Indication Form

Lawfirm Professional liability  
Firstname*:
Lastname*:
Address*:
City*:
State*:
Zip / Postal Code*:
Phone*:
Fax:
Email*:
Website Address:
   
1. Please provide the number of full time attorneys within your firm, & their years of experience:
   
Yrs w/this Firm: # of Attorneys:
5+
4
3
2
1
   
2.Please tell us what percentage of Billable Hours - not income - you spend in the following areas of practice (please express in whole numbers):
   
% of Time : Areas of Practice:
Admirality / Marine
Banking / Financial Institutions
Business Transaction / Commercial Law
Civil Litigation / Plaintiff (not personal injury)
Civil Litigation / Defense
Civil Rights / Discrimination
Collection & Bankruptcy
Construction (Building Contracts)
Consumer Claims
Coporate Business Organization
Criminal
Environmental Law
Family Law
Governmental Contracts / Claims
Immigration / Naturalization
Intellectual Property (Patent, Trademark, Copyright)
Labor Law
Local Government
Natural Resources / Oil & Gas
Other:
Personal Injury / Property Damage - Plaintiff
Personal Injury / Property Damage - Defense
Real Estate / Title - Commercial
Real Estate / Title - Residential
Securities (SEC)
Taxation
Wills, Estate, Probate & Planning
Workers Compensation - Defense
Workers Compensation - Plaintiff
100%
 
3. Please tell us about your current coverage:
 
Number of years of continuous coverage:
Retroactive Date (if any) :
 
 
 

Whether you’re a sole practitioner, independent contractor, or law firm in Pennsylvania, New York or California, whether you are a full-time, part-time attorney or just moonlight, we have the right lawyers’ professional liability insurance plan for you.