Insurance Specialists, Inc.
 
MEMBERS
  PRODUCTS & SERVICES
   
CONTRACT LITIGATION INSURANCE
Welcome
Product Overview
FAQs
Application

APPLICATION
Please take a moment to fill out the form below and one of our representatives will contact you with a free, no-obligation quote. This information will be kept confidential and will be used for quote purposes only.

* Please complete the below application in its entirety.

Applicant Information
Your Full Name:
Street Address:
City:
State:     Zip:
Phone:  
Contact E-mail Address:
Case Description

1. Is the applicant the plaintiff in the action?
Yes No

2. Is this a state or federal court litigation?
Yes No
3. Is the litigation based upon a breach of contract claim?
Yes No

4. Does the contract at issue contain a prevailling party provision?
Yes No

5. Did the applicant file his/her complaint within the past 75 days?
Yes No
6. Please answer all of the following:
a. Has the applicant been involved in 3 or more contractual lawsuits in the past 5 years?
Yes No
b. Has the applicant had 3 or more contract trial losses in the past 5 years?
Yes No
c. Has the applicant been found to have violated Federal Rule of Civil Procedure 11 or its state court equivalent? Yes No

Please click the "Submit Application" button to send your quote request. No coverage is in effect until bound by an insurance carrier. This is a request for quotation only.

 
TOLL FREE: 1-888-474-1959
SERVICE. STRENGTH. SECURITY.
PRIVACY © Copyright 2012 Insurance Specialists, Inc. All rights reserved.