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AA-1000 (10/11) ATTN: UNDERWRITING DIVISION Twenty North Michigan Avenue Suite 700 Chicago, IL 60602 Telephone 312-782-2749 Toll Free 800-782-4767 Fax 312-782-2023 www.ismie.com Application for Processing
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How to fill out physician application - ismiecom
How to fill out physician application - ismiecom?
01
Visit the ismiecom website.
02
Locate the physician application section on the website.
03
Click on the application form to download it.
04
Open the downloaded application form on your computer.
05
Read through the instructions carefully before filling out the form.
06
Fill in your personal information such as name, contact details, and address.
07
Provide your medical qualifications, including your education and credentials.
08
Include information about your current medical practice or employment.
09
Fill in details about any previous malpractice claims or disciplinary actions, if applicable.
10
Provide information about your liability insurance coverage, if you have any.
11
Review the completed application form to ensure accuracy and completeness.
12
Submit the application form as instructed on the ismiecom website.
Who needs physician application - ismiecom?
The physician application - ismiecom is needed by healthcare professionals who are looking to become members of the Illinois State Medical Inter-Insurance Exchange (ISMIE). This application is specifically designed for physicians who are seeking liability insurance coverage from this organization.
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What is physician application - ismiecom?
Physician application - ismiecom is a software application designed for physicians to complete and submit their application for malpractice insurance coverage through ISMIE Mutual Insurance Company.
Who is required to file physician application - ismiecom?
All physicians who wish to obtain malpractice insurance coverage through ISMIE Mutual Insurance Company are required to file the physician application through ismiecom.
How to fill out physician application - ismiecom?
Physicians can fill out the physician application on ismiecom by creating an account, entering their personal and professional information, answering relevant questions, and submitting the application electronically.
What is the purpose of physician application - ismiecom?
The purpose of the physician application on ismiecom is to collect necessary information from physicians in order to underwrite and provide malpractice insurance coverage through ISMIE Mutual Insurance Company.
What information must be reported on physician application - ismiecom?
Physicians must report personal information, professional credentials, areas of practice, claims history, and other relevant information on the physician application through ismiecom.
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