Request an Indication

Please fill in the information below and, based on the information you provide, a team member will contact you with an estimated annual premium.
Firm Information
Firm Name*
Contact Person*
Email*
Address*
City*
State*
Zip*
Phone*
Fax
Number of Full-Time Lawyers in Firm*
Number of Part-Time Lawyers in Firm*

Add each lawyer who is to be insured under this policy

Lawyer Name	Date of Employment (or start date if sole practitioner)	Prior Acts Date with Current Carrier
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We will contact you via email with an estimated quotation. It is an estimate of premium only and does not constitute approval. This indication is subject to receipt, review, and approval of a completed Lawyers’ Mutual Application. Please visit www.lawyersmutual.com to download an application or to submit a Quick Quote Form. To speak with the Underwriting Department, please call 800.252.2045.
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Firm Information