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Professional Liability Insurance
Fax: (410) 846-6420 | Email: firstname.lastname@example.org | Mail: GEBA, 1362 Mellon Road, #100, Hanover, MD 21076
Your session will expire in one minute. If your session expires, any information you enter for this application will not be transferred to any subsequent application you fill out.
Transferring information from one application to another is a service GEBA offers, but only if applications are submitted within 30 minutes of each other.
By providing your email address to us, you expressly consent to receive emails from us. We may use email to communicate with you, to send information that you have requested or to send information about other products or services developed or provided by us, provided that, we will not give your email address to another party to promote their products or services directly to you.
*Retroactive date – The date that represents the beginning of coverage. Only claims made to the insurer and occurrences that occurred on or after that date will be honored under the current policy. As respect to this program, the retroactive date will be the verifiable date from which your continuous uninterrupted claims-made professional liability coverage commenced, whether with us or another provider.
Plan year is January 1 – December 31.
Coverage can begin at the first of any month. Premium will be prorated based on the effective date (date the policy starts). Effective date is the first day of the following month from the date of application submission. The policy automatically renews in January of the next year. Annual automatic debits are collected on the first business day of January for $290 for the year (January 1 – December 31). Policy is only cancellable for retirement and resignations.
*Rate includes Surplus Lines Tax.
You must include your ABA (Routing) Number for your bank. Use this image to see where your routing number is listed, if you don't already know. An ABA/Routing number is always 9 digits, no letters or punctuation.
By signing and dating this application, I request GEBA’s Professional Liability Insurance for which I am eligible as an employee of the federal government in good standing and to the best of my knowledge and belief, the answers to the questions are true and complete. It is also understood that any acts, error or omission, or allegation thereof that occurs prior to the effective date and/or retroactive date of the coverage will not be covered by the policy.
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We’re available by phone:
M–F 8:00 a.m.–4:30 p.m. ET.
Securities are offered through Cape Securities, Inc. Member FINRA, SIPC Investment Advisory Services are offered through Cape Investment Advisors, Inc.
1600 Pennsylvania Avenue, McDonough, GA 30253 –
Tel: (678) 583-1120
GEBA Financial Advisors are Registered Representatives of Cape Securities, Inc.
For information about our Wealth Advisors, please visit Broker Check.