United Brokers is committed to being the best!

3216 Ballard Lane | New Albany, Indiana 47150

800-444-4824 • 812-949-4015 fax

United Brokers, Inc.

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Allied Medical Forms & Applications

	Acupuncturist application
	Additional insured supplemental application
	Adult day care centers application
	Air ambulance supplemental application
	Ambulatory surgery centers application
	Application update form
	Beazley Insurance Policy Application
	Blood bank supplemental application
	Chiropractors application
	Claim supplement
	Claims Warranty application
	Clinical trials and research professional liability, general liability and products liability application
	Clinics - medical, dental, public health application
	Crime Application - Beazley
	Fiduciary Liability Insurance Application - Beazley
	General liability application
	Home health, infusion therapy, nurse registry supplemental application
	Hospital professional liability and general liability application
	Locum tenens and contract staffing application
	Managed care organizations application
	Media Tech Application - Beazley
	Medical laboratory and imaging centers application
	Medical spa supplement application
	Medical students professional liability application
	Mental health facility application
	Micro pigment implantation application
	Miscellaneous Professional Liability Insurance Application - Beazley
	Non-Profit Organization Management Liability Insurance Application - Beazley
	Nurse anesthetist application
	Nurse midwife supplemental application
	Nurse practitioner, physician assistant, paramedic, EMT application
	Nursing home, assisted living professional liability and general liability application
	Pharmacy professional liability and general liability application
	Post mortem services supplemental application
	Public access defibrillation application
	Specified medical professionals application
	Urgent care centers application
	Veterinary services application
	Wage and Hour Coverage Enhancement Supplemental Application - Beazley

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Architects & Engineers Forms & Applications

	AFB A & E Media Tech New Business - Beazley
	Architects' & Engineers' Errors & Omissions application
	Application Update Form
	Claims Warranty
	Condominium Supplemental Application - Beazley
	Construction Related Services
	Equity Interest Supplement
	FINAL A & E Specific Additional Project Limit Supplemental Application - Beazley
	FINAL A & E Technology Supplemental Application - Beazley
	Joint Venture Supplement
	Large Project Supplemental Questionnaire - Beazley
	Specific Project Increase Limits Supplement
	Supplemental Application for Third Party Technology Coverage - Beazley

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Community Associations Forms & Applications

	Community Associations application
	Community Associations umbrella
	Community Associations package

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Corporate Directors & Officers Liability Forms & Applications

	Corporate Directors & Officers application
	Corporate Directors & Officers Indication Sheet
	Corporate Directors & Officers application for EPLI & Fiduciary Coverage
	Directors, Officers and Company Liability Insurance Policy Application - Beazley

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Employment Practices Forms & Applications

	Employment Practices Liability application
	Employment Practices Liability Insurance Application - Beazley
	Employment Practices Liability Insurance Application - Beazley
	Medical Providers' Employment Practices Liability application

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Insurance Agency Errors & Omissions Forms & Applications

	Insurance Agency application (less than $10 premium volume)
	Large Insurance Agency, MGA, Plan Administrators application
	Insurance Agency Renewal applciation
	Life-Accident-Health Agents' supplemental application
	Financial Planners' supplemental application
	Claims supplemental application

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Lawyers Professional Liability Forms & Applications

	Lawyers' Professional Liability application
	Application Update Form
	Bodily Injury Firms supplement
	Entertainment Law supplement
	Claims Warranty

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Medical Malpractice Forms & Applications

	Physicians & Surgeons Medical Malpractice application
	Anesthesiologists application
	Dentists & Oral Surgeons application
	Podiatrist application
	Application Update form
	Locum Tenens & Contract Staffing Organization application
	Alternative Therapy supplement
	Claims supplement
	Claims Warranty
	Threat of Claim supplement
	Legal Expense Reimbursement application

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Miscellaneous Errors & Omissions Forms & Applications

	Errors & Omissions application
	E & O Renewal application
	Broadcaster Liability application (LSC1788)
	Claims Adjuster supplemental application
	Collection Agency supplemental application
	Computer Consultant supplemental application
	Consultant (general) supplemental application
	General Liability & Property supplemental application
	Interior Exhibit, Light, Designer application
	Management, Human Resources, Marketing supplemental application
	Mortgage Brokers supplemental application
	Paralegals supplemental application