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Travelers professional liability coverage claim suit or incident supplement form 2026

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The document is a claim, suit, or incident supplement form for professional liability coverage provided by Travelers Casualty and Surety Company. It outlines the necessary information that applicants must provide regarding any known claims, suits, or incidents related to their professional services. The form includes sections for applicant information, details about the claim or incident, compensation notices, fraud warnings, and a signature authorization. It emphasizes the importance of reporting any relevant incidents to ensure coverage under the insurance policy.

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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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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a claims made coverage form?

The claims-made form covers incidents that you report during the active policy period or during an extended reporting period and occur after a policys retroactive start date.

What does professional liability insurance not cover?

Professional liability insurance will pay the cost of legal defense against claims and payment of judgments against you, up to the limit of the policy. In general, coverage does not extend to non-financial losses or losses caused by intentional or dishonest acts.

What is an example of a liability claim?

Bodily Injury Example 1 That morning a customer enters her place of business and slips and breaks their leg. Her customers broken leg is a perfect example of a customers bodily injury claim against Kristas hair salon. Kristas customer can now sue for damages, medical costs, and pain and suffering.

Does Travelers offer professional liability insurance?

Travelers Professional Liability insurance includes pre-claim assistance to cover expenses associated with the evaluation and mitigation of a potential claim. With a Travelers policy, your deductible is not triggered nor are your policy limits reduced for any dollars spent on this assistance.

Which event would be covered by professional liability insurance?

Examples of liabilities covered by PLI are: Mistakes, errors, and oversights in services provided. Undelivered services. Missed deadlines.

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