These applications are generic and will be sent to several of our preferred Underwriters,
Supplemental Claims Applications
- Most Recent State Survey.
- Copy of your facility current license.
- Copy current and past 5 years loss history, please request them from your current broker/agent.
- Copy of your marketing brochure.
- Copy of your current policy declaration page from your professional liability insurance, this helps to make sure we match coverage`s, to avoid leaving out any coverage. We must match what you currently have and /or offer more coverage`s for less cost.
- Copy of Administrator resume and the DON