Louisiana Policyholders: Notice to policyholders in Louisiana recently affected by severe weather. 

Oregon Policyholders: Notice to policyholders in Oregon recently affected by wildfires. 

Business Insurance Quote Form

To receive a free quote, call toll free 800-769-2000, ext. 8180. Or fill in the information below. Information is required unless noted as optional. When finished, click the "Submit" button at the bottom of the page.

All fields marked with * are required.


Quote Selection

Select the product(s) for a quote:(Optional)


Contact Information

Please contact NCMIC to inquire about availability of coverage in Florida. 1-800-769-2000, ext 8180 or agents@ncmic.com.

 
 

Is your practice address the same as the mailing address?: *

Address

Please contact NCMIC to inquire about availability of coverage in Florida. 1-800-769-2000, ext 8180 or agents@ncmic.com.

 
Practice Information

Practice Type: *

 

Do your business operations involve growing, storing, selling, dispensing, manufacturing/processing or otherwise providing access to medically-prescribed or recreational marijuana? *

Facility Information

Do you own the building? *

Building Info
 

Is building ownership the same as chiropractic business ownership? *

Building Construction: *

 
 
Updates

Year of last updates to: (Optional)

NCMIC provides the insurance quote based on replacement cost of contents. Please use a dollar amount based on what it would cost to replace the items today if purchased new.

Example: Flooring, walls, etc.

Coverage and Quote Information

Have you filed a claim for your office insurance in the last 5 years? *

Claims
 

Choose a liability coverage amount: *

Do you currently have Business Owners' Coverage? *

Carrier

Do you have multiple practice locations? *

Other Locations An NCMIC insurance representative will contact you for information about your other locations.
Employee Information
 

Are owners/principals included? *

Have you had any workers' comp. claims in the past 5 years? *

Workers Comp
 
Patient Data Information

What patient information do you store electronically or on paper? (Check all that apply)*

Which of the following are in place on your business' computer systems? (Check all that apply) *

Which of the following are in place to safeguard personal information stored at your office? (Check all that apply) *

Comments

(maximum 2000 characters)

Once your completed information is received, a representative will contact you.

Questions? Call toll free at 1-800-769-2000, ext. 8180.



Customized Coverage Designed for Chiropractors and Naturopaths

Get a Quote

This website uses first party and third party cookies to improve your experience and anonymously track site visits. By visiting this website, you opt-in to the use of cookies. OK