Can an electronic signature authorize release?

Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, electronic signatures can form valid authorizations when intent, consent, attribution, and record retention are documented. Confirm carrier policy for specific authentication requirements.

How long will the insurer take to respond?

Response times vary by carrier and the completeness of your request; common windows are 7–30 days. If you need faster service, ask the carrier about expedited handling and any associated fees.

What if the loss run contains errors?

Contact the carrier or TPA immediately with supporting documentation. Request a corrected loss run in writing and keep copies of communications. Disputes may affect underwriting outcomes and should be resolved before renewal.

Do carriers require notarization or RON?

Most carriers do not require notarization for loss run requests but may require signed authorization. Remote Online Notarization (RON) or notarized letters are sometimes requested for third-party releases; follow carrier instructions.

Are health-related claims subject to HIPAA protections?

Yes. Medical claim detail may implicate protected health information; carriers and requestors must follow HIPAA (45 CFR §164) and may require limited authorizations or redaction unless proper consent is provided.

How should I store received loss runs securely?

Store signed loss runs in encrypted systems with access controls and retention policies. Use platforms that support TLS and AES-256 encryption at rest and maintain audit trails for authorized access.

Electronic Signature
Templates
Insurance
Insurance Loss Run Report

Insurance Loss Run Report

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

INSURANCE LOSS RUN REPORT

Insured Name: Insurer Name:

Insured Date of Birth: Policy Number:

Insured Address

Policy Details

Policy Type / Lines of Business

Auto Property General Liability Workers' Compensation Other:

Coverage Limit Deductible Annual Premium

Policy Period From: To:

Loss Run Period Requested & Coverage Options

Loss Run Period From: To:

Include Claims

Open Claims Closed Claims Payments / Reserves / Incurred

Claims Summary (Provide all claims during period)

The insurer shall list each claim including claim number, dates, cause, status, payments, reserves and total incurred. If claim files are voluminous, attach an indexed schedule and check the appropriate boxes below.

Claim #	Date of Loss	Date Reported	Status	Paid	Reserved	Total Incurred

Per-Claim Narrative / Cause and Location (Attach further pages if necessary)

Documentation Checklist

Police Report Photographs Repair / Damage Estimates Medical Records & Bills Receipts / Invoices

Exclusions / Reservations

Loss Payee / Beneficiary Information

Loss Payee / Beneficiary Name

Relationship: Percentage:

Certification and Release

By signing below the undersigned certifies that the information contained in this Loss Run Report is accurate, complete, and fairly represents all claims and claim activity for the insured identified above during the requested period. The insurer makes no warranty as to future claim activity. This report is provided for underwriting, claims handling, and risk transfer evaluation purposes only and shall not be interpreted to alter, waive, or expand the terms and conditions of any policy of insurance.

The insurer or authorized representative further certifies that claim payments and reserve figures reflect payments and reserves recorded in company claim systems as of the date of this report. Any material changes after the report date will be reflected only in subsequent reports or supplemental documentation.

Additional Remarks

Authorized Representative Printed Name:

Title / Position:

Signature:

Date:

What an Insurance Loss Run Report Is and When It’s Used

An Insurance Loss Run Report is a historical record of claims activity tied to an insurance policy or insured entity. It lists reported losses, claim dates, amounts paid and reserved, claim status, and brief descriptions. Underwriters, brokers, and insureds use loss runs to evaluate risk, set premiums, and support renewals or new policy applications. Lenders and buyers often request loss runs during due diligence. The report is typically produced by the insurer or its third-party administrator and is a core underwriting input for property, casualty, and specialty lines.

Why the Insurance Loss Run Report Matters for Risk and Renewal

Loss runs provide a factual claims history used by underwriters to price coverage, by brokers to advise clients, and by insureds to spot reporting errors or disputed entries. They reduce underwriting uncertainty and support accurate premium calculation, renewal negotiations, and regulatory or lender requests.

Who Typically Requests or Prepares Loss Run Reports

Identifying the requester and intended use helps the insurer produce a loss run with the necessary detail and date range.

Real Estate professionals and property managers seeking claim history for acquisitions or lease underwriting (g2 sample: 15 mentions).
Healthcare and medical practice administrators verifying malpractice and liability claims as part of credentialing and coverage renewals (g2 sample: 11 mentions).
Finance, legal, and insurance brokers performing due diligence for mergers, financing, or policy placement (g2 sample: finance 9, legal 6).

Typical Signatories and Their Roles

Authorized Representative

A company officer or designated employee who can request and receive loss runs on behalf of the insured. This signer must have written authorization on company letterhead or be listed as an authorized contact in the policy records; insurers may require identification before releasing reports.

Insurance Producer

A licensed broker or agent who requests loss runs for underwriting or placement. Producers must supply client authorization and may submit requests via carrier portals, email, or secure eSignature-enabled forms when carriers accept electronic requests.

Key Data Elements to Include in a Loss Run Request

Policyholder Name: Exact legal name

Policy Number: Insurer policy identifier

Coverage Period: Start and end dates

Requested Date Range: Full history or specified years

Authorized Requestor: Name and title

Delivery Preference: Email, secure portal, or paper

Consequences of Incomplete or Incorrect Loss Runs

Underwriting Delays: Renewal postponed

Premium Mispricing: Incorrect premium

Coverage Gaps: Placement issues

Regulatory Exposure: Compliance queries

Lender Holds: Financing impeded

Dispute Costs: Time and legal fees

Common Pitfalls When Preparing or Requesting Loss Runs

Requesting an incomplete date range that omits older claims can misrepresent loss experience and lead to unexpected underwriting outcomes.
Using mismatched legal names or abbreviations prevents carriers from locating the correct file and can cause unnecessary delays.
Failing to supply written authorization or account numbers often triggers carrier privacy checks and extends response time.
Relying on informal email summaries rather than official carrier loss runs increases the risk of missing paid or reserved amounts.

