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It is important that we receive complete underwriting information
in order to provide a timely quote.
A "Complete Submission" consists of:
- Completed, Signed and Dated Lighthouse Eldercare Supplemental Application
- Completed & Signed acord applications with signed Statement
of Values
- Resident Service Contract
- Five years currently valued loss runs by line of business and policy period
- Five years of premium history by line of business and policy period
- Most recent financial statements, including Balance Sheet, Income and Expense Sheets, & Notes
- Copy of Licenses
- Brochures
- State Inspection Reports (SNF/ICF) (Last two years with any
statement of deficiencies and plan of correction)
- Resumes if business is less than 3 years old
- Copy of Business Plan and Pro-Forma Budget if business is less than 3 years old
- Copy of Risk Management Plan including policies, procedures, and protocol
To print out a copy of the Lighthouse Eldercare supplemental application,
click here
Please fax,
or email your submission to (703) 770-0989 or eldercare@lighthouseunderwriters.com
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