For the convenience of our users, we’ve made these important forms available online.
Here you can download applications, and other resources you may need to get started or manage your coverage. Simply select the form you need below, complete it at your own pace, and submit it as directed — making the process quick and straightforward.
A fill-in pdf version of the full application for the Legal Defense Expense Insurance Policy. Requested information includes practice details, prior or current insurance information, education, and past/current claims.
Required should you have been a party to a settled claim within the past ten years or have an open pending claim. A separate form is requested for each claim, medical incident, ACHA or any other action against your license.
Please download the Additional Coverages form should you desire to add these common additional endorsements to your policy: Medicare / Medicaid Defense, Legal Defense, Vicarious Liability.
If you are looking for a quick and easy application form to submit to our underwriters for review, please download our premium indication form.
View the flexible premium payment options Gulf Atlantic offers. Use this form to authorize premium payments via a credit card – either a single payment or a convenient recurring payment.
