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It’s easy to begin the claim process

A medical malpractice claim is one of the most difficult and trying experiences you can go through as a doctor. We want you to know that here at MedMal Direct Insurance Company, we will aggressively defend your interests and work with the best defense attorneys to ensure that your claim is handled effectively and with the best possible outcome for your practice.

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How to submit the claim form

You can submit your claim form in any of the following methods:

Upload your form below
E-mail to: claims@mymedmal.com
Fax to: (904) 354-4813
Mail to:
MedMal Direct Insurance Company
Claims Department
One Independent Drive, Suite 3205
Jacksonville, Florida 32202

Name and Email Address


First Name *
Last Name *
Email Address *


	Resume or CV (Word, PDF, Text or Image File :: Limit 1MB)


	Business Letterhead (Word, PDF, Text or Image File :: Limit 1MB)


	If yes, please upload your NICA Certificate (Word, PDF, Text or Image File :: Limit 1MB)


	Current Declarations Page or Certificate of Insurance (Word, PDF, Text or Image File :: Limit 1MB)

Already have a claim form? Upload it below.
Don't have a claim form? Complete and upload ours: Incident/Claim Form »


	Upload Incident/Claim Information File (Word, PDF, Text or Image File :: Limit 1MB)

Report a Claim Back to Get a Quote »

It’s easy to begin the claim process

How to submit the claim form

Name and Email Address

UPLOAD a copy of current curriculum vitae or resume

UPLOAD a copy of your business letterhead

NOTE: If you are a NICA member please provide membership proof. UPLOAD a copy of your NICA Certificate

NOTE: If you currently carry insurance, please UPLOAD a copy of your current declarations page or certificate of insurance

Already have a claim form? Upload it below.
Don't have a claim form? Complete and upload ours: Incident/Claim Form »

Report a Claim Back to Get a Quote »

It’s easy to begin the claim process

How to submit the claim form

Name and Email Address

UPLOAD a copy of current curriculum vitae or resume

UPLOAD a copy of your business letterhead

NOTE: If you are a NICA member please provide membership proof. UPLOAD a copy of your NICA Certificate

NOTE: If you currently carry insurance, please UPLOAD a copy of your current declarations page or certificate of insurance

Already have a claim form? Upload it below. Don't have a claim form? Complete and upload ours: Incident/Claim Form »

Already have a claim form? Upload it below.
Don't have a claim form? Complete and upload ours: Incident/Claim Form »