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How to use or fill out travelers professional liability coverage claim suit or incident supplement form
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Click ‘Get Form’ to open it in the editor.
Begin by entering your Current Travelers Policy Number in the designated field. This is crucial for identifying your existing coverage.
Fill in your Full Legal Name as the applicant. Ensure accuracy, as this will be used for all official correspondence.
In the Claim, Suit or Incident Information section, provide details about individuals involved, including their names and any additional defendants.
Specify the Date of the alleged wrongful act and indicate whether this matter has been reported to another professional liability carrier.
Complete either the Pending Claim or Suit section or the Closed Claim or Suit section based on your situation, providing relevant dates and financial figures.
In the Description of Claim, Suit, or Incident section, provide comprehensive details about the services provided and any alleged wrongful acts.
Finally, review all entries for accuracy before signing electronically at the end of the form. Your electronic signature confirms your agreement with all statements made.
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Feb 28, 2026 liability, or expense that may be imposed upon or reasonably incurred by him or her in connection with or resulting from any claim, action, suitRead more
employee benefits liability application coverage on a claims-
2011 The Travelers Indemnity Company. All rights reserved. Page 4 of 4. I. Page 7. Travelers. PUBLIC ENTITY EMPLOYMENT - RELATED PRACTICES LIABILITY - CLAIMS
If Yes, please complete a Claim Supplement (form attached) for each claim and civil action. Have any judgments been made against you, or any out-of-courtRead more
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