Name: Excess Malpractice Liability
SKU: 334
Availability: InStock

$70.50 – $791.50

Excess Malpractice Liability Up to $23,000,000 available.
Excess of primary RCDSO policy $2,000,000
Claims Made

Your College Registration Number: *Forgot your College ID?
Effective Date of Policy: *
LimitSelect your choice for additional coverage above the mandatory $2,000,000 Professional Liability Program limit. (Limits are per occurrence and aggregate)Limits and Premium Choices
QuarterLimits and Premium Choices	Clear
Add Legal Expense Coverage? *Covers legal expenses to defend and/or pursue legal action against a third party. Annual premium $165.00 Learn More	Yes No
Add Excess Liability Coverage? *This coverage is in excess of the Primary Malpractice Liability Per Occurrence Limit of $2,000,000 which is included as part of your registration with the Royal College of Dental Surgeons of Ontario. Learn More	Yes No
Would you like to renew your Legal Expense Insurance policy? *	Yes No
Would you like to renew your Excess Malpractice Liability policy? *	Yes No
Time Zone: *

Excess Malpractice Liability Limit
Select a Limit: *What Limit Should I Purchase?

Premium*

*Incl $55.00 Agency Fee

Premiums are pro-rated depending on your effective date, subject to a minimum retained amount.

Policy Effective [] to

Primary Contact Information
NOTE: Your details will appear exactly as entered on your documentation. Please type carefully.
First Name: *Do not type "Dr." as it is already included.
Surname: *
Email: *IMPORTANT: Do not use a generic email addresses such as "info@" or "admin@" as we are not able to send renewal emails to generic email addresses.
Phone: *
Business Tel:

Business Contact Information
NOTE: Your details will appear exactly as entered on your documentation. Please type carefully.
Professional Designation:
Licensed Since (YYYY):
Address: *
City: *
Province: *
Postal Code: *

Please Answer the Following:
Would you like an invoice in the name of your Health Professional Corporation? *	Yes No
Please enter the name of your Health Professional Corporation: *
Are you planning on retiring this year? *	Yes No
Date of Retirement: *
Have you had Excess Malpractice Liability coverage in the past? *	Yes No
Follow Form Policy Disclosure Agreement There have been no changes to the intent of coverage, the following discloses that your policy responds in the same way as the primary policy when more than one dentist is involved. I acknowledge that this Berkley Canada excess policy will follow the same structure as the RCDSO Professional Liability Insurance Program / primary policy with respect to the sharing of the limit of insurance amongst multiple dentists. If an Occurrence takes place that involves more than one Registered Member, and the RCDSO Professional Liability Insurance Program / primary insurance policy aggregates all dentists or claimants into sharing one $2,000,000 Limit of Liability, then Berkley’s total Limit of Liability will be similarly limited to one available Limit of Liability.	I Agree
Has there been, or are there now pending, damages against you that have not been reported to the Professional Liability Program? *(If yes, you will be contacted before being able to purchase Excess Liability.)	Yes No
Are you aware of any fact, circumstance or situation which may give rise to a Claim under the policy to which this application will be attached? *(If yes, you will be contacted before being able to purchase Excess Liability.)	Yes No
View Warranty Statement & Privacy Information Consent
By clicking ‘I agree’, it is acknowledged that you have read and agree with the Warranty Statement & Privacy Information Consent.	I Agree

SKU: N/A Category: Uncategorized

RCDSO Excess Malpractice Liability Insurance Program

Personal Information Consent Form

Warranty Statement & Personal Information Consent

What Limit Should I Purchase?

Four Important Considerations when Deciding your Excess Limits

1. The size of your practice:

2. Years in business:

3. Location of your practice:

4. Tolerance for risk and Cost/Benefit:

Why Should you buy Legal Expense Insurance?