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For
the fast and smooth processing of your application
for professional liability insurance, please follow
these steps:
- Download
the INDIVIDUAL
MENTAL HEALTH PRACTITIONER’S APPLICATION form.
This download will include:
- Application
- Faxing Instructions
- Direct Draft Authorization Form
- Complete,
sign and date the APPLICATION and either fax it
with the Direct Draft Authorization Form and a
copy of a voided check or mail it with your payment
in the form of a personal check, cashier’s
check or money order.
- If you are not licensed or certified and/or you
do not have a degree in a mental health field, you
must send a resume or curriculum vitae with your
application. If you have no degree, you must be licensed
or certified. If you are a Social Worker, you must
be licensed or certified as a social worker.
If
you currently have a "claims-made" type
of policy in your name and that policy
has not yet expired, you may wish to apply for PRIOR
ACTS coverage. If you are unsure what type of
policy you currently have, please call your current
carrier to discuss. Download the PRIOR ACTS
APPLICATION and submit it with the Individual Mental Health Practitioner's
Application above.
We will process your application as quickly as possible.
Thank you for considering Rockport Insurance Associates
for your professional liability insurance.
GROUP
APPLICANTS
Please
visit our "Groups" page for the application
form.
CALIFORNIA
AND LOUISIANA
GROUP APPLICANTS
Coverage
is available only for groups of licensed psychologists.
For an estimate of premium, please call us Toll
Free at 1-800-423-5344 or email us. |
