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Claim Notice Report (Step 1 of 3)                (Aussi disponible en française)

If you do not receive a confirmation number, we did not receive your notice, and it is imperative that you contact the Claims Coordinator.

This form is to be completed ONLY when providing notice of a claim against YOURSELF or on BEHALF OF ANOTHER LAWYER. DO NOT complete this form to provide notice against another lawyer. Please do not delay filing this notice because you are waiting on additional information. Complete as much of the form as possible so we can commence our investigation, or consider the appointment of counsel. You should take any necessary steps to protect your interests and those, if any, of LAWPRO with respect to any deadline in the interim.

* mandatory field

I am providing notice of a claim or a potential claim *
     against me      on behalf of another lawyer



     Insured LAWYER Last Name: *
     Insured LAWYER First and Middle Name(s): *
     - -    ext.
     E-mail: A confirmation e-mail will be sent to this address
     Country: *
     If other, please specify:
     Mailing Address: *
     City: *
     Firm Name on date of alleged error: *
     Name of the Managing Partner and/or Shareholder(s) of the Insured's current   law firm/law corporation:


2. Claimant Last or Corporate Name: *
     Claimant First Name:
3. Self-Represented?
     Yes      No


4. Date on which the alleged error or omission occurred: *
5. Date on which you first became aware of the claim or potential claim against you: *
6. Did the claim or potential claim arise out of the provision of pro bono services? *
     Yes      No     
7. How did you become aware of the claim or potential claim? *
8. Has a proceeding been commenced against you? *
     Yes      No
9. Does your firm carry excess insurance? *
     Yes      No      Don't know
10. Area of Practice:
11. Your status on the date on which the alleged error or omission occurred?
     Sole Practitioner
     Partner in Firm
     Employee in Firm
     Associate in Firm
     Employed Other
     Employed-In-House Counsel


12. Describe fully the circumstances giving rise to the claim. To the extent known, include relevant dates: *
      We recommend you save the content using Notepad or Microsoft Word as a text file in your computer first,
      and then copy the content and paste into the text area below.

      Note: You will have the opportunity of uploading documents in Question 13.
13. Do you have Pleadings, Motion Records and/or Notice Letters related to the possible/alleged error? *
       Yes      No     


14. As our claims document handling process is electronic, we strongly encourage you to upload all relevant documentation regarding the claim. If you are unable to attach the above-noted document(s) electronically, please indicate below the method by which you are planning to send them: *
     e-mail    fax    same-day courier    overnight courier    All relevant documents attached   
     No relevant documents to provide   

Next steps:
  • Note that you must first 'Review' your Claim Notice form before being able to SUBMIT it online.
  • Click 'Review' to see a summary of your entries before submitting your Claim Notice form; OR
  • Click 'Reset' to abandon your entries and start over; OR
  • Click 'Cancel' to exit the Claim Notice form.

Fax: 1-800-286-7639     Attn.: Claims Coordinator
Attn: Claims Coordinator
250 Yonge Street, Suite 3101
P.O. Box 3
Toronto, ON M5B 2L7


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