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DocuSign Envelope ID:656DF690-72BC-42BC-9E47-7038084D8FFA <br /> e. i berty <br /> €rater nazi nal <br /> U rd rc+,ra ers> <br /> Healthcare Professional Liability <br /> LIBERTY INSURANCE UNDERWRITERS INC. <br /> (.Stock Insurance Company,hereinafter the"Company") <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> COVERAGE EXTENSION UPON MEMBERSHIP TERMINATION ENDORSEMENT <br /> The premium for this endorsement is included in the premium shown on the Declarations unless a specific amount is <br /> shown here: <br /> Premium: $ <br /> In consideration of an additional premium of$ per member, each Insured shall be entitled, upon <br /> termination of active membership status,to an indefinite period of time following the effective date of such termination <br /> in which to give written notice to the Company of Claims first made against the Insured during this Reporting Period <br /> for an Incident occurring prior to the termination of their membership in the Federation subject to all other policy <br /> terms, conditions, limitation and exclusions. This Reporting Period shall terminate in the event that this policy is <br /> cancelled or non-renewed by the Named Insured or the Company. <br /> ALL OTHER lERNIS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. <br /> • 1 <br /> HCPL-8004(Ed. 11/09) <br />