Get Professional Liability Insurance Occurrence Application
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How to fill out the Professional Liability Insurance Occurrence Application online
Completing the Professional Liability Insurance Occurrence Application online is a vital step for professionals seeking insurance coverage. This guide provides clear, step-by-step instructions tailored to assist users in accurately filling out the application.
Follow the steps to successfully complete your application.
- Click ‘Get Form’ button to access the application form and open it in your chosen online editor.
- In the applicant information section, provide the firm's name, owner(s), and their practitioner certifications. Specify the type of firm, such as Staffing/Registry or Rehab Clinic.
- Identify the contact person and indicate if the business is operating under a different name. Fill in the address details, including city, state, and zip code.
- Confirm whether the firm is a franchise and if there are any expected changes in operations over the next year, providing explanations where required.
- Respond to questions about the firm's incorporation status and if all services are provided from the listed location.
- Complete the hiring/screening and employment procedures section by marking 'Yes' or 'No' to various employment verification questions and detailing how references and background checks are conducted.
- Fill out the risk management and quality assurance section, indicating licensing status in the operational states and documenting any past license issues.
- In the claims history section, disclose any past claims made against the applicant or employees, noting if there are any known circumstances that could lead to future claims.
- Proceed to the professional liability section to detail employees/independent contractors, including their professions and annual payrolls.
- Specify the location where services are provided, ensuring the total percentage equals 100%. Likewise, complete the type of services provided section, again ensuring total percentage equals 100%.
- Indicate whether the firm provides overnight services and disclose previous professional liability insurance coverage for the past five years.
- Decide if you would like optional general liability coverage, completing the necessary sections if 'Yes' is selected.
- Confirm the existence of written agreements with third parties and note any mutual indemnification or hold harmless agreements.
- Fill in the agent/broker information, sign the application, and add the date.
- Once you have filled out all sections, review your inputs for accuracy and completeness. Save changes, download, print, or share the form as needed.
Start your Professional Liability Insurance Occurrence Application online today!
The per-occurrence limit is the most your insurance company will pay for a single covered loss under the terms of your policy.
Fill Professional Liability Insurance Occurrence Application
Your NSO professional liability insurance uses the occurrence form. An occurrence policy protects you from any incident occurring while the policy is in force. The policy then covers those incidents forever. "Claims-made" insurance protects you from malpractice claims only if the company that insured you at the time of the alleged "occurrence" is the same company. An occurrence policy provides coverage for incidents that happen during your policy period, regardless of when you file a claim. With your fully completed, signed and dated application, please submit the following information: 1. Current coverage verification (i.e. An occurrence form covers losses that happen during the policy period, regardless of when the claim is made. The loss can be reported years later. Professional liability insurance protects businesses that provide advice and services against negligence claims.
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