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TDIA

Current clients

Applications, forms, and changes.

Everything a current client needs, in one place.

A clipboard, a stack of forms, and a pen on a desk

What we need to quote you.

The first three decide the price. The rest decide the terms.

The completed application
Answer every question. The carrier returns an incomplete application, which delays the quote by days rather than hours.
Your current declarations page
The declarations page states your limits, your retroactive date, and the policy period. The retroactive date decides which policy answers a claim about earlier care. What a retroactive date does
Loss runs for the last six years
Ask each carrier to send the loss runs to us directly. A loss run lists claims and payments. Send the report, not a summary of it.
A current CV
Show the month and year for each position. Explain each gap. The carrier asks about every gap it finds.
Your tail quote, if you have one
A tail extends the reporting period after a claims-made policy ends. If your current carrier quoted a tail, send the quote so we can compare it against the alternative. Estimate a tail premium
Board certification
Send the certificate or the board number. Certification can change the class the carrier assigns.
The exact wording for a certificate of insurance
A hospital, landlord, or medical group asks for a certificate. Send us the exact legal name and address of the party that needs it. A wrong name means a second certificate.

Forms.

Fill these in on your computer. Every field accepts typed text.

Professional Liability Express Application

Use this to apply for medical malpractice coverage with The Doctors Company.

PDF, 14 pages, 468 KB. The Doctors Company form J11161B, revision 7/17.

Download the form

Practice Address or Procedure Change Request

Use this to tell The Doctors Company that your practice address or your procedures changed.

PDF, 2 pages, 69 KB. The Doctors Company revision 10/2016.

Download the form

The Doctors Company publishes these forms. It also takes the application on its own site.

How to send it.

Fax
(858) 800-4804

Tell us when the practice changes.

Add a physician or clinician

Contact us after the clinician accepts the offer. Do not wait until the start date.

(858) 345-1370

Report a practice change

Contact us before you add an entity, location, service, or contract.

(858) 345-1370

Review a renewal

Tell us the renewal month and each change since the last application.

(858) 345-1370