Can this form be signed electronically?

Yes. Electronic signatures that meet ESIGN (15 U.S.C. ch. 96) and UETA standards are generally enforceable, provided intent, consent, attribution, and record retention requirements are met.

Is notarization required?

Not usually for simple endorsements, but state law or lender requirements may demand notarization or witness acknowledgement in some jurisdictions.

What if the mortgagee objects?

Notify mortgagee per contract terms; their objection may block the exclusion until resolved, and lenders may require replacement coverage or written waivers.

How should parties store the signed form?

Store the signed endorsement in the policy administration system with an audit trail, and retain a copy for the recommended retention period described above.

Can the exclusion be revoked later?

Yes, revocation or amendment is possible with a new endorsement executed by authorized parties; any change should be documented and dated to avoid coverage gaps.

When should I seek legal review?

Obtain counsel for bespoke exclusions, lender conflicts, complex risk allocation, or when state law raises unusual formal requirements.

Electronic Signature
Templates
Insurance
Insurance Wind & Hail Exclusion Form

Insurance Wind & Hail Exclusion Form

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

INSURANCE WIND & HAIL EXCLUSION FORM

Purpose: This form documents the insured's election to exclude, limit, or otherwise alter coverage for loss or damage caused by wind and hail under the policy identified below. By signing this form the insured certifies that the exclusion or modification will be attached to and made part of the referenced policy and that the insurer's obligation to pay for wind or hail loss is limited as set forth herein.

Insured / Applicant Information

Applicant Name

Date of Birth:

Telephone:

Email:

Mailing Address

Policy & Insurer Details

Insurer Name

Policy Number:

Policy Type:

Coverage Amount:

Current Deductible:

Annual Premium:

Policy Period From:

To:

Insured Property Information

Location Address

Property Type:

Year Built:

Construction:

Wind & Hail Exclusion Options (select applicable)

Full exclusion of wind and hail perils from the policy for all covered property at the location(s) identified above. The insurer shall have no obligation to indemnify, repair, replace or pay for any loss or damage caused directly or indirectly by wind, hail, hurricane, tornado, wind-driven rain or related phenomena.

Exclusion limited to specified locations or structures on the policy (describe locations):

Partial exclusion or limitation (describe specific covered items or conditions):

Temporary exclusion for a defined period (start and end dates): Start: End:

Increased wind/hail deductible in lieu of exclusion. Agreed increased deductible amount:

Premium adjustment agreed as a result of this exclusion/modification:

Exclusion — Legal Language

Subject to the other terms, conditions and exclusions of the policy, and except as specifically set forth in any separate endorsement attached to the policy, the insurer is released from all liability for loss, damage, cost or expense directly or indirectly caused by, resulting from, contributed to by, or arising out of wind, hail, hurricane, tornado, cyclone, windstorm, wind-driven rain, or any act or condition of the atmosphere or elements associated therewith (collectively, Wind & Hail Perils). This exclusion applies regardless of any other cause or event that contributed concurrently or in any sequence to the loss.

The insured acknowledges that other coverages contained in the policy remain subject to all other policy provisions, and that acceptance of the wind and hail exclusion does not enlarge or create coverage for perils that are otherwise excluded by policy terms. Any claims arising from excluded perils will be denied to the extent of this exclusion and no payment shall be made for loss attributable to Wind & Hail Perils.

Claims, Duties & Mitigation

The insured must continue to comply with all policy conditions regarding notice of loss, prompt mitigation, reasonable care, and cooperation with the insurer. The existence of this exclusion does not relieve the insured of any duty to take reasonable actions to prevent or minimize loss or damage.

Acknowledgment and Certification by Insured

By signing below, I certify that I have read and understand the terms of the wind and hail exclusion or modification indicated above. I acknowledge that I have received clear notice of the effect of this exclusion and that I accept the modification or exclusion voluntarily. I understand that this election is binding upon me and any assignees and that it will apply to the referenced policy and any renewals, except where changed by subsequent written endorsement signed by the insurer.

