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The simplest method is to apply online!

Online Method

  • Complete the online application, and upon completion, the application will return you to a page where you can upload any supplementary documents needed.

Paper Method

  • Click the pdf application which will open on your computer, where you can complete it.
  • Print it, Sign it and choose:
  • E-mail it: send it via e-mail to
  • Fax it: Fax it to: (855) 715-0376
  • Mail it: “snail mail” it to us at: MedMal Direct Insurance Company, 245 Riverside Ave, Suite 550, Jacksonville, FL 32202

If you have supplementary documents to get us, then simply UPLOAD YOUR FILES ONLINE to submit your documents directly to MedMal Direct. You may also submit the documents via E-mail, Fax or U.S. Mail as well.