Law Firm Professional Liability Renewal Application

    Total Gross Billings for 12 months ending:

    Areas of Practice

    Attorneys and Predecessor Firms

    Roster of lawyers (include all lawyers affiliated with the firm, including "Of Counsels" and independent contractors)

    *Status = O - Owner, E - Employee, OC - Of Counsel, IC - Independent Contractor

    Lawyer Name


    Hours Worked per Week

    Approximate Month/Year of Hire

    File Opening and Client Management

    How often does the firm use:





    If the letters above are not used or not used in all circumstances please explain how the firm documents the commencement and discontinuation of services with a client.

    If you are a sole practitioner, please identify the lawyer with whom you have a written emergency coverage agreement and the expiration date of the agreement.

    Loss Information

    Within the past five years, has any firm member been the subject of any of the following disciplinary actions or investigations/proceedings?

    General Information

    Annual Payroll for:

    Two Major Benefits For You Happen Here:

    Plug Fatal Gaps

    Recommendations can be made to absolutely plug all fatal gaps in your Insurance

    Save Money & Time

    All of the comparisons can be done for you so you don’t have to figure it all out on your own

    This will take you roughly 15 minutes to complete the above secure true online professional liability application to make certain that you’re properly protected at marketplace best pricing.

    Act today, right now while you are thinking of this!