• Professional Liability Insurance Online Quote - Florida

    To obtain the most accurate quote,please complete all fields below.
  • Format: (000) 000-0000.
  • Does The Firm Have Any Additional Locations?*

  • Firm Details

    Please answer the following questions about your law firm
  • Applicant firm is*
  • Is the number of non-attorney staff higher than 5 times the number of attorneys at your firm?*
  • Rows
  • Does any outside attorney provide services to your firm in any of the following capacities: Of Counsel, independent contractors, per diem attorneys?*

  • Areas of Practice

  • GROUP 1

  • Rows

  • GROUP 2

  • Rows
  • In the past five (5) years, has the Applicant Firm provided legal services for a cannabis industry client?*
  • In the past five (5) years, has the Applicant Firm provided legal services for a cryptocurrency or blockchain client?*

  • Please respond to all following questions that apply to the Applicant Firm’s areas of practice above:

  • a. In the past 5 years, have there been more than two plaintiff cases with a value greater than $5 million?*
  • b. For any legal or medical malpractice cases, is any of the work done in house (not referred to other firms)?*
  • a. During the past 5 years, has the firm had more than two residential real estate or condo transactions greater than $10 million ?*
  • b. During the past 5 years, has the firm had more than two commercial transactions greater than $50 million ?*
  • c. Does your firm, or any attorney for whom coverage is sought, wholly own a title agency ?*
  • d. During the past 5 years, of all commercial real estate transactions, was the percentage that involved more than 5 passive investors higher than 5% ?*
  • a. Has the firm received more than one allegation or notice of violation of the Fair Debt Collections Practices Act or any similar “fair debt collection” law?*
  • a. Is discretionary investment authority either greater than $1 million or not limited in writing?*
  • a. Has any past or present financial institution client of the firm ceased operations, gone insolvent or become controlled or operated by the FDIC, OCC, OTS, or any other government agency?*
  • 8. Please indicate which of the traits below apply to your firm (select all that apply):
  • a. Does any lawyer of the Applicant Firm practice in jurisdictions outside of the United States?*
  • b. In the past 5 years, has any attorney currently working at the firm provided service as an Officer, Director, Regulatory or General Counsel?*
  • c. In the past 5 years, has the firm filed three or more suits to collect unpaid client fees?*
  • d-1. Has anyone at your firm been disbarred?*
  • d-2. Has anyone at your firm been the subject of reprimand, censure, sanction, or other disciplinary action?*
  • d-3. Has anyone at your firm been convicted or pled guilty to a crime? :*
  • d-4. Has anyone at your firm:*
  • d-5. Has anyone at your firm been refused admission to the Bar? :*
  • e-1. In the past 5 years, has any attorney at your firm been the subject of a professional liability claim?:*
  • e-2. In the past 5 years, has any attorney at your firm had knowledge of anything that could result in a professional liability claim that has not yet been reported to an insurance carrier?*
  • e-3. In the past 5 years, has any attorney at your firm had professional liability insurance cancelled or non-renewed for any reason other than the insurance carrier exiting the market? (Missouri Applicants Need Not Reply) :*

  • 9. Coverage Information

  • a. Does your firm currently have Professional Liability insurance?*
  • What is the expiration date of your policy?
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  • b. Does your current policy have a retroactive or prior acts date listed on your firm?*
  • What is the expiration date of your policy?
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  • c. Has the firm had continuous professional liability coverage from the retroactive or prior acts dateindicated above to present?*
  • d. When would you like your policy to start?*
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  • e. Limits Requested – Per Claim/Aggregate:
  • f. Deductible Requested
  • Deductible Type:*

  • Signature

    Please read carefully and sign below where indicated.

    The undersigned proprietor, partner, member or officer, acting on behalf of the Applicant Firm and all others to be insured, hereby,

    1. Declares after diligently inquiry that the above statements and particulars are true and that no material facts have been omitted or misstated to the best of his or her knowledge;
    2. Understands and agrees that the completion of the application does not bind the Company to issue no the Applicant Firm to purchase the insurance; and
    3. Acknowledges that (1) this application will be the basis of the policy, if issued; (2) all written statements and material furnished to the company in conjunction with this application are hereby incorporated by reference in this application and made part hereof; and (3) if the Company issues a policy, the Company will have relied upon, as representations, the declarations and statements which are contained in or attached to orincorporated in this application.
  • Date*
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  • NOTICE TO FLORIDA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DEFRAUD, OR DECEIVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY OF THE THIRD DEGREE.

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