Please share a few details about your current medical malpractice insurance situation so we can best assist you at renewal time.
Insurance Renewal Month
Practice Name *
# of Physicians in Practice *
First Name *
Last Name *
Current Medical Malpractice Insurer *
The Doctors Company
MLMIC (Medical Liability Mutual Insurance Company)
PRI (Physicians’ Reciprocal Insurers)
Hospitals Insurance Co., Inc.
Current Medical Malpractice Insurer
Please enter your current medical malpractice insurer.
Orthopedic Surgery – Including Spine
Orthopedic Surgery – No Spine
Number of Claims in past 6 years *
Coverage Limits *
Do you work less than 20 hours per week? *
Are there other physicians or midlevel providers in your practice? *