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Insurance
Medical Professional Liability Insurance
Employer Stop Loss Solutions
Medicare Contractual Risk Protection
Provider Excess Loss Insurance
International
Coverys Europe
Coverys London
Services
Risk Management
Business Analytics
Education
Claims
About Us
Inside Coverys
Financial Strength
Careers
Coverys Community Healthcare Foundation
Knowledge Center
Find an Agent or Broker
Request A Quote
Name:
Specialty:
Phone:
Email:
Coverage Requested:
Select One
Modified claims-made
Claims-made
Occurrence
Retroactive date:
Limits:
Select One
$100K/$300K
$200K/$600K
$1M/$3M*
Other
Requested effective date:
Number of hours worked per week in office and hospital:
Select One
20 or less
21-30
31 or more
Please list any physicians in your practice that are insured through Coverys:
Claims in the past 10 years?:
Select One
Yes
No
If yes, how many?:
Total of the settlement amounts: