Report A Claim

As a policyholder, it is critical you notify us immediately if an incident occurs that may lead to a claim or if a claim has been made against you by filling out the form below or calling us at 800.227.4527. Our MIEC Claims Specialists will immediately go into action to protect you. We will be with you every step of the way.

Uncertain whether an incident or situation may warrant reporting? Review our When to Report a Claim page or give us a call at 800.227.4527 and request to speak with one of our Claims Specialists. Our experienced staff will gladly guide you through the claims process and answer any questions you may have.

As your professional liability insurance provider, know that we are a valuable resource and partner that’s just a phone call away.

Report A Claim

Name *

Policy Number *

Group Name

Phone Number *

Email *

Preferred Method of Contact

By Phone

By Email

Best Time to Contact

Address *

Address

Address

Address

City

City

State/Province State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

State/Province

Zip/Postal

Zip/Postal

Regarding *

Advice Requested

Concerns about an unexpected patient outcome

Received legal papers

Received formal or informal complaint directly from a patient

Received an inquiry or notice from the medical licensing board

OtherOther

Relevant Files

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Maximum file size: 2.1MB

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