Applications, Supplemental Forms, and Related Questionnaires

Below are the applications and forms needed to initiate the quotation process for insurance products offered through TDC Specialty Underwriters. Each link opens a fillable PDF, which means the form can be completed on-screen. Once completed, print the forms, sign and date them, and include any additional required materials before emailing the submissions package.

How to Submit

Send completed application materials via email.

Or regular mail:
TDC Specialty Underwriters, Inc.
29 Mill Street
Unionville, CT 06085

Questions?

(860) 269-2810

Our Submissions Team will send you an email confirmation to acknowledge receipt and advise you of any further action you need to take to ensure we have designated you as the broker of record on a respective submission. Our goal is to respond within one business day of receipt.

Please keep in mind that, at a minimum, completed forms must be accompanied by loss and exposure information related to a respective submission in order to be deemed complete and eligible for broker of record status.

Hospitals

Long Term Care

Medical Facilities

E&S Physicians

Managed Care

Management Liability

Life Sciences

Excess

Additional