Apply with MICA

MICA offers Medical Professional Liability on a direct basis. If you would prefer to work with one of our broker partners, please click here to find one in your area. There are 4 ways to apply for coverage with MICA directly:

  • Apply online. Click here to get started.
  • Apply by email. Download application, complete, and email to
  • Apply by mail. Download application, complete, and mail to 2602 E Thomas Rd, Phoenix, AZ 85016.
  • Apply by fax. Download application, complete, and fax to 602-627-7033.

If you are applying by email, mail or fax, select your coverage type and click on the link(s) below to download the application.

+Individual Physician Application
+Advanced Healthcare Professional Application – CNM, CRNA, NP or PA
+Business Entity (Group) Application
+Facility Application