"PLICO processes new applicants, certificates of insurance, and claims histories faster than any other medical malpractice carrier in Oklahoma."
                                         -Jim Mays, CPCU, Vice President, Underwriting



Professional Medical Liability Insurance

Applications & Forms



  • Physician Application MS Word or PDF
  • Ancillary Application MS Word or PDF
  • Change Request Form MS Word or PDF
  • Miscellaneous Facilities Application MS Word or PDF
  • Request for Locum Tenens Coverage PDF
  • Release of Claims Information PDF
  • Volunteer Application  MS Word or PDF
Don't have Adobe PDF Reader?  

*Note: If you have difficulty completing the MS Word version of any application, please download the Adobe PDF document and complete it manually. If you continue to have difficulties, please contact technical support between the hours of 8 a.m. and 5 p.m., Monday-Friday at (405) 815-4888.


PLICO Professional Medical Liability Insurance

PLICO proudly offers medical professional liability coverage to Oklahoma physicians in all medical specialties. Since 1980, many thousands of physicians have placed their trust in PLICO for:

  • Complete coverage for all medical specialties
  • Competitive premiums based on Oklahoma-specific loss trends
  • Progressive Risk Management & Loss Prevention CME programs for physicians, residents and ancillary medical personnel
  • Oklahoma defense counsel with extensive experience defending Oklahoma physicians
  • Matchless customer service
For a premium indication, please complete a Physician Application and fax it to (405) 815-4900. Or you may return the application to us at the following address:

      PLICO
      Attn: Underwriting
      P.O. Box 1838
      Oklahoma City, OK 73101

If you have additional questions or if you do not see a particular form, please contact one of our professional underwriters for additional information.




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