Valiant New York Applications & Supplements

New York Law Firm

Forms and Applications

 

 

Fully completed, signed and dated applications and supplements are required for complete underwriting and pricing. No coverage can be bound without first completing, submitting and receiving approval from underwriting.

 

Applications

  • Lawyers Professional Liability Application

Supplemental Applications

  • Additional Office Location(s) Supplement
  • Banking Supplement
  • Claim Supplement
  • New Attorney Supplement
  • Outside Interest Supplement
  • Plaintiff Supplement
  • Real Estate Supplement
  •  

You may download each of these forms by selecting the Adobe file below.

 

Completed applications including appropriate supplemental applications should be submitted to:

 

New Business Underwriting Department

FLAG Insurance Services

84 Court Street

Freehold, NJ 07728

 

 

Download Applications & Supplements Here

Do you have questions about completing these applications or do you want to make an appointment to discuss your legal malpractice insurance?

Please call us at 732-462-8929 or use our contact form.

Valiant New York Application
VIC LPL NY APP 1-long form app.pdf
Adobe Acrobat document [46.2 KB]
Valiant Additional Office Location(s) Supplement
VIC LPL NY APP 6- Offices Supp1.pdf
Adobe Acrobat document [21.4 KB]
Valiant Banking Supplement
VIC LPL NY APP 5- Banking Supp.pdf
Adobe Acrobat document [27.2 KB]
Valiant Claim Supplement
Complete one supplement for each claim or circumstance
VIC LPL NY APP 7-claim supp1.pdf
Adobe Acrobat document [28.2 KB]
Valiant New Attorney Supplement
Use this supplement when an attorney joins your firm during the policy period
VIC LPL NY APP 13-New Attny.pdf
Adobe Acrobat document [22.6 KB]
Valiant Outside Interest Supplement
VIC LPL NY APP 4- outside interests.pdf
Adobe Acrobat document [50.0 KB]
Valiant Plaintiff Supplement
VIC LPL NY APP 14 - Plaintiff Supp.pdf
Adobe Acrobat document [21.4 KB]
Valiant Real Estate Supplement
VIC LPL NY APP 10- Real Estate Supp.pdf
Adobe Acrobat document [33.6 KB]