Start by reading our Completion and Delivery Instructions.
Then, download an application as an Adobe PDF file that you can complete and return.
Physicians and Surgeons:
Physicians/Surgeons Professional Entity:
Physician Assistants, Specialist Assistants, Nurse Practitioners, Midwives and Nurse Anesthetists:
Other Health Care Providers:
There are 3 easy ways to apply for MLMIC dental professional liability coverage.
Start or complete an application at the MLMIC Insurance Company rapid application portal.
- Mail (or Email/Fax)
- Download the Application for Dentists Professional Liability Insurance and return the completed application to MLMIC.
- Follow the Completion and Delivery Instructions for details on submitting your application.
- Part time practitioners must also submit a Supplemental Application for Part Time Practice.
Need help? Give us a call at 800-ASK-MLMIC (800-275-6564).
Hospitals and Groups:
Contact a MLMIC representative today.