Professional Liability Insurance
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Transferring information from one application to another is a service GEBA offers, but only if applications are submitted within 30 minutes of each other.
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*Retroactive date – The date that represents the beginning of coverage. Only claims made to the insurer and occurrences that occurred on or after that date will be honored under the current policy. As respect to this program, the retroactive date will be the verifiable date from which your continuous uninterrupted claims-made professional liability coverage commenced, whether with us or another provider.
The policy provides an Accidental Death Benefit for a death directly related to the scope of your employment. Please provide a Beneficiary Designation.
*Rate includes Surplus Lines Tax.
You must include your ABA (Routing) Number for your bank. Use this image to see where your routing number is listed, if you don't already know. An ABA/Routing number is always 9 digits, no letters or punctuation.
By signing and dating this application, I request GEBA’s CareerGuard® Professional Liability Insurance for which I am eligible as an employee of the federal government in good standing and to the best of my knowledge and belief, the answers to the questions are true and complete. It is also understood that any acts, error or omission, or allegation thereof that occurs prior to the effective date and/or retroactive date of the coverage will not be covered by the policy.
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