2004-2005 Professional Liability Insurance Certification; No. 27 Disciplinary Rules; Doc. No. 1
[34 Pa.B. 2321]
And Now, this 15th day of April, 2004, pursuant to this Court's inherent and exclusive power to supervise the conduct of attorneys, as set forth in Section 10(c) of Article V of the Constitution of Pennsylvania, and in furtherance thereof, It Is Hereby Ordered that every attorney admitted to practice law in this Commonwealth and selecting active status shall respond to all inquiries made by the Administrative Office pursuant to Rule 219(d)(1)(vi), Pa.R.D.E. concerning professional liability insurance. Responses to such inquiries will be used to provide statistical information to the Court and will be kept strictly confidential.
It is Further Ordered that the failure to fully respond to all such inquiries shall be deemed a request for transfer to inactive status, and the Administrative Office shall certify the names of such attorneys to the Court, which shall immediately enter an order transferring the attorney to inactive status. Attorneys transferred to inactive status for failure to respond shall not regain active status until they have fully responded to all such inquiries.
2004-05 PROFESSIONAL LIABILITY INSURANCE CERTIFICATION
To obtain current, accurate information about the financial responsibility of each attorney electing to assume or continue active status for professional liability claims, the Supreme Court requires this certification to be fully executed and returned with your 2004-2005 Annual Fee Form to: Administrative Office of PA Courts/Lawyer Assessment, P. O. Box 46, Camp Hill, PA 17001-0046. A copy of the Supreme Court's Order requiring certification is provided on reverse.
1. Name: _________________ 2. Attorney ID Number: _________________
3. Office Address: ___________________________
4. County Where Primary Practice is Located: _________________
5. Places of Legal Employment (Check all that apply):
[ ] Small Law Firm (2-5 attorneys) [ ] Corporate Legal Department [ ] Medium Law Firm (6-20 attorneys) [ ] Federal Government [ ] Large Law Firm (21+ attorneys) [ ] State Government [ ] Solo Practitioner [ ] Local Government [ ] Public Defender [ ] Legal Service Organization [ ] Other Law Related Employment
6. I am engaged exclusively in the practice of law as a full-time government attorney, legal service organization attorney, public defender, judicial clerk or corporate in-house counsel and do not represent clients outside that capacity. If yes, I am not required to provide information requested in Questions 7-8 below.
[ ] YES [ ] NO
7. I am currently covered by a professional liability insurance policy, other than an extended reporting endorsement (also referred to as ''tail'' coverage, it generally provides liability coverage for claims that are made after a policy's expiration and only if the claim-related occurrence took place prior to the expiration date).
[ ] YES [ ] NO
If yes, then provide the policy details below (or attach a copy of a verification of insurance by carrier(s) providing policy details as specified).
Name of Insurance Carriers Per Claimant or Occurrence Limits
Aggregate Limits $ . 0 0 $ . 0 0 $ . 0 0 $ . 0 0 $ . 0 0 $ . 0 0
8. I am engaged in the private practice of law (full or part-time) involving representation of one or more clients within the Commonwealth of Pennsylvania. [ ] YES [ ] NO
9. I have unsatisfied legal malpractice judgments entered against me or against a professional entity arising from my performance of legal services. [ ] YES [ ] NO
If yes, then provide the date of judgment, amount of judgment and court below.
Courts $ . 0 0 $ . 0 0 $ . 0 0
I certify the information provided is true. If any statements are false, I realize I am subject to discipline by the Supreme Court of Pennsylvania.
Signature of Attorney Date
ALL CERTIFICATION QUESTIONS MUST BE ANSWERED TO RETAIN ACTIVE ATTORNEY STATUS.
[Pa.B. Doc. No. 04-756. Filed for public inspection April 30, 2004, 9:00 a.m.]
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