Note: PMSLIC writes professional liability insurance in Pennsylvania and Delaware only.

Application Requirements for Pennsylvania Physicians

• Physicians and Surgeons Application
• Claims Supplement and Business Associate Agreement
• A copy of the Declarations page from the physician's most recent policy if Prior Acts coverage is requested

Application Requirements for Pennsylvania Entities

• Professional Corporation and Partnership Application
• Claims Supplement and Business Associate Agreement
• A copy of the Declarations page from the entity's most recent policy if Prior Acts coverage is requested
• A copy of the signed and date stamped Articles of Incorporation

To download the Pennsylvania application files, you must have Acrobat Reader installed on your computer. To install Acrobat Reader, click on the icon below to download it from Adobe's Web site.

Download Pennsylvania Applications:

I UNDERSTAND THAT THIS APPLICATION IS SUBJECT TO ACCEPTANCE BY PMSLIC AND DOES NOT BIND COVERAGE.

Please note that the following applications are for Pennsylvania-based medical professionals and practices.

Physicians and Surgeons Professional Liability Insurance application

Claims Supplement and Business Associate Agreement

Professional Corporation and Partnership application

Locum Tenens application

Designated Employee (Allied Professionals) application
(Please note that coverage for designated employees is available ONLY for employees of insured physicians or insured entities.)

If you have any questions, contact PMSLIC's Marketing Department.

Contact Information