Orange County NC Website
Browse       Search
PF-15215a (04/07)© 2007 The Trust <br />Psychologists’ Professional Liability <br />Claims Made Insurance <br />Policy Declarations <br />ACE American Insurance <br />Company <br />PRODUCER NUMBER 273865 DATE OF ISSUE July 24, 2025 <br />PSYCHOLOGISTS’ PROFESSIONAL LIABILITY <br />CLAIMS MADE INSURANCE POLICY <br />NOTICE: THIS IS A CLAIMS MADE POLICY, PLEASE READ THE POLICY CAREFULLY <br />THIS POLICY/CERTIFICATE IS ISSUED IN ASSOCIATION WITH THE PSYCHOLOGISTS PURCHASING <br />GROUP ASSOCIATION <br />Item POLICY/CERTIFICATE NUMBER: 58G74115974 <br />1. <br />Named Insured:Dr. Samantha B England <br />Address:113 Cinder St <br />City, State & Zip Code:Knightdale, NC 27545 6001 <br />2.Policy Period: <br />12:01 A.M. local time at the address shown in Item 1. <br />From:09/11/2025 To:09/11/2026 <br />3.COVERAGE LIMITS OF LIABILITY PREMIUM <br />Professional Liability <br />Wrongful Employment <br />Practices <br />$1,000,000 Each Incident $3,000,000 <br />$5,000 <br />Aggregate <br />Aggregate $577.00 <br />REIMBURSEMENTS <br />Licensing Board Defense <br />Other Governmental Regulatory <br />Body Defense <br />Deposition Expense <br />Premises Medical Payment <br />Assault and/or Battery <br />Loss of Earnings <br />$5,000 <br />$5,000 <br />$5,000 <br />$2,500 <br />$500 <br />per Proceeding <br />per Proceeding <br />per Insured <br />per Person <br />per Day, per Insured <br />$75,000 <br />$1,000 <br />$15,000 <br />Aggregate <br />Aggregate <br />Aggregate Per Incident <br />Surcharge(s) <br />Total Premium $577.00 <br />4.Retroactive Date 09/11/2023 <br />5.This policy is made and accepted subject to the printed conditions in this policy together with the provisions, stipulations and <br />agreements contained in the following form(s) or endorsement(s). <br />PF15215a, PF33748 , PF15217a (05/07), CC-1K11k (10/24), PF15245a, PF15235a, PF15282b, PF17914 (02/05), <br />6.Notice of claim should be sent to: <br />Trust Risk Management Services, Inc. <br />111 Rockville Pike Ste 700 <br />Rockville MD 20850 <br />All other correspondence should be sent to: <br />Trust Risk Management Services, Inc. <br />1791 Paysphere Circle <br />Chicago, IL 60674 <br />7.REPRESENTATIVE:Agent or broker: Trust Risk Management Services, Inc. <br />doing business in NC as Potomac Risk Management Services, Inc. <br />Office address:1791 Paysphere Circle <br />City, State, Zip Chicago, IL 60674 <br />Website:www.trustinsurance.com <br />Phone:1.877.637.9700 <br />Docusign Envelope ID: 868EF087-BD0C-4926-8370-5D4A232273A6