Insurance Specialists, Inc. Has Been Providing Professional Liability Insurance Since 1965
Lawyers Professional Liability Insurance Premium Estimate
Applicant Firm Information
Firm Name Contact Person # of Attorneys in Firm Phone Number Fax Number
Street Address( City, State, Zip Code, County)
E-mail Address
Practice Survey Indicate the percentage of firm income derived from each area of practice.
1. Area of Practice % of Firm Income 4. Area of Practice % of Firm Income
2. Area of Practice % of Firm Income
5. Area of Practice % of Firm Income
3. Area of Practice % of Firm Income
6. Area of Practice % of Firm Income
To receive RaPid Rate premium estimate, please complete and return this request to:
Insurance Specialists, Inc.- Professional Liability Dept. 12 Lenox Pointe Atlanta, GA 30324
Please attach a copy of firm letterhead and a copy of policy declarations page( if available). Coverage may be bound only upon submission and acceptance of a fully completed application.
Phone:( 888) ISI-1959 • Fax:( 866) 871-2170 |
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E-mail: SalesDirect @ isi1959. com |
Agent |
Date of Completion |