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STATEMENT OF INSURED ON POLICIES ISSUED UNDER THE ALABAMA SURPLUS LINES INSURANCE LAW Revised 04.2013 Surplus Lines Carrier: Named Insured: Policy Number: Policy Effective Date: Policy Issue Date:
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01
To fill out a statement of insured, you need to follow the below steps:
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Start by writing the insured's full name, address, and contact information.
03
Provide details about the insurance policy, such as the policy number and effective date.
04
Mention the reason for filing the statement of insured, including any incidents or claims.
05
Include details of any witnesses or supporting documents that can verify the insured's statement.
06
Sign and date the statement of insured, and provide any additional information or declarations if required.
07
Keep a copy of the completed statement for your records and submit it to the relevant insurance company or party.

Who needs statement of insured on?

01
Anyone who has an insurance policy and wants to make a formal statement regarding a claim or incident may need a statement of insured.
02
This includes individuals who have been involved in accidents, suffered property damage, or experienced any other covered events.
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Insurance companies often require a statement of insured to process claims and determine liability.
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It is also important for claimants to provide a clear and concise account of the incident when dealing with legal or insurance proceedings.
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Statement of insured on is a document that provides details of insurance coverage on a specific asset or individual.
The policyholder or insured individual is required to file the statement of insured on.
The statement of insured on can be filled out by providing relevant information about the insurance coverage, including policy details, coverage limits, and beneficiary information.
The purpose of statement of insured on is to document and verify the insurance coverage on a particular asset or individual.
The information that must be reported on the statement of insured on includes policy details, coverage limits, beneficiary information, and any changes to the insurance coverage.
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