How to Request and Obtain an Insurance Loss Run Report

Follow a clear sequence to speed delivery and reduce errors when requesting loss runs from carriers.

01

Identify Scope: Decide the policy numbers and date range needed
02

Provide Authorization: Attach client-signed letter or broker authorization
03

Submit Request: Use carrier portal, email, or secure eSubmission
04

Confirm Delivery: Verify receipt and check for completeness

Where to Send or Upload Your Loss Run Request

Insurers accept requests through multiple channels; choose the one that meets carrier policy and data-security needs.

Carrier Portal: Most carriers provide secure upload and direct delivery
Email Request: Accepted by many carriers; include authorization
Producer / Broker Submission: Brokers submit on behalf of clients
Secure eSignature: Signed authorization delivered via eSubmission

What a Professional Loss Run Report Should Contain

A complete loss run should present claims clearly, consistently, and with supporting metadata so underwriters and auditors can interpret exposure and frequency.

Claim Identifiers

Unique claim number plus insurer or adjuster reference, enabling cross-checks with claim files and payments history for audit and underwriting verification.

Dates and Timeline

Reported date, loss date, payment dates, and closure date for each claim so reviewers can assess latency, development patterns, and severity trends.

Financial Detail

Paid amounts, case reserves, incurred amounts, and payment breakdowns that show how costs developed over time and potential future exposure.

Loss Descriptions

Brief factual summaries of the incident, coded cause of loss where available, and coverage parts implicated to aid underwriting decisions.

Coverage Mapping

Identification of which policy period and coverage part applied to each claim so analysts can attribute losses to correct limits and endorsements.

Report Metadata

Date prepared, producing carrier or TPA name, requestor details, and any caveats or exclusions affecting interpretation of the data.

Practical Tips for Clean, Actionable Loss Run Requests

Small preparation steps improve accuracy and shorten the carrier response time.

Use Exact Legal Names and Identifiers

Provide the insured’s full legal name, DBA entries, and policy numbers. This avoids mismatches and ensures the carrier locates the correct underwriting file without back-and-forth.

Specify Exact Date Range and Coverage Parts

State the precise start and end dates and list coverage parts (GL, PL, Property). Narrow requests reduce extraneous data and speed review by the insurer.

Provide Written Authorization

Attach a signed authorization on company letterhead or a broker authorization form so the carrier can release records promptly under privacy rules.

Request a Standardized Format

Ask for a dated PDF or CSV with column headers for easy import into underwriting systems; note preferred delivery method to avoid conversion errors.

Typical Timing to Expect When Requesting Loss Runs

Response times vary by carrier, policy type, and the completeness of your request; set expectations early with the insurer or TPA.

Initial Acknowledgement:

Within 3–7 business days

Standard Delivery Window:

Typically 7–30 days depending on carrier

Rush Requests:

May be completed within 24–72 hours for a fee

Complex or Historical Searches:

Can take 30+ days

Carrier-Specified Deadlines:

Follow carrier or state DOI timelines

eSignature Vendor Comparison for Submitting and Signing Loss Run Requests

Comparing eSignature vendors can help decide how to collect signed authorizations and deliver requests securely; signNow is listed first per vendor comparison convention.

	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	7-day free trial	No	No	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Key Milestones When Requesting a Loss Run

Track each milestone from request through delivery so stakeholders know responsibilities and timing expectations.

01

Request Submission

Sender supplies authorization and scope to carrier or TPA

02

Carrier Acknowledgement

Carrier confirms receipt and logs the request

03

Report Preparation

Carrier extracts claims, formats report, and applies caveats

04

Delivery and Verification

Requestor confirms completeness and requests corrections if needed

Frequently Asked Questions About Insurance Loss Run Reports

Answers to common questions about requesting, signing, and using loss runs, including legal and technical points.

Need help? Contact support

Can an electronic signature authorize release?
Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, electronic signatures can form valid authorizations when intent, consent, attribution, and record retention are documented. Confirm carrier policy for specific authentication requirements.
How long will the insurer take to respond?
Response times vary by carrier and the completeness of your request; common windows are 7–30 days. If you need faster service, ask the carrier about expedited handling and any associated fees.
What if the loss run contains errors?
Contact the carrier or TPA immediately with supporting documentation. Request a corrected loss run in writing and keep copies of communications. Disputes may affect underwriting outcomes and should be resolved before renewal.
Do carriers require notarization or RON?
Most carriers do not require notarization for loss run requests but may require signed authorization. Remote Online Notarization (RON) or notarized letters are sometimes requested for third-party releases; follow carrier instructions.
Are health-related claims subject to HIPAA protections?
Yes. Medical claim detail may implicate protected health information; carriers and requestors must follow HIPAA (45 CFR §164) and may require limited authorizations or redaction unless proper consent is provided.
How should I store received loss runs securely?
Store signed loss runs in encrypted systems with access controls and retention policies. Use platforms that support TLS and AES-256 encryption at rest and maintain audit trails for authorized access.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now