Service Insurance Agency - Optometric Quote

Optometric Quote

 Required Fields

Additional Information

Basic Information

Location Information

Property Information

Estimated Replacement Values

General Liabilities/Professional Optometrist Liability

  • $1,000,000 Each Occurrence/$3,000,000 aggregate Products Completed Operations Limit
  • $2,000,000 Each Occurrence/$4,000,000 aggregate Products Completed Operations Limit

Please list any Additional Insured you are required to show on the policy.
Interest: building owners, equipment lease, etc. Include the names and addresses of addtional insured.

Professional Liability Limit Options

The Optometrist Professional Liability coverage is subject to the following limits of insurance. Limits apply to each Doctor.

  • $1,000,000 Each Occurrence/$3,000,000 aggregate Products
  • $2,000,000 Each Occurrence/$4,000,000 aggregate Products

Automobile Liability

Workers Compensation

(complete only if coverage is desired)

Excluding monopolistic states -- North Dakota, Ohio, Washington, West Virginia, Wyoming, and Maine. Stop Gap Coverage.

(If yes, please note that minimum payrolls will be applicable depending on the state required.) NOTE: If you do not answer this question, Worker's Compensation coverage will be automaticly afforded and premium will be charged.