LSA Entity Application For Professional Liability Coverage

ENCLOSED ARE THE FORMS NECESSARY FOR

ENTITY APPLICATION

Thank you for choosing to apply with LSA. We know that you have choices when purchasing liability insurance to protect your reputation and your medical practice. We appreciate the opportunity to earn your business.

A few items that are especially helpful to know at the start of the application process:

Please review the Business Associate Agreement. click here

Entity coverage may not be available unless all partners, shareholders, and employed physicians are insured by the company.

Coverage is not typically available if you have an uninsured period (gap). Please contact us to discuss further.

When submitting your application, please enclose:

A copy of your current declarations page

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Current loss run(s) for a five-year period

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Select File

Any additional documentation requested in the application

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Select Files

We want to make your application experience as simple as possible. If you have any questions during the process, we will be happy to assist you. Call 1-844-595-8866 and ask for Underwriting or visit our website at https://www.lonestar.com/resources/frequently-asked-questions-2

Payment Options

Which billing and payment option is right for you?Missing or incorrect value

Billing email address

There are no finance charges or transaction fees associated with LSA payment plans. You can set up recurring automatic payments once your policy is issued by contacting Customer Service at 1-844-595-8866 ext. 5050 for assistance.

LSA Entity Application For Professional Liability Coverage

ENCLOSED FORMS