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Allied Health Submission Requirements |
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Please
contact us about your specific
risk as some requirements can be waived.
• Completed applications.
• Currently valued loss runs for the last 5 years.
• Detailed description of all claims greater than $25,000.
• Insured’s brochures, web site and/or description of operations.
• Copy of the current declarations page to include coverage form, limits and retro
date if applicable.
• Expiring company and premium with target price if available.
• Last annual financials of the insured.
• Where appropriate, a breakdown of all procedures done by the insured. If possible
this should be more detailed than the application.
• Copy of state facility license.
Surgery Centers – the following must also be included
• Any certification the insured has, i.e. AAHC. This includes any inspection or
report done by the certifying organization. (This is the full report done not just
the cover page. If it is current and addresses appropriate issues, it might allow
the waiving of the required inspection.)
• Medical bylaws. If they do not address the doctor’s limits requirement, this should
be stated on the insured’s letterhead.
• Any and all transfer agreements.
Start Up Facilities – the following must also be included
• ProForma financials
• Copy of business plan
• Copy of procedures manual
• Resume of key individual(s)
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