APPLICATION INSTRUCTIONS

This is for claims-made lawyers professional liability insurance. Please submit the completed application on line. Please call 502.568.6100 if you have any questions.

Please read the following instructions carefully to avoid processing delays.

1. Please answer all questions completely. If you need more space to answer, see “Additional Information” section on the last page of the application.

2. The application and all supplemental forms must be completed in full. The completion of EACH form is required, if it is applicable. Filling out the “Time and Docket Control” form is mandatory.

3. Provide supplemental information regarding any “yes” answer to questions 29, 30, 31, or 32.

4. Bear in mind that the information you provide is on behalf of all lawyers in your organization.

5. New business applications will have an effective date no earlier than the date the application is received in our office.

DEDCTIBLE OPTIONS

1. per claim-The deductible applies to each claim asserted during the policy period.

2. aggregate deductible-This caps your deductible for all claims asserted during the policy period. However, the entire aggregate could be applied to the first claim.

3. combination per-claim and annual aggregate-Under this option, each claim is subject to its own deductible, but the total of all deductibles for the term of the policy will not exceed 2.5 times the per-claim deductible. The per-claim deductible is applied to each claim until the aggregate has been paid.

Thank you for considering Lawyers Mutual Insurance Company of Kentucky for this important coverage.

Should you have any questions concerning the completion of this application,
please contact:
Asa P. “Pete” Gullett or Lois A. Smith