To report a claim, please contact us at:
Fax: 866-260-0104
Mail: Domestic Claims, Inc.
Attn: CID
101 Hudson Street, 31st Floor
Jersey CIty, NJ 07302
To check the status of a claim, please contact us at 866-473-0756
To report a claim, please contact us at:
Fax: 866-260-0104
Mail: Domestic Claims, Inc.
Attn: CID
101 Hudson Street, 31st Floor
Jersey CIty, NJ 07302
To check the status of a claim, please contact us at 866-473-0756
The applications below are for the exclusive use of licensed surplus lines insurance brokers. As a surplus lines insurer, Lexington Insurance Company does not accept applications from or provide quotes to individuals.
Hospital Professional Liability and General Liability Application - online (.pdf)
A web-based application form for Hospital Professional and General Liability insurance.
Hospital Professional Liability and General Liability Application - print (.pdf)
Application form for Hospital Professional and General Liability insurance.
Healthcare netAdvantage Application
Healthcare organizations of all types - from hospitals, to managed care companies, to physician groups - are vulnerable to security breaches, both malicious and accidental. Even the best internal processes and data security measures cannot guarantee that private data will be kept safe. And while the potential liability is formidable, the exposure is typically not addressed by conventional insurance policies - including professional liability, commercial general liability or even media liability insurance policies. Security & Privacy Insurance with Crisis Management Insurance Coverage rom Healthcare® covers the multiple facets of a healthcare organization's data breach exposure.
Features and Benefits
- Failure of their network security
- Failure to protect or wrongful disclosure of private or confidential information
- Failure to protect personally identifiable information from misappropriation
- Violation of federal, state, or local privacy statute alleged in connection with failure to protect private information, including HIPAA-related information