Get Cmic Physicians And Surgeons Professional Liability Application 2019-2025

This guide provides a clear and straightforward process for completing the CMIC Physicians And Surgeons Professional Liability Application online. By following these steps, users can ensure that they accurately and completely fill out the necessary information for their professional liability coverage.

Follow the steps to successfully complete the application:

1. Press the ‘Get Form’ button to access the application and open it in your preferred digital editor.
2. Begin with the Producer Information section by entering the name, address, phone number, and email of your insurance representative. Ensure that all fields are accurately filled out.
3. Move to the General Applicant Information section. Here, provide the complete name of the applicant, date of birth, title, gender, and all relevant addresses, including home and primary office addresses.
4. Continue to the Education section. Fill in the medical school of graduation, residency and fellowship training details, and ensure to attach a current copy of your curriculum vitae.
5. In the Limits of Liability section, select your desired limits for coverage and complete the specifics related to your practice locations.
6. Provide the Coverage Information by indicating desired effective and expiration dates for your policy. If applicable, check the appropriate status for prior acts exposure.
7. Complete the Practice Activities section by stating your medical specialty, sub-specialty, and percentage of practice dedicated to different types of surgical activities.
8. Answer all additional underwriting questions meticulously. Pay attention to ensure that each question is addressed, indicating 'N/A' where necessary.
9. Finally, review your application for completeness. You can save any changes, download or print the application, and ensure it is signed before submission.

Complete your application online to secure your professional liability coverage today.