To apply for coverage:
Apply for coverage by e-mail
View PDF Fillable Form Instructions
- Save the PDF application to your computer.
- Ensure you have the current version of Adobe Reader.
- Open Adobe Reader.
- Choose File > Open, and find the PDF application you saved to your computer. Open it.
- Complete all required fields. When you are finished, click the Signature of Applicant field.
- Follow the steps onscreen to create and insert your electronic signature.
- Save the document.
Apply for coverage by mail or fax
Print the application, complete it by hand, and fax or mail it to your insurance agent. If you are not working with an agent, you can fax or mail it directly to MMIC:
ATTN: Sales and Marketing
MMIC, Suite 500
7701 France Avenue South
Minneapolis, MN 55435