Attorneys Errors & Omissions Indication Request

 You can use the secure online form below to request a premium indication or contact one of our brokers at (925) 677-7400.

Attorney Malpractice Application

APPLICANT INFORMATION:

Are any attorneys employed part-time (750 hour per year or less)?



Does your firm specialize more than 50% in any area of practice?



Does your firm practice in any of the following areas of practice (AOP)?







In the past five years has any professional liability claim or suit been made against the applicant or predecessor firms?



COVERAGE REQUEST:

POLICY HISTORY (if currently insured):

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