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The premier provider of medical professional liability insurance for physicians, other medical professionals, clinics, and hospitals in Washington, Oregon, and Idaho. |
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Policy Requests
For each of the following applications, forms, and questionnaires, please complete the information, sign, and send it to us. Send by fax to (206) 343-7100, by e-mail to marketing@phyins.com, or by mail to Physicians Insurance, PO Box 91220, Seattle, WA 98111. Please note that we require a signature for processing.
Professional Liability Insurance Applications Applications and Forms Specialty Questionnaires Professional Liability Insurance Applications For personal assistance with either of the following professional liability insurance applications, please contact our Marketing Department at (206) 343-7300 or 1-800-962-1399. Corporation/Partnership Professional Liability Insurance Application (available for practices with two or more physicians) Physicians and Surgeons Professional Liability Insurance Application Applications and Forms For personal assistance with any of the following applications and forms, please contact our Underwriting Department at (206) 343-7300 or 1-800-962-1399. Ambulatory Surgical Facilities Underwriting Information Form Increase Limits of Liability Application Locum Tenens Application Midlevel Provider Application Midlevel Providers Providing Care to Obstetrical Patients Application Moonlighting Residents & Fellows Application Per-Diem Physician Application Practice Change Application Suspension Request Form Specialty Questionnaires For personal assistance with any of the following specialty questionnaires, please contact our Underwriting Department at (206) 343-7300 or 1-800-962-1399. Acupuncture Questionnaire Bariatric Surgery Questionnaire Body Imaging Questionnaire Nighthawk Questionnaire Pain Management Questionnaire Practice Association Questionnaire Refractive Surgery Questionnaire Sleep Medicine Questionnaire Teleradiology Questionnaire |
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