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Dental Malpractice Insurance Quote


It only takes a few minutes to request a quote.

Compare our rates and coverage before you renew your current insurance.

Yes, I am interested in receiving a Coverage and Rate Quotation for my practice. I understand that I am under no obligation by requesting this information.



Company Information
Company Name
Required
First Name
Required
Last Name
Required
Street
Required
City
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
Fax Number
Optional
E-Mail Address
Required
Best time to contact
Optional
How would you like to receive your quote?
Optional


A. AVAILABLE PREMIUM CREDITS
Check (4) all that apply
Optional







Organizations
Optional
B. PROFESSIONAL LIABILITY COVERAGE
I am currently Insured
Required

If claims-made, what is your retroactive date?
Required
/ /
Please quote
Required


DENTAL PROFESSIONAL LIABILITY LIMITS - Please check desired limit option
Optional




Requested effective date
Required
/ /
Are you a General Dentist?
Required

If limiting your practice to a specialty, are you licensed in that specialty?
Required

Level of Sedation Used
Required
What is your specialty?
Optional





Please provide the percentages (based on number of procedures) of your practice which fall into the following CDT codes (must total 100%)
Diagnostic - D0100 - D0999
Optional
Preventive - D1000 - D1999
Optional
Restorative - D2000 - D2999
Optional
Endodontics - D3000 - D3999
Optional
Periodontics - D4000 - D4999
Optional
Prosthodontics (Removable) - D5000 - 5899
Optional
Maxillofacial Prosthetics - D5900 -D5999
Optional
Implant Services - D6000 -D6199
Optional
Prosthodontics (Fixed) - D6200 -D6999
Optional
Oral and Maxillofacial Surgery - D7000 - D7999
Optional
Orthodontics - D8000 -D8999
Optional
Adjunctive General Services - D9000 -D9999
Optional
Do you perform any surgical procedures?
Required

If "yes," please estimate the percentage each surgical procedure bears to your total practice (based on numbers of procedures) on an annual basis.
Surgical Implants
Optional
Extractions of bony impacted, or partially bony impacted teeth
Optional
Other dental cosmetic procedures (excluding biopsies, but including T MJ)
Optional
Other surgery, including non-dental procedures (describe)
Optional
I administer the following types of Anesthesia. (Please check all that apply)
Optional



Have you ever had any disciplinary action, restriction, suspension, probation or revocation of a license to practice dentistry?
Required

Other than traffic violations, have you ever been convicted of a crime?
Required

Have you ever been declined or cancelled for any Dental Professional Liability Insurance? (Missouri residents: Do not respond)
Optional
In the past 10 years, have you been involved, directly or indirectly, in a claim or suit arising out of the rendering or failure to render professional services?
Required
If Yes, how many (Open and Closed)
Optional
Submission Validation
Required
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

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