The Department of Insurance requires the Lawyers
Professional Liability Form to be submitted by insurers providing coverage
for members of the Florida Bar for any claim resulting from error, omission,
or negligence in the performance of the insured.
How to Submit an LPL Form
Now that you've completed the initial
steps of creating your new closed claim form, and you understand the
claim summary page you're ready to get
into the details of your LPL form.
On the LPL Claim Summary page below, you'll
notice that the LPL form has five primary sections:
Insured/General Claim
Information
Attorney Information
Plaintiff Information
Legal Information
Financial Information
The status of each of these five sections must
be complete in order to submit the form to the Office of Insurance Regulation
for review.
Note: Completing all sections of the LPL form
may take some time. Feel
free to save your data in the current section of the form and return to
other sections as your time permits.
The LPL Claim Summary
Page
Section 1: Insured Information
The first section of the LPL form provides fields in which you will
enter information about the insured person or entity. The
Insured Information page is displayed below.
The Insured Information
Page
To Edit the Insured Information Page:
Fill in the following list of fields (Fields in
blue apply only if Type: Individual is selected):
Type
Type indicates whether the insured is an individual or entity. Select
Individual or Entity from the drop down box as appropriate.
First Name
The given name of the insured if the Type is Individual.
Middle Initial
The middle initial of the insured if the Type is Individual.
Last Name
The family name/surname of the insured if the Type is Individual.
Entity Name
The name of the insured company if the Type is Entity
Street Address of Business Practice
The street address of the insured's business.
City
The city in which the insured's business is located.
State
The state in which the insured's business is located.
County
The county in which the insured's business is located.
Zip Code
The ZIP/Postal Code address in which the insured's business is located.
Policy Number
The insured's insurance policy number.
Per Claim Policy Limits
The per claim policy limits on the insured's policy.
Aggregate Policy Limits
The aggregate policy limits on the insured's policy.
Type of Claim
This field specifies the type of claim filed against the insured.
Other
If the type of claim you're looking for does not appear in the Type
of Claim list, select "Other" from the Type of Claim list and
type a description of the claim in this field.
Date of Occurrence
The date of the claim's occurrence.
Date Reported to the Insurer
The date on which the claim was reported to the insurer.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking
the Reset button will reset all
fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
Upon clicking the Save button
all address fields are verified using CODE1 validation. If
the CODE1 validation does not find the address you input into the address
fields, the following Address Validation page will display.
The CODE1 Address Validation
Page
The CODE1 validation page will display the address data you supplied,
CODE1 data that offers a possible known address that is correct, and remarks
regarding the address data.
You may choose to either:
Select "User Data". Selecting
this option will use the address information you supplied, rather than
the CODE1 suggested address.
Select "CODE1 Data". Selecting
this option will use the CODE1 address data found by CODE1 and replace
the address information you supplied.
Select "Reject Report". This
will ignore the CODE1 validation report entirely.
Click the Done button after
making your selection to return to the Insured Information page.
Section 2: Attorney Information
The next section of the LPL form allows you to add additional attorneys
involved in this particular claim that are not covered by the policy.
The AttorneyInformation page is displayed below.
The Attorney Information Page
To Add an Attorney:
Enter the first name of the attorney.
Enter the middle initial of the attorney.
Enter the last name of the attorney.
Click the Add
button. You will notice the name of the attorney you added will appear
in the List of Attorneys box.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking
the Reset button
will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
To Remove an Attorney:
Select the attorney from the List of Attorneys
box.
Click the Remove
button. The
attorney will be deleted.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking the Reset
button will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
To Update an Attorney:
Select the attorney from the List of Attorneys
box.
Alter the name of the attorney as appropriate.
Click the Update
button to finalize the change.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking the Reset
button will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
Section 3: Plaintiff Information
This section of the LPL form allows you to enter the name of the individual
or entity acting as the plaintiff in the lawsuit.
The Plaintiff Information Page
To Edit the Plaintiff Information Page:
Fill in the following list of fields (Fields in
blue apply only if Type: Individual is selected):
Type
Type indicates whether the plaintiff is an individual or entity. Select
Individual or Entity from the drop down box as appropriate.
