Medical Professional Liability Policy Renewal Resources
Step 1: Complete Your Renewal Application
Everyone must complete a Renewal Application.
Click the button below to select the appropriate application based on your policy type.
The health care provider renewal application has the option to elect Higher Limits for License Defense Coverage. CLICK HERE for more information.
Select a Renewal Application
Step 2: Complete the Election of Payment Form
Everyone must complete an Election of Payment Form.
Those with group policies should send in one form for the entire group. Individual members of group policies cannot elect an individual payment method.
Requests to change payment methods after the policy has been renewed may delay processing.
If this form is not returned with your renewal documents, KAMMCO will renew your policy with the same payment method as the previous year.
If your policy was on a quarterly payment plan and payments were not made timely, payment may be adjusted to annually at KAMMCO's discretion.
This year, quarterly payments will be processed via ACH debit. All members who choose the quarterly installment option on the Election of Payment form must also fill out the Authorization Agreement for Installment Collection form.
Download the Forms
Step 3: Premium Financing Option
Download and complete the Finance Premium Acceptance Form if you want to use third-party financing from Fidelity State Bank and Trust to pay your annual premium.
Do not send this form to KAMMCO. Follow the direction in the form to send it directly to Fidelity State Bank.
If you have questions about the financed premium option, contact Fidelity Assistant Vice President Shelly Apodaca at 1-785-295-2100 or email@example.com.
Download the Finance Premium Acceptance Form
Step 4: Cyber Higher Limits Coverage Option
Every KAMMCO policy comes with embedded cyber coverage.
Fill out the Cyber Breach Response Application if:
- You previously opted to have higher limits on cyber coverage and would like to continue with that option in 2023; or
- You want to increase your cyber coverage limits beyond your embedded cyber coverage limits.
CLICK HERE for more information about cyber coverage.
Download the Cyber Breach Response Application
Step 5: Submit Your Renewal Materials for Processing
Important. Please Read.
Submit materials together at the same time.
We cannot process your renewal until we receive all your renewal materials. Submitting materials one at a time will delay processing.
To process a renewal for a group policy, we must receive the renewal forms for each individual on the policy before proceeding.
Deadline for Submission:
For policies that renew on January 1, 2024, the deadline to submit renewal materials is October 13, 2023.
Materials to Submit to KAMMCO:
1. (Required) Renewal Application
2. (Required) Election of Payment Form
3. (Optional) Cyber Breach Response Application
How to Submit Materials:
Email all materials to firstname.lastname@example.org. Include the subject line below.
Subject: 2024 Renewal for [Your name/Group name + Policy No.]
Submit Renewal Materials Now