**Legal Malpractice Insurance**

**Client Resources**
**• Report a claim**
**• Make a change**
**• Request information/documentation**
**• Manage Premium Financing**
**• Earn CLE credits**

I want to...

Report a Legal Malpractice Insurance Claim or Incident

Your Name

First Name

Last Name

Name of Your Law Firm or Organization

Your Email Address

Your Phone Number

(###)

###

####

What are you reporting?

Message (optional)

Please describe what you

If you have experienced a Legal Malpractice claim, complaint or incident, please complete this form to notify our agency as soon as possible. We will advise you on next steps.

Make a Change

Name

First Name

Last Name

Name of Law Firm/Organization

Phone

(###)

###

####

What change(s) would you like to make?

Please select all that apply

Update my contact information

Add an attorney to my policy

Remove an attorney from my policy

Update my Areas of Practice

Alter my current coverage

Add another line of coverage

Other (please describe)

Message (optional)

Please describe the change you would like to make.

Update contact information
Add/Remove attorneys
Change the terms of your coverage
Update areas of practice

Manage Premium Financing

If you have financed your premium through Imperial PFS®, the above button will take you to the Imperial PFS® website. You will be able to create an online account, make a premium payment, update contact info, etc.

Earn CLE Credits

The Chicago Bar Association provides a number of CLE seminars and webinars on a regular basis. Additionally, our Legal Malpractice Insurance Carriers periodically provide Free CLE webinars to clients.

Certificate of Insurance Request

Your Name

First Name

Last Name

Name of Your Law Firm or Organization

Your Email Address

Certificate Holder Information

Often times, the entity will provide the exact specifications for how they would like their name/address listed on the form.

Name of Certificate Holder

Enter the full, formal name of the entity that is requesting the certificate.

Address of Certificate Holder

Enter the full, formal address of the entity that is requesting the certificate.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Information (optional)

If a client or partner of yours has requested a Certificate of Insurance, please complete this form and we will create it for you.

Policy Request (LPL)

Name

First Name

Last Name

Name of Law Firm or Organization

Email Address

Phone

(###)

###

####

Message (optional)

If you would like a copy of your current policy, please complete this form and we will email it to you.

I want to...

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