Please find below the alternative method of submitting your renewal application.

Please note: It is highly recommended to submit your application through the Client Online Renewal Application (CORA). You still may do so by clicking here. Our secure online application portal will guide you step-by-step through the application process, provide you helpful hints, and allow you to upload any pertinent documentation. Use of the CORA will also ensure a more efficient renewal process. 

By selecting the alternative method of submitting a .pdf with your information, the review and processing of the application will take additional time and may require follow-ups from your underwriter. Please be sure to submit your application prior to the deadline listed on your notification letter to avoid non-renewal of your policy. 

When your application is submitted via this method, an underwriter will review and process your application and will contact you if there are any additional questions or clarifications needed.  Once reviewed and approved, your proposal and invoice will be sent to you to pay and complete your renewal process.  Application review is prioritized by renewal date. Due to the volume of renewal applications currently being submitted, the review process could take several weeks.

Please view our Renewal FAQs for additional information as you complete the application.

Individual Policies: Download .pdf of Renewal Application

Group Policies: Please select the state of your group practice below to download the .pdf.
Your client ID is a 6-digit number starting with 60 (i.e., 60####)

Individual Policies

If your practice is any of the following, please complete and submit the Practice Structure/Vicarious Liability supplemental application included in the .pdf document:

  • Employer of other professionals
  • Professional corporation
  • Professional partnership/association
  • Contractor of the services of other professionals
  • Incorporated solo private practice (e.g., "MD, Inc.")
  • Fictitious name entity or DBA
  • Joint venture or LLC

Additionally, if your business has healthcare providers who are co-owners, employees or independent contractors, please include a copy of their current malpractice insurance (e.g. Certificate of Insurance (COI)) if they are not a PRMS active client. More information about vicarious liability is available in our Renewal Application FAQs.

Group Policies

If you are a group client (client ID is 6-digit number that begins with 60 (i.e, 60####)), please complete only the entity application provided via the state-specific drop down above.

Helpful Hints

  • As you complete the application, we understand you may have questions, please feel free to use the "additional notes" page at the end to add any further explanation or clarification of your answers or information. Upon review, we will be in touch if we have any further questions regarding the information provided.
  • It is advisable that you download and save the .pdf to your computer. iphones or other smart phones are not recommended when completing the .pdf due to some incompatibility with Adobe .pdfs on some devices.
  • For more information, tips and technology troubleshooting tips, please read our complete Renewal Application FAQs

Return Instructions

Please download, complete, sign your renewal application. Please ensure that you save your completed .pdf to your computer prior to sending.

Return your completed application by the date provided on your notification letter via:

An underwriter will review and process your application and will contact you with any questions. Once reviewed and approved, your proposal and invoice will be sent to you to pay and complete your renewal process.  Application review is prioritized by renewal date. Please note: Due to the volume of renewal applications currently being submitted, the review process could take several weeks.

Thank you for being our valued client. We look forward to continuing to meet, and exceed, your needs for medical professional liability insurance.