Durable Medical Equipment (DME) Insurance Indication

You can use the secure online form below to request a premium indication. You can also download a copy of our full application to complete offline and fax to (925) 677-7401 or email to healthcare@polaris-ins.com. If you would also like an indication for a bond you can download our bond application. Contact one of our risk specialists at (925) 677-7400 if you have any questions or need additional assistance.
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1800 Sutter Street, Suite 775, Concord, CA 94520  |  Ph: 925.677.7400  |  Fx: 925.677.7401 | CA License #0D80810
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