Moonlighter Application for Professional Liability Coverage

ENCLOSED ARE THE FORMS NECESSARY FOR

MOONLIGHTING APPLICATION

Thank you for choosing to apply with TEXAS MEDICAL LIABILITY INSURANCE (TMLT). 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:

Completion of one year of residency training (internship) is required prior to applying for coverage.

You must be a member of the Texas Medical Association or have a membership application pending to obtain coverage through TMLT. To start this process, please visit the TMA web site www.texmed.org or call 1-800-880-1300

Missing or incorrect value

Please review the Business Associate Agreement. click here

Only claims-made coverage is offered.

When submitting your application, please enclose:

Your current CV

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Missing or incorrect value

A copy of your current declarations page

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

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Any additional documentation requested in the application

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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 1-800-580-8658 and ask for Underwriting or visit our website at https://www.tmlt.org/resources/frequently-asked-questions

Payment Options

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Billing email address

There are no finance charges or transaction fees associated with TMLT payment plans. You can set up recurring automatic payments once your policy is issued by contacting Customer Service at 1-800-580-8658 ext. 5050 for assistance.

Moonlighter Application for Professional Liability Coverage

ENCLOSED FORMS