Healthcare Liability Insurance for Cancer Care Centers

Click on the state that you wish to apply

Currently writing business
Currently not writing business
 

 

Please Note: If you are experiencing difficulty opening the above applications, you may need to upgrade your browser to
IE8 or higher, or Firefox 7 or higher. In addition, please be sure your pop-up blocker is disabled.
 
 
We use Adobe Acrobat
Reader to view PDF files

Complete the application and send to us:

Email: facilities@medpro.com

Fax: 972.543.9240

Mail:
Medical Protective
Healthcare Facilities Team
5814 Reed Road
Fort Wayne, IN 46835

Submission Requirements:

  • Current applications (MedPro Application required within 30 days of binding coverage)
  • Currently valued prior carrier loss runs (Minimum of 10 Years of Data)
  • Detailed narrative for open/closed claims >$50K
  • Current audited financial statement
  • Organizational chart
  • Schedule of physicians/advanced allieds requiring coverage