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Insurance Wind Only Form

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INSURANCE WIND ONLY FORM

Applicant / Insured Information

Phone:

Email:

Date of Birth:

Entity Type:

Property / Risk Details

Property Type: Construction:

Year Built:

Occupancy:

Stories:

Square Footage:

Policy Details

Requested Policy Period Start:   End:





Coverage Limit: $

Deductible: $

Premium: $

Exclusions and Limitations

The undersigned acknowledges that wind-only coverage excludes perils not expressly listed in the policy. Typical exclusions include, but are not limited to: flood and storm surge; earthquake or seismic activity; mold, fungus, and rot; wear, tear and gradual deterioration; mechanical, electrical or structural failure not caused by a covered wind peril; war, nuclear hazard, and intentional acts. Coverage for ordinance or law, sinking or settling, and mold require separate endorsements and additional premium where available.

Loss Payee / Beneficiary

Loss Payee / Mortgagee Name:

Claims Reporting — Wind Loss

Date of Loss:   Time of Loss:

Police report filed

Photographs attached

Contractor estimate attached

Payment and Premium Terms

Payment Method:

Payment Frequency:

Down Payment: $

Declaration and Certification

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that this application, any supplements, and any inspections made by the insurer or its representatives will form the basis for the policy declaration, coverage and premium determination. I authorize inspection of the described property, verification of statements made herein, and release of information to reinsurers, adjusters, or other entities as required for underwriting and claim handling. I acknowledge that issuance of a binder or policy is subject to underwriting approval and to payment of premium as required by the insurer.

By signing below, I certify under penalty of perjury that the foregoing statements are true and correct and that I accept the terms and conditions of wind-only coverage as stated in the insurer's policy forms and endorsements, if issued.

Applicant Name:

Signature:

Date:

Enter text✕

What the Insurance Wind Only Form Is

The Insurance Wind Only Form is a policy endorsement or standalone form that narrows property coverage to wind-related perils only, excluding other causes such as fire, theft, or water damage. Insurers and agents use it to offer focused protection in high-wind or hurricane-prone areas, to apply specific wind deductibles, or to clarify coverage limits when standard multi-peril policies are not appropriate. The form typically states covered locations, policy period, specific wind exclusions, declared limits, and any premium or deductible adjustments tied solely to wind events.

Why a Wind-Only Endorsement Matters

A Wind Only Form provides clearer underwriting boundaries and can lower premiums for properties exposed primarily to wind perils. It reduces ambiguity during claims, establishes explicit deductibles for wind events, and helps insurers and reinsurers quantify wind exposure separate from other perils.

Why a Wind-Only Endorsement Matters

Who Typically Prepares and Signs This Form

Agents, underwriters, and insureds all interact with the Wind Only Form during placement and renewal.

  • Insurance agents and brokers who place coastal or high-wind risks and complete endorsements for insurers.
  • Policyholders or property owners who must acknowledge limited peril scope and any wind-specific deductibