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New Business Applications
Applications for Prospective Clients
Find below medical professional liability insurance applications for physicians, paramedical and allied healthcare professionals, and hospitals and facilities. Dental professional liability applications are on the DentistCare website ; select the 'How to Apply' menu item and then find your state in the drop box. Applications for the Ob-Gyn Risk Alliance (OBRA) are posted to OBRA's website ; select the 'How to Apply' menu item and then find your state in the drop box.
Completed applications can be emailed to our Service Center using Submissions@ProAssurance.com . For more information please call 800-282-6242.
Those seeking renewal applications can find then on the Renewal Applications page .
Select a State
Show All
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Select a Line of Business
Show All
Physicians
Physician Corporations
Physician Supplemental
Paramedicals
Allied Healthcare Professionals
Hospitals and Healthcare Systems
Multi-State Organizations
Physicians
Alabama
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9
pages
• 8.5 x 11 in • 479 KB
Arizona
|
9
pages
• 8.5 x 11 in • 543 KB
Arkansas
|
9
pages
• 8.5 x 11 in • 543 KB
Colorado
|
9
pages
• 8.5 x 11 in • 543 KB
Delaware
|
9
pages
• 8.5 x 11 in • 439 KB
Florida
|
9
pages
• 8.5 x 11 in • 503 KB
Georgia
|
9
pages
• 8.5 x 11 in • 543 KB
Idaho
|
9
pages
• 8.5 x 11 in • 543 KB
Illinois
|
9
pages
• 8.5 x 11 in • 439 KB
Indiana
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9
pages
• 8.5 x 11 in • 522 KB
Iowa
|
9
pages
• 8.5 x 11 in • 432 KB
Kansas
|
9
pages
• 8.5 x 11 in • 543 KB
Kentucky
|
9
pages
• 8.5 x 11 in • 439 KB
Maine
|
9
pages
• 8.5 x 11 in • 522 KB
Maryland
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9
pages
• 8.5 x 11 in • 522 KB
Michigan
|
9
pages
• 8.5 x 11 in • 439 KB
Missouri
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9
pages
• 8.5 x 11 in • 484 KB
Montana
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9
pages
• 8.5 x 11 in • 299 KB
Nebraska
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9
pages
• 8.5 x 11 in • 432 KB
Nevada
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9
pages
• 8.5 x 11 in • 428 KB
New York
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10
pages
• 8.5 x 11 in • 263 KB
Ohio
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9
pages
• 8.5 x 11 in • 522 KB
Oklahoma
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9
pages
• 8.5 x 11 in • 543 KB
Oregon
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9
pages
• 8.5 x 11 in • 543 KB
Texas
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9
pages
• 8.5 x 11 in • 430 KB
Utah
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9
pages
• 8.5 x 11 in • 299 KB
Vermont
|
9
pages
• 8.5 x 11 in • 522 KB
Virginia
|
9
pages
• 8.5 x 11 in • 424 KB
Wyoming
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9
pages
• 8.5 x 11 in • 543 KB
Physician Corporations
Alabama
|
4
pages
• 8.5 x 11 in • 197 KB
Arizona
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4
pages
• 8.5 x 11 in • 220 KB
Arkansas
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4
pages
• 8.5 x 11 in • 220 KB
Colorado
|
4
pages
• 8.5 x 11 in • 220 KB
Delaware
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4
pages
• 8.5 x 11 in • 172 KB
Florida
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4
pages
• 8.5 x 11 in • 196 KB
Georgia
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2
pages
• 8.5 x 11 in • 220 KB
Idaho
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4
pages
• 8.5 x 11 in • 220 KB
Illinois
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4
pages
• 8.5 x 11 in • 172 KB
Indiana
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4
pages
• 8.5 x 11 in • 146 KB
Iowa
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4
pages
• 8.5 x 11 in • 200 KB
Kansas
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4
pages
• 8.5 x 11 in • 220 KB
Kentucky
|
4
pages
• 8.5 x 11 in • 172 KB
Maine
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4
pages
• 8.5 x 11 in • 146 KB
Maryland
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4
pages
• 8.5 x 11 in • 146 KB
Michigan
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4
pages
• 8.5 x 11 in • 172 KB
Missouri
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4
pages
• 8.5 x 11 in • 184 KB
Montana
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4
pages
• 8.5 x 11 in • 154 KB
Nebraska
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4
pages
• 8.5 x 11 in • 200 KB
Nevada
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4
pages
• 8.5 x 11 in • 208 KB
New York
|
5
pages
• 8.5 x 11 in • 207 KB
Ohio
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4
pages
• 8.5 x 11 in • 146 KB
Oklahoma
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4
pages
• 8.5 x 11 in • 220 KB
Oregon
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4
pages
• 8.5 x 11 in • 220 KB
Texas
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4
pages
• 8.5 x 11 in • 180 KB
Utah
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4
pages
• 8.5 x 11 in • 154 KB
Vermont
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4
pages
• 8.5 x 11 in • 146 KB
Virginia
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4
pages
• 8.5 x 11 in • 176 KB
Wyoming
|
4
pages
• 8.5 x 11 in • 220 KB
Physician Supplemental
Paramedicals
Alabama
|
3
pages
• 8.5 x 11 in • 190 KB
Arizona
|
3
pages
• 8.5 x 11 in • 216 KB
Arkansas
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3
pages
• 8.5 x 11 in • 216 KB
Colorado
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3
pages
• 8.5 x 11 in • 216 KB
Delaware
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3
pages
• 8.5 x 11 in • 167 KB
Florida
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3
pages
• 8.5 x 11 in • 181 KB
Georgia
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3
pages
• 8.5 x 11 in • 216 KB
Idaho
|
3
pages
• 8.5 x 11 in • 216 KB
Illinois
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3
pages
• 8.5 x 11 in • 167 KB
Indiana
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3
pages
• 8.5 x 11 in • 221 KB
Iowa
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3
pages
• 8.5 x 11 in • 174 KB
Kansas
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3
pages
• 8.5 x 11 in • 216 KB
Kentucky
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3
pages
• 8.5 x 11 in • 167 KB
Maine
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3
pages
• 8.5 x 11 in • 221 KB
Maryland
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3
pages
• 8.5 x 11 in • 221 KB
Michigan
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3
pages
• 8.5 x 11 in • 167 KB
Missouri
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3
pages
• 8.5 x 11 in • 134 KB
Montana
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3
pages
• 8.5 x 11 in • 137 KB
Nebraska
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3
pages
• 8.5 x 11 in • 180 KB
Nevada
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3
pages
• 8.5 x 11 in • 168 KB
New York
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4
pages
• 8.5 x 11 in • 156 KB
Ohio
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3
pages
• 8.5 x 11 in • 221 KB
Oklahoma
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3
pages
• 8.5 x 11 in • 216 KB
Oregon
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3
pages
• 8.5 x 11 in • 216 KB
Texas
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4
pages
• 8.5 x 11 in • 170 KB
Utah
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3
pages
• 8.5 x 11 in • 137 KB
Vermont
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3
pages
• 8.5 x 11 in • 221 KB
Virginia
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3
pages
• 8.5 x 11 in • 180 KB
Wyoming
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3
pages
• 8.5 x 11 in • 216 KB
Allied Healthcare Professionals
Illinois
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6
pages
• 8.5 x 11 in • 171 KB
Michigan
|
6
pages
• 8.5 x 11 in • 171 KB
Hospitals and Healthcare Systems
Multi-State Organizations