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Sample Policy Forms

To view or download NSO and HPSO’s sample professional liability insurance policy forms, please select your state of residence below. There will be two categories of forms: forms that are applicable to all states, and forms that are specific to each state.  

To determine the appropriate forms, please refer to the list of forms found on Page Two of your Certificate of Insurance, if applicable. Please note that these forms are specimen and do not constitute or replace the terms and conditions of any insurance policy. If you would like to obtain a paper copy of your policy, please email us at service@nso.com.

Click here to view sample policy forms for policies renewed after July 1, 2024.

Select your state of residence:
This information is provided for general informational purposes only and is not intended to provide individualized guidance. All descriptions, summaries or highlights of coverage are for general informational purposes only and do not amend, alter or modify the actual terms or conditions of any insurance policy. Coverage is governed only by the terms and conditions of the relevant policy. Any references to AIS, NSO, HPSO websites are provided solely for convenience, and AIS, NSO and HPSO disclaims any responsibility with respect to such websites.  This information is not intended to offer legal advice or to establish appropriate or acceptable standards of professional conduct. Readers should consult with a lawyer if they have specific concerns. Neither Affinity Insurance Services, Inc., NSO, HPSO, nor CNA assumes any liability for how this information is applied in practice or for the accuracy of this information.   

Healthcare Providers Service Organization is a registered trade name of Affinity Insurance Services, Inc., a licensed producer in all states (TX 13695); (AR 100106022); in CA, MN, AIS Affinity Insurance Agency, Inc. (CA 0795465); in OK, AIS Affinity Insurance Services, Inc.; in CA, Aon Affinity Insurance Services, Inc., (CA 0G94493), Aon Direct Insurance Administrators and Berkely Insurance Agency and in NY, AIS Affinity Insurance Agency.