I further represent that I am authorized to bind the insured and that no misrepresentation has been made to induce this exclusion. I agree to hold harmless and indemnify the insurer from claims, suits or demands arising solely from the insured's election to exclude or limit Wind & Hail Perils as set forth in this form.

Optional: Additional Remarks or Conditions (if any)

Applicant Name:

Signature:

Date:

What the Insurance Wind & Hail Exclusion Form Is

The Insurance Wind & Hail Exclusion Form is a policy amendment or endorsement used by insurers or insured parties to remove wind and hail perils from property coverage or to document that such perils are excluded. It records the parties, policy number, effective date, and the precise scope of the exclusion so there is a clear, enforceable record of what risks are not covered. Insurers use the form to adjust premium, note additional underwriting requirements, or document insured consent where required by contract or state regulation.

Why this Form Matters for Liability and Coverage Clarity

Using a formal Wind & Hail Exclusion Form creates a written, date-stamped record that clarifies coverage boundaries, reduces disputes over claims, and supports accurate premium adjustments. It helps both carriers and policyholders document intent, limits insurer exposure, and provides a consistent administrative trail for audits and regulatory review.

Who Typically Prepares and Signs This Form

Several parties may complete or sign the exclusion: the insurer's underwriting or policy administration team, the named insured, mortgagees, and sometimes a broker or agent acting on behalf of the insured.

Insurer Underwriting or Policy Admin — Prepares the endorsement, records changes to coverage, and issues the revised policy documents.
Named Insured or Authorized Representative — Reviews, initials, and signs to acknowledge and accept the coverage exclusion or change.
Mortgagee / Lienholder — May need to acknowledge or consent if their interests are affected by changes to hazard coverage.

Ensure signatory authority is documented and matches the policy records to avoid processing delays or rejection by the carrier.

Common Signers and Their Roles

Claims Manager — Insurer

A Claims Manager or Policy Administrator signs or initials to confirm underwriting instructions and that the exclusion has been added to the insured file; their role ensures internal approval chains are followed and the audit trail captures the change for regulatory compliance and future claims handling.

Authorized Insured Representative

An insured's authorized representative or corporate officer signs to acknowledge and accept the exclusion; their signature indicates consent to reduced coverage and potential premium adjustment and can be used to defend against later claims for excluded perils.

Step-by-Step: Filling Out the Wind & Hail Exclusion Form

Complete the form in the order below and verify each field against the policy declarations and underwriting notes before signing.

01

Identify Policy: Enter insurer name and accurate policy number.
02

Define Parties: Record the named insured and any mortgagee or loss payee details.
03

Set Effective Date: Use MM/DD/YYYY and confirm with underwriting.
04

Sign and File: Authorized parties sign; retain copy in policy file.

How to Configure an Online Endorsement Workflow

Set up a simple digital workflow to collect signatures, ensure version control, and attach the exclusion to the correct policy record.

Field	Configuration
Upload Document	PDF or DOCX; include policy declaration page.
Signers	Named insured, insurer rep, optional mortgagee
Authentication	Email link or SMS code; consider KBA for higher assurance
Delivery	Send signed copy to all parties and file in AMS

Typical eSubmission Flow for the Exclusion Form

A streamlined sequence reduces errors: upload, position fields, assign signers, authenticate, collect signatures, and archive with an audit log.

Upload: Sender uploads the exclusion form as a PDF or DOCX.
Place Fields: Add signature, date, and initial fields where required.
Authenticate: Choose email link, SMS code, or stronger methods.
Archive: Store signed file with audit trail and policy record.

Technical and Integration Considerations

Confirm the e-signature platform supports secure uploads, audit trails, and the integrations your organization uses before collecting signatures.

File Formats: PDF and DOCX supported
Integrations: CRM and AMS connectors available
Security: TLS in transit; AES-256 at rest

Ensure the chosen platform can produce a tamper-evident signed PDF and store metadata in your policy administration system for audit and retrieval.

Timing and Deadlines That Affect the Exclusion

Track effective dates, notice periods, and policy renewal windows to ensure the exclusion takes effect as intended and to avoid coverage gaps.

