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(OFFICE USE) APPLICATION DATE: Oct. TO Sept. NEW HAVEN COUNTY BAR ASSOCIATION LAWYER REFERRAL SERVICE CERTIFICATION AND AGREEMENT PROFESSIONAL MALPRACTICE PANEL I hereby certify that I have handled
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exp panel applic prof-maldoc is a form used to apply for professional malpractice insurance coverage.
All professionals in a specific field who are seeking malpractice insurance coverage are required to file exp panel applic prof-maldoc.
Exp panel applic prof-maldoc can be filled out by providing accurate information about the professional seeking malpractice insurance coverage, including details about their field of expertise and previous claims history.
The purpose of exp panel applic prof-maldoc is to assess the risk level of a professional seeking malpractice insurance coverage and to determine the appropriate coverage and premium rates.
Information that must be reported on exp panel applic prof-maldoc includes details about the professional's education and training, current practice details, any past malpractice claims, and desired coverage limits.
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LRS NHCBA Oct Sept remitted advocacy enclose CERTIFICATION certify REFERRAL waiver thereof labeled requirement MALPRACTICE

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