ACORD 37 Statement of No Loss – Free Printable PDF Template

ACORD 37 (2008/01)

Statement of No Loss

Form Number:

ACORD 37 (2008/01)

Category:

Insurance Forms

Last Updated:

January 2008

Page Count:

01 page

File Format:

PDF, Fillable PDF

Statement Of No Loss Acord 37

To reinstate or renew an insurance policy, the insurer requires proof of no losses, accidents, or claims occurring during a specified period. The Acord 37 statement of no loss form provides evidence to the insurer that no losses have occurred during a lapse or cancellation period. Policyholders, agents, and insurers use the Acord insurance reinstatement form to verify risk stability for personal and commercial policies.

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Benefits of the Acord 37 PDF

Enables Policy Reinstatement

The certificate of no loss statement allows policyholders to reinstate policies without delays.

Prevent Fraudulent Claims

The statement assures insurers that no loss occurs during the lapsed period to avoid fraudulent claims.

Prevents Policy Cancellation

The timely submission of the Acord 37 form fulfills the legal requirements and avoids permanent policy cancellation.

Instant Approval

Accurately completing the form ensures instant approval to reinstate or renew the policies.

Key Sections of the Fillable Acord 37 Form

Producer Information

Includes the details of the producer to help the insurer authenticate the agency’s involvement and coordinate processing.

Insured Details

Contains the insured’s information to verify the identity of the policyholder providing the statement.

Insurance Company Information

Records the insurance company’s details to certify that the correct insurer is connected with the no-loss statement.

Certification Statement

The statement provided ensures the insurer that no loss occurs during a specific period and helps reinstate approval.

Signature and Date

The insured’s or authorized representative’s signature and date validate the statement.

Payment Receipt

Records the documents to reinstate the policy for cleared premium arrears.

How to Fill Out the Acord 37 No Loss Form?

  1. Write the agency’s name, residential address, phone number, email address, fax number, and customer ID number.
  2. Write the insured’s name, mailing address, and phone number.
  3. Mention the insurance company’s name and NAIC number.
  4. Write the policy number.
  5. Write the statement that no loss or damage occurs during the specific period.
  6. Get the insured’s signature and mention the date.
  7. Write the amount received for reinstatement, the producer’s name, and witnesses, and mention the date.
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Frequently Asked Questions

No, the Acord certificate of no loss is only for existing policies during the cancellation period.

Check your insurance policy’s effective and expiration dates, or contact the insurance agent for the exact start and end dates.

Yes, the form helps the policyholder to reinstate or renew the existing policy and avoid rate hikes.

The no-loss statement form helps to reinstate the existing policy and avoid the costs associated with new policy underwriting.

The process usually takes a few business days to complete, depending on the insurer’s verification and payment processing.

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ACORD 31

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ACORD 31 (2016/03)