Utilities (not finance)
  • Corporate Finance
  • Intellectual Property
  • Real Estate - Finance
  • Creditor/Debitor Rights and Collections
  • Investment Advice
  • Real Estate Residential & Basic Commercial
  • Criminal Defense
  • Mediation, Arbitration
  • Schools & Education (not finance)
  • Defense Lit. Insurance Carrier Rep.
  • Mergers & Acquisitions
  • Securities/Private Plcmnts/Public Regist. (*)
  • Elder Law
  • Municipal - General (not finance)
  • Employee Benefits Plans, ERISA
  • Municipal - Finance or Bonds
  • Tax Preparation - Individual
  • Employment Law - Employee Rep
  • Oil & Gas, Mineral Rights
  • Taxation(ex. estate tax & individual tax prep

If "Securities/Private Plcmnts/Public Regist." contains a value:
enter the # of investers

Attorney Name Individual Retro Hours/Week-Part Time or Full Time
(Part Time is 25 Hours/Week or Less)		 Employee Status

To add more than five attorneys, please complete and submit downloadable PDF

  1. Are you currently Insured? Yes No
    If Yes, Carrier
    Premium
  2. Check the limit and deductible options below that you are interested in seeing a quote for, you may selecte more than one:
    • Requested Limits of Liability (per claim/annual aggregate - listed in thousands):
      $100,000/$300,000 $250,000/$750,000 $500,000/$1,500,000
      $1,000,000/$2,000,000 $2,000,000/$4,000,000 Other
    • Deductible
      $0 $1,000 $2,500 $5,000 Other
  3. Has any professional liability claim been made or suit brought against the firm, any predecessor firm, or any member of the firm? Yes No
    If Yes, how many?
    Name(s) of claimaint(s):

    A complete Claim Supplement form must be provided for each claim or suit.

Note This form is for Estimate Purposes Only. Coverage May Be Bound Only Upon Submission and Acceptance of a Completed Application