Downloadable Applications and Forms

We welcome the opportunity to speak with you about finding the right coverage for your unique situation. If you have questions, feel free to call 864.240.5449 or 866.893.6270, and we will gladly assess your risk and discuss your coverage options.

To apply for coverage, please download the appropriate form below and return it with all required materials, such as current declarations, curriculum vitae, a loss history report and other materials.

Unless otherwise requested, all JUA insured individual physicians, dentists and allied healthcare providers will receive renewal quotes based upon the information currently in our system.

Hospitals and other medical facilities are required to submit renewal applications each year.