Below you’ll find links to download all necessary forms and applications by category. When a specific form is required by state, download the form listed under your state name.
Please return completed PDF forms to: [email protected]
CA Insurance Lic. #0652783
The Dentists Insurance Company underwrites Professional Liability in AK, AZ, CA, HI, ID, IL, MN, MT, NV, NJ, ND, OR, PA, TN, WA, as well as Commercial property and GL in OR, WA, ID, TN & MT. Additional coverages written by TDIC include: Commercial Property and Cyber Suite Liability in AZ, CA, HI, IL, MN, NV, NJ, ND and PA. TDIC also underwrites Workers’ Compensation in CA. Other insurance products are placed through TDIC Insurance Solutions or other brokers with outside carriers, or with WDIA, a full service brokerage that places disability, health, life, long-term care, cyber security and other coverages in Washington, or IDIA, a full service brokerage that places workers’ comp, disability, health, life, long-term care and other coverages in Idaho with outside carriers.