Transcription of JOB#: MISCELLANEOUS PROFESSIONAL LIABILITY …
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Example: dental hygienist
JOB#: MISCELLANEOUS PROFESSIONAL LIABILITY …
Page 1 of 4 MISCELLANEOUS PROFESSIONAL LIABILITY short form APPLICATIONNOTICE: THIS LIABILITY COVERAGE PART IS WRITTEN ON A CLAIMS MADE BASIS, AND AS SUCH, TO ALL PROVISIONS, APPLIES ONLY TO ANY CLAIM FIRST MADE DURING THE POLICY PERIOD. NO COVERAGE EXISTS FOR CLAIMS FIRST MADE AFTER THE END OF THE POLICY PERIOD, AND TO THE EXTENT THAT, THE EXTENDED REPORTING PERIOD APPLIES. DEFENSE COSTS REDUCE THE LIMIT OF LIABILITY AND ARE SUBJECT TO THE RETENTION. PLEASE REVIEW THE POLICY CAREFULLY AND DISCUSS THE COVERAGE WITH YOUR INSURANCE AGENT OR BROKER. 1. The Applicant to be named in item 1 of the Declarations (the named insured): Street Address (No Box): City: State: Zip: Telephone: Years in Business: Website: Prior Acts Coverage: If you currently have PROFESSIONAL LIABILITY or Errors & Omissions coverage in place, please give us the current Retro Date: 2.
page 1 of 4 miscellaneous professional liability short form application notice: this liability coverage part is written on a claims made basis, and as such, to all provisions, applies only to any claim first made during the policy period.
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