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Application for Classmate Coverage Professional & Dental Business Liability Insurance The Dentists Insurance Company 1201 K Street, 17th Floor, Sacramento, CA 95814 Please type or print Clear Form
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How to fill out application for claims-made coverage:

01
Start by gathering all the necessary information and documentation, such as personal details, contact information, and professional history.
02
Carefully read the instructions provided in the application form to ensure you understand each section and requirement.
03
Begin filling out the application form by entering your personal information, including your full name, address, phone number, and email address.
04
Provide the details of your professional background, including your education, certifications, and any relevant experience.
05
Specify the type of coverage you are seeking, in this case, claims-made coverage.
06
Clearly state the effective date or desired start date for the coverage.
07
Fill out the claims history section, reporting any past claims or incidents that may impact your coverage eligibility.
08
Attach any requested supporting documents, such as copies of licenses or certifications.
09
Review the completed application form thoroughly to ensure accuracy and completeness.
10
Submit the filled-out application form, along with any required payment, either electronically or via mail, as per the instructions provided.

Who needs application for claims-made coverage?

01
Individuals or professionals seeking liability insurance coverage for claims made against them for professional errors, mistakes, or negligence.
02
Organizations or businesses that want to protect their employees or professionals from potential legal claims related to their services or products.
03
Those involved in high-risk professions, such as doctors, lawyers, consultants, or contractors, commonly require claims-made coverage to protect themselves and their assets from potential lawsuits.

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