Call the NLADA Insurance Program at (800) 725-4513 to request an application. One will be faxed or mailed to you immediately. To download an application form, click on one of the links below:

Download the Insurance Application in Word format (msword, 59 Kb) from this site.

Download the Insurance Application in PDF format (pdf, 50 Kb) from this site.

Complete the sections that correspond to the coverages you desire:

• Lawyers Professional Liability Policy
• Management Liability Errors & Omissions Endorsement
• Management Liability Errors & Omissions Endorsement plus Employment Practices Liability Endorsement

Complete Supplemental Claim Form(s) if applicable.

Assemble copies of the enclosures as requested in the application. If applying for Lawyers Professional Liability Policy, please include:

• Declarations page from expiring policy

If applying for Management Liability Errors & Omissions Endorsement, please include:

• Latest financial statement
• Schedule of directors, trustees, and officers
• By-laws or comparable document (including indemnification provisions)
• Brochures or other materials descriptive of operations and purpose

Submit application and enclosures to:

Applications may be submitted via FAX to (202) 452-9879 although the original application must follow via regular mail.

Documents linked from this page are in the PDF format and require the free Adobe Acrobat Reader in order to view or print them. Click to download the Acrobat Reader software.