How to Apply

Medical Practitioners Application
Claims-Made Coverage

Thank you for your interest in applying for Professional Liability Coverage from Millennium Insurance Company. The application is several pages long and certain specific information will be required. Before beginning, please make sure you have the following items available:
  • Social Security Number
  • Tax ID Number
  • Prior Carrier Information
  • Claims Information
  • Medical License Numbers
  • DEA License Number
We offer claims-made coverage. This provides coverage for claims reported during the policy year - regardless of when the incident occurred.

By downloading a digital file of the application, you agree that you understand that the completion of this application and subsequent submission of this application does not guarantee coverage or that coverage will be offered.
 
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