To obtain a Quick Quote, simply complete the form below and click submit. Please note that your completion of this form only allows Lawyers Mutual to provide you with an estimate of the premium we would offer you. You must complete our full application in order to receive a binding quotation.

Firm:
Address:   Contact:
City: Phone:
State: Fax:
Zip:   E-mail:

Current carrier:
Premium: $

How long have you been continuously insured?
What is the policy renewal date?
Current Limits: Current Deductible:
Desired Deductible: Desired Limits of Liability:

Please provide the number of attorneys next to their years of experience:
Experience # of Attorneys Experience # of Attorneys
5+ years: 2 years:
4 years: 1 year:
3 years:
How many of the attorneys listed above practice part-time?
Hrs per week Number Part-Time Years of experience:
1-10 hours:
11-20 hours:
21-30 hours:

How many claims have you had or reported in the last five years?
Please describe each claim, the date reported, amount paid
with defense expenses if closed.


How many lawyers in the firm earned at least 20 CLE credits in the preceeding KBA's CLE year, July 1-June 30?

What percentage of time (not income) does your firm spend in the
following practice areas? (Total must equal 100%)
% %
Admiralty AntiTrust /
Trade regulation
Banking Bankruptcy
BI/DI Defendants BI/PI Plaintiffs
Collection/Repossession Communications
Copyright/Patent/
Trademark		 Corporation Formation/
Alteration (Excluding public offerings)
Oil and Gas Public Utilities
Real Estate Federal SEC
Criminal Domestic Relations
Entertainment Syndication
Estate Planning Estate Probate / Trust
International Law Foreign Practice
Labor Relations Money Management
Municipal Law State Securities (Including public offerings)
Taxation Social Security
Litigation (General Civil) Environmental Law
Workers Compensation/
Plaintiffs		 Workers Compensation/
Defendants

Please include any additional comments or questions:
 
 
 

 

Lawyers Mutual Insurance
Waterfront Plaza
323 West Main Street,
Suite 600
Louisville, KY 40202
Waterfront Plaza
KY Wats 1-800-800-6101
Ph. 502-568-6100
Fax 502-568-6103

Disclaimer:
The contents of this website are intended for general information purposes only and should not be construed as legal advice or legal opinion on any specific facts or circumstances. It is not the intent of this website to establish an attorney’s standard of due care for a particular situation. Rather, it is our intent to advise our insureds to act in a manner which may be well above the standard of due care in order to avoid claims having merit, as well as those without merit.