Applications, Supplemental Forms, and Related Questionnaires

Provided below is a list of applications and forms needed to initiate the quotation process for insurance products offered through TDC Specialty Underwriters. Each link provides access to a PDF version of the document in a writable form, which means the form can be completed on-screen. Once completed, print forms for signature.

After the forms have been signed and dated, scan the documents for inclusion with other required submission materials and e-mail them to:

Or send them by regular mail to:

TDC Specialty Underwriters, Inc.
29 Mill Street
Unionville, CT 06085

Upon receipt of your submission, our Submissions Team will send you an e-mail confirmation to acknowledge receipt and advise you of any further actions you need to take to assure 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.

If you have any questions regarding these forms, please contact our Submissions Team at (860) 269-2810.

Complex Risks:


Life Sciences:

Long Term Care:

Managed Care:

Medical Facilities:

Non-Standard Physicians:


About TDC Specialty Underwriters

TDC Specialty Underwriters is a subsidiary of The Doctors Company, the nation's largest physician-owned medical malpractice insurer. Read more about The Doctors Company and its mission to relentlessly defend, protect, and reward the practice of good medicine.


In August 2016, The Doctors Company announced the creation of TDC Specialty Underwriters, a new excess and surplus lines subsidiary, to bring industry-leading products and services to healthcare industry insurance buyers. Read the press release

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Some coverages may be underwritten by TDC Specialty Insurance Company or TDC National Assurance Company, wholly owned subsidiaries of The Doctors Company. Insurance coverages, products, or policy terms may vary by state.