Effective Date:

Applies as of the MM/DD/YYYY specified on the form

Renewal Coordination:

Align exclusion with upcoming renewal to avoid overlap

Notice to Mortgagee:

Some mortgagees require 10–30 days notice

Underwriting Review:

Underwriting may require up to 14 days to finalize

Premium Adjustment Date:

Pro rata change usually effective same day as exclusion

Key Processing Milestones from Request to Filing

A typical timeline clarifies responsibilities and expected completion stages for internal teams and the insured.

01

Request Received

Underwriting logs the exclusion request and links to policy

02

Underwriting Decision

Underwriting approves or requests additional information

03

Document Preparation

Policy admin prepares the exclusion endorsement

04

Signature & Filing

Parties sign and the endorsement is filed to the policy

Common Mistakes to Avoid When Preparing the Form

Entering an incorrect policy number that prevents the endorsement from being associated with the correct policy file.
Using vague language in the exclusion scope, which can cause disputes about what perils or parts of the property are excluded.
Failing to confirm signatory authority, resulting in a signature that is later challenged as unauthorized or invalid.
Not retaining the signed endorsement in the policy administration system with a searchable audit trail and timestamp.

Potential Risks and Regulatory Consequences

Coverage Disputes: Ambiguous exclusions invite litigation or regulatory complaints

Regulatory Scrutiny: State insurance departments may investigate improper notice

Mortgagee Objections: Unnotified lienholders can assert contractual violations

Contractual Breach: Unauthorized changes risk breach claims

Premium Errors: Incorrect premium adjustments may lead to refunds

Recordkeeping Failures: Missing audit trail can invalidate electronic execution

eSignature Vendor Comparison for Collecting Signatures on Exclusions

Compare common eSignature features and starting prices for platforms used to collect signatures on endorsements and policy forms. signNow is listed first per vendor ordering rules.

	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	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes (BAA available)	Yes	Yes	No	No

Key Security and Compliance Details to Capture

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Audit Trail: IP, timestamp, and action history

BAA: Business Associate Agreement when PHI present

ESIGN/UETA: Meets ESIGN and UETA legal tests

21 CFR: Support for 21 CFR Part 11 where required

Access Controls: Role-based permissions and SSO

Real-World Examples of Using a Wind & Hail Exclusion

Two brief examples illustrate typical situations where an exclusion is used and how it was documented.

Case Study 1

A coastal condo association sought lower premiums by excluding wind/hail for certain exterior fixtures

Underwriting required an inspection and a signed exclusion form
The endorsement recorded exact scope, the insured accepted reduced coverage, and the mortgagee acknowledged the change to avoid later disputes.

Case Study 2

A commercial property owner requested an exclusion for roof-mounted equipment to reflect separate self-insurance

Carrier prepared a tailored exclusion and adjusted premium pro rata
The signed endorsement was archived in the policy system and supplied to the tenant as part of lease risk allocation.

Frequently Asked Questions About Wind & Hail Exclusions

Answers to the most common practical and legal questions when preparing or accepting a Wind & Hail Exclusion Form.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures that meet ESIGN (15 U.S.C. ch. 96) and UETA standards are generally enforceable, provided intent, consent, attribution, and record retention requirements are met.
Is notarization required?
Not usually for simple endorsements, but state law or lender requirements may demand notarization or witness acknowledgement in some jurisdictions.
What if the mortgagee objects?
Notify mortgagee per contract terms; their objection may block the exclusion until resolved, and lenders may require replacement coverage or written waivers.
How should parties store the signed form?
Store the signed endorsement in the policy administration system with an audit trail, and retain a copy for the recommended retention period described above.
Can the exclusion be revoked later?
Yes, revocation or amendment is possible with a new endorsement executed by authorized parties; any change should be documented and dated to avoid coverage gaps.
When should I seek legal review?
Obtain counsel for bespoke exclusions, lender conflicts, complex risk allocation, or when state law raises unusual formal requirements.

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