Apply for Coverage
Apply for medical liability insurance coverage with ISMIE Mutual today. Questions? Please contact us by email at email@example.com or at 800-782-4767.
Apply for a new policy or add someone to an existing policy:
Physician Application: Policy application for physicians seeking new coverage, or for existing policyholders seeking to add a physician(s) to an ISMIE policy (MDs and DOs only).
Locum Tenens Coverage Application: Policy application for an existing policyholder to add a temporary physician to fill in while away from practice (e.g. maternity leave, extended travel).
Ancillary Employee Application: Policy application for allied healthcare professionals seeking new coverage when joining an existing ISMIE policy. Allied healthcare professionals included: registered nurses, technicians, medical assistants, and physical therapists.
Non-Physician Professional Application: Policy application for non-physician professionals seeking coverage, or for existing policyholders seeking to add a non-physician professional to an existing ISMIE policy. Non-physician professional examples: physician assistants, nurse practitioners, certified registered nurse anesthetists, midwives, chiropractors, and podiatrists.
Corporation or Clinic Application: Policy application for healthcare corporations or clinics. Common for: physician groups, independent physician groups, private practices, MRI centers, urgent/immediate care centers, and mental health clinics.
Surgicenter Application: Policy application for ambulatory surgery center coverage.
Part-time Rating Application: Application for existing policyholders seeking part-time coverage.
Make changes to a policy:
Clinic/Corporation Application for Risk Manager Premium Discount: For clinics/corporations who employ a dedicated risk management professional (only available to a clinic policyholder).
Change Request Form: Change policy information (e.g. update limits; add a hospital; change mailing or billing address; add employees).
Practice Location Form: Add a new practice location.
Cancellation Request: existing policyholder cancellation form.