Get Indication Form - Usi Affinity Lawyers Complete

The Indication Form - USI Affinity Lawyers Complete is designed to gather preliminary information for a non-binding indication regarding insurance coverage. This guide will assist you in accurately completing the form online, ensuring you can submit all necessary details effectively.

Follow the steps to fill out the Indication Form online.

1. Click the ‘Get Form’ button to access the Indication Form - USI Affinity Lawyers Complete and open it for editing.
2. Provide your contact information in the designated fields. Fill in the firm name, street address, city, state, zip code, county, phone number, fax number, email, and website.
3. Enter your insurance history. Specify your current carrier, expiration date, coverage limits, deductible, retroactive date, and annual premium.
4. List details of the attorneys within your firm. For each attorney, input their name, date of hire, position, and average weekly hours worked. If there are more attorneys, note that additional information can be provided on a separate sheet.
5. Indicate the areas of practice for your firm. Allocate percentages per practice area ensuring the total equals 100%. Fill in the corresponding fields showing the percentage of practice in each area listed.
6. Answer operational questions related to your firm’s practices regarding client fees, docket systems, engagement letters, and conflict avoidance systems. Use checkboxes to indicate your firm’s current processes.
7. Identify any professional liability claims or disciplinary actions against any lawyer in your firm in the past five years. Use the provided fields to elaborate if applicable.
8. Specify any wholly owned entities for coverage consideration, if applicable, by checking the relevant options.
9. Complete the section on solo practitioners by indicating if you work part-time at your law firm and providing average weekly hours spent in primary employment, if relevant.
10. Once all sections are completed, review the form for accuracy. You can then save changes, download, print, or share the form as necessary.

Complete your Indication Form - USI Affinity Lawyers Complete online to proceed with your insurance inquiry.