First Name
The given name of the plaintiff if the Type is Individual.
Middle Initial
The middle initial of the plaintiff if the Type is Individual.
Last Name
The family name/surname of the plaintiff if the Type is Individual.
Entity Name
The name of the plaintiff company if the Type is Entity
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking the Reset
button will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
Section 4: Legal Information
Next is the Legal Information section of the LPL form. In
this form you'll fill out information pertaining to the legal action taken
on the liability claim. The
Legal Information page is displayed below.
The Legal Information Page
To Edit the Legal Information Page:
Fill in the following list of fields:
Date of Suit
The date the lawsuit of the injured individual was filed against the
insured attorney.
Circuit Court Case Number
The circuit court case number assigned to the lawsuit.
County Suit Filed In
The county in which the lawsuit was officially filed.
Date of Final Disposition
The date of the final outcome of the lawsuit (i.e., date of the settlement
or court verdict, etc.).
Final Method of Claim Disposition
The method that resolved the lawsuit (e.g., settled by parties, disposed
of by court, etc.).
Court Decision
The final decision of the court on the lawsuit, if the lawsuit was not
resolved out of court. If
the lawsuit was resolved out of court, select "No Court Proceedings".
Other Court Decision
If the Court Decision rendered does not appear in the drop down list
of Court Decision options, select "Other" from the list of court
decisions and type in the type of court decision.
Date of Final Payment
Enter the date on which the malpractice claim was paid by the insurer,
if a verdict rendered payment necessary. If
no payment was made, leave this field blank.
Stage of Legal System at Which Settlement was Reached
At what point in the legal process was the lawsuit resolved (i.e., after
arbitration, after court verdict, etc.).
Arbitration
Describes the result of the arbitration used to settle the case, if
any.
List of Other Defendants
This is an area where you may add other defendants involved in the case
that are not covered under this policy. If
there are no other defendants, be sure click the checkbox next to the
text "No Other Defendants Involved in this Claim". See step
3 below for more information.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking the Reset
button will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
If you need to add additional defendants involved
in the case that are not covered under this policy or update the list
of defendants, click the Add/Update/Remove
Defendant button. The
Other Defendant Information page will display. If
you do not need to add or update additional defendants, proceed to step
6.
The Other Defendant Information
Page
To Add a Defendant:
Select Individual or Entity from the Type
drop down list.
Enter the name of the entity or individual.
Enter the license number of the entity
or individual.
Click the Add
button. You will notice the name of the entity or individual you added
will appear in the Defendants Involved in this Claim box.
To Remove a Defendant:
Select the individual or entity from the
Defendants Involved in this Claim box.
Click the Remove
button. The
defendant will be deleted.
To Update a Defendant:
Select the individual or entity from the
Defendants Involved in this Claim box.
Alter the name of the individual or entity
as appropriate.
Alter the license number as appropriate.
Click the Update
button to finalize the change.
When you are finished updating defendant information,
click the Done button. This
will return you to the Legal Information page.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking the Reset
button will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.
Section 5: Financial Information
The last section of the LPL form you'll need to fill out is the Financial
Information section. This
section captures the monetary values paid to the plaintiff, if any, as
well as costs incurred by the defendant. The
Financial Information page is displayed below.
The Financial Information Page
To Edit the Financial Information Page:
Fill in the following list of fields:
Plaintiff Payment Indicator
Click the radio button next to Yes or No to indicate whether there was
a settlement or judgment resulting in payment to the plaintiff.
Indemnity Paid by Insurer
If the plaintiff received payment as a result of the settlement or judgment,
list the amount of the indemnity paid by the insurer on behalf of the
insured individual.
Deductible Paid by Defendant
List the amount of the deductible paid by the defendant.
Defense Counsel Expense
List the amount of loss adjustment expense paid to the defense counsel.
Other Expenses
List all other loss adjustment expenses paid.
Safety Management
List any safety management steps that were taken as a result of this
incident of medical malpractice, if any were necessary.
Click the Save
button to save your changes and return to the LPL Claim Summary Page.
Clicking the Reset
button will reset all fields to blank.
Clicking the Cancel button will return you to the
LPL Claim Summary page without saving your changes.