Dental Liability Excess and Surplus Program
is a program designed specifically for dental professionals who are unable to obtain professional liability insurance through a standard lines carrier.
· Limits vary from $100,000 per claim $300,000 aggregate to $1 Million per claim $3 Million aggregate
· Minimum per claim deductible not required
· No cap on number of dentists within a group
· World-wide coverage
· Claims-made coverage
· No consent to settle
· Expense within the limits of liability
· Corporate/entity coverage only to the extent of named insured's liability and on a shared limit basis
· Twelve-month extended reporting period (ERP) option
· No flat cancellation and 25% minimum earned premium
· Fully complete, signed and dated application.
· Other carrier's applications acceptable for premium indication. CNA application is required if indication is accepted. The application must be received prior to binding.
· A copy of applicant's current business letterhead: If not available, a letter of explanation is required. A copy of a billing statement or voided prescription sheet is acceptable.
· Complete claim data (past 10 years), including those claims that are closed without payment, pending or paid.
· The Supplemental Claim Information Form must be completed for each claim or incident which has occurred.
· Copy of applicant's current declaration page.
· Board transcripts must accompany any submission where the dentist has been the subject of a board inquiry. Compliance with any board stipulations must also be submitted. Indications will not be provided without this information.
· Applicants with any impairments must submit a treating physician statement. Premium indication will not be provided without a statement. This statement must be updated each year at renewal.
· License Verification - All applicants must have their license checked annually for board actions and active status. License action can be obtained via Internet or telephone call to the board.
· Evidence of Insurance for all dentists who the applicant shares space with, all non-CNA insured independent contractors and/or employee dentists. Certificates showing policies, which have expired, are not acceptable.
· Oral Surgeons Questionnaire (must be completed by all oral surgeon applicants).
· Insurance History - Any applicant who indicates he has practiced without insurance, had professional liability insurance refused, cancelled or non-renewed, must provide details including the dates and reason.
For questions or assistance please contact us at firstname.lastname@example.org or by phone at 888-336-3831.