Please see the links below where you can download applications for your corresponding coverage need. Fill out the form and
send it to us by e-mail, fax or mail.

CoverX Corporation
29621 Northwestern Highway
Southfield, MI 48034

Phone: (800) 762-6837
Fax: (248) 358-2459
coverxuw@coverx.com
 

NON-MEDICAL PROFESSIONAL LINES/COVERX PRO

Miscellaneous Professional Liability

Miscellaneous Professional Liability - Renewal

Employment Practices Liability

Employment Practices Liability - Renewal

Franchisees Management Liability*

Alternative Staffing Firms/Professional Employer Organizations*

Lawyers Professional Liability*

Accountants Professional Liability*

Technology Errors & Omissions*

Private Company Directors and Officers Liability

Not-for-Profit Organizations Directors and Officers Liability*

Following Form Excess Liability*
 

MEDICAL PROFESSIONAL LINES/COVERX HEALTHCARE

Physician Application