Welcome to our online quote process.

To receive a free attorney malpractice insurance quote, please fill out the following form. We typically respond within one business day.

This information is used solely to provide the insurance proposal you are requesting.

If you would prefer to talk to us about your malpractice insurance quote, please call (800) 817-6333 from 7 a.m. to 4 p.m. Pacific Standard Time.

Please provide us with pertinent contact information for your firm:

Your Name


Firm Name

Address


City


State

Zip


(Please note that our services are available only for the states listed.)

Email


Phone



List the first date of employment for each attorney employed in your firm. Include yourself and any "of counsel" and "independent contractor" attorneys you want insured in your policy.

Start Date (mm/yy, mm/yy, mm/yy, etc.)


Do you practice Part time?
YesNo

If part-time, please complete the following:

Average # of hours per week:
per week

Length of time you have been working these hours:


Estimate the percentage of hours per year you work in each area of practice. (Must total 100%)

%

%

%

%

% Other (if above 5%, describe below)



Does your firm currently have professional liability insurance?
YesNo

Current policy expires on (approximate date if unknown):

Month Year

The estimated date you first became insured and have been insured continuously ever since:

Month Year

Desired Limits:

Who referred you to us?



We’d like to send them a thank you!

Any additional Comments or Questions:



Please answer this simple math question to prevent SPAM