Get Illinois Miscellaneous Application Form For Rli Insurance Company

Filling out the Illinois Miscellaneous Application Form for Rli Insurance Company is an essential step in securing professional liability insurance. This guide will help you navigate the process effectively, ensuring you complete each section with the required information accurately.

Follow the steps to complete the application form online.

1. Click ‘Get Form’ button to obtain the form and open it for completing the required fields.
2. Begin with section 1 where you will input the name of the applicant, their doing business as (DBA) name, and the appropriate street address including suite, city, state, and zip code.
3. Proceed to section 1b to indicate the type of applicant, selecting from individual/sole proprietorship, partnership, corporation, LLC, LLP, or other, providing necessary details where required.
4. In section 2, you will need to outline any additional entities related to the applicant that require coverage, if applicable.
5. Complete section 3 by providing the dates when the applicant was established and when they first offered their services and products.
6. In section 4, detail the professional activities or services for which you seek coverage. Make sure to include any necessary elaborations.
7. Continue to section 5, where you will list any professional activities that do not require coverage and their corresponding gross annual revenues, if applicable.
8. Fill out section 6 by recording the gross revenues for the indicated fiscal years, ensuring accuracy in your annual projections.
9. Sections 7 through 14 require detailed responses related to previous professional liability claims, client relationships, contractor engagements, and disciplinary actions; complete these sections with thorough explanations and additional sheets if needed.
10. In section 15, indicate the requested limits of liability and deductible amounts tailored to your organization’s needs.
11. Finalize the application by reviewing all sections for completeness, signing, and dating the form as indicated in the final section.
12. Once you have completed the form, you can save your changes, download a copy for your records, print the application, or share it as required.

Begin your application process online and ensure your professional activities are covered by Rli Insurance Company.