The applications below are for the exclusive use of licensed surplus lines insurance brokers. As a surplus lines insurer, Lexington Insurance Company does not accept applications from or provide quotes to individuals.
Miscellaneous Healthcare Facilities Application (.pdf)
Application form for Miscellaneous Healthcare Facilities, Professional and General Liability insurance.
Abortion Clinic Application (.pdf)
Application form for AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance for abortion clinics
ASC Application (.pdf)
Application form for ASC, Professional and General Liability insurance.
Birthing Centers Supplemental Application (.pdf)
Supplemental application form for birthing centers for the AIG Miscellaneous Healthcare Facilities product.
Blood Banks Supplemental Application (.pdf)
Supplemental application form for blood banks centers for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Diagnostic Radiology Facility Application (.pdf)
Supplemental application form for diagnostic radiology facilities for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Dialysis Centers Supplemental Application (.pdf)
Supplemental application form for dialysis centers for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Emergency Medical Services Supplemental Application (.pdf)
Supplemental application form for emergency medical services for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Healthcare Clinic Supplemental Application - Lexington (.pdf) Supplemental application form for heathcare clinics for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Healthcare Clinic Supplemental Application - Landmark (.pdf) Supplemental application form for healthcare clinics for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Hospice Supplemental Application (.pdf)
Supplemental application form for hospice services for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Laboratory Application (.pdf)
Application form for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability laboratories insurance product.
Lasik Supplemental Application (.pdf)
Supplemental application form for lasik providers for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Medical Spa Supplemental Application - Lexington (.pdf)
Supplemental application form for medical spas for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Medical Spa Supplemental Application - Landmark (.pdf) Supplemental application form for medical spas for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Mental Health Facilities Supplemental Application (.pdf)
Supplemental application form for mental health facilities providers for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Organ Procurement Organization and Tissue Bank Supplemental Application (.pdf)
Supplemental application form for organ procurement organizations and tissue banks facilities for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
PBM Pharmacy Benefit Managers Application (.pdf)
Application form for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability Pharmacy Benefit Managers insurance product.
Pharmacy Supplemental Application - Lexington (.pdf) Supplemental application form for pharmacies for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Pharmacy Supplemental Application - Landmark (.pdf) Supplemental application form for pharmacies for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Physicians and Surgeons Professional Liability Application (.pdf)
Application form for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability Physicians and Surgeons insurance product.
Schools Supplemental Application (.pdf)
Supplemental application form for schools for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Weight Loss Center Supplemental Application (.pdf)
Supplemental application form for weight centers for the AIG Miscellaneous Healthcare Facilities, Professional and General Liability insurance product.
Healthcare netAdvantage Application
Security & Privacy Supplemental Application
Security & Privacy IT Assessment
Healthcare Clinic Supplemental Application - Lexington (.pdf)
Medical Spa Supplemental Application - Lexington (.pdf)
Pharmacy Supplemental Application - Lexington (.pdf)
Healthcare Clinic Supplemental Application - Landmark (.pdf)
Medical Spa Supplemental Application - Landmark (.pdf)
Pharmacy Supplemental Application - Landmark (.pdf)