Insured Details
Full legal entity name, mailing address, and contact information for the insured and any named insureds; use exact legal names as shown on primary policy.
A clear, complete request prevents coverage gaps, supports contractual compliance, and reduces claim disputes. It provides underwriters and certificate holders the information needed to confirm excess limits and any special endorsements required by a contract or project.
Who completes or receives these requests varies by role and industry; the following outlines common participants.
The document often circulates between the insured, broker, insurer underwriting team, and the certificate holder; accuracy at each step reduces delays and disputes.
Full legal entity name, mailing address, and contact information for the insured and any named insureds; use exact legal names as shown on primary policy.
Name and address of the party requesting evidence of excess coverage; specify whether coverage must name the holder as additional insured or provide endorsement language.
Specify excess limit amounts (for example, $1,000,000 per occurrence / $2,000,000 aggregate) and explain whether limits are per-project or blanket.
Effective and expiration dates in MM/DD/YYYY format, matching contract term; state if coverage must be retroactive to a project start date.
Detail the primary insurer, policy number, limits and self-insured retentions that must remain in place before excess attachment.
Signature block for an authorized representative, printed name, title, and date to validate the request and permit release of policy information.
| Field | Configuration |
|---|---|
| Authentication Method | Use email link or SMS code for signer verification. |
| Conditional Fields | Show excess-limit fields only if excess coverage is requested. |
| Routing Order | Route to broker then underwriter then certificate holder. |
| Notifications | Enable status emails for each completed step. |
Electronic submission should use secure platforms that support audit trails, common formats, and integrations with broker systems.
Choose a platform that preserves the signed record, stores an audit trail, and integrates with your document management system to support compliance and future audits.
Submit at least 10 business days before coverage is required by contract.
Varies by carrier; allow multiple business days for underwriting checks.
Ensure policy effective date matches contract start to avoid gaps.
Request renewals 30 days before policy expiration to secure continuous coverage.
Keep copies until retention obligations expire per company policy.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | Yes, 7-day trial | Varies by vendor | Varies by vendor | Varies by vendor | Varies by vendor |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |