Transcription of Specified Professions Professional Liability …
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Specified Professions Professional Liability …
App_Professional_Specified_Professions_L iability 07/14 This application is for a Claims Made policy. Please read your policy carefully. Defense costs shall be applied against the deductible (except in New York). Applicant may qualify for an INSTANT QUOTE by completing Section I below. Section II answers will be required prior to binding and are subject to 1 of 4 Specified Professions Professional Liability Application - All StatesII. UNDERWRITING INFORMATION1. a) Date established: _____ b) If business has been in operation less than one year, please provide principal, partner or key employee s a) Is the Applicant controlled, owned, affiliated or associated with any other firm, corporation or company?
app_Professional_Specified_Professions_Liability 07/14 FRAUD STATEMENTS Alabama, Arkansas, District of Columbia, New Mexico, Rhode Island and West Virginia: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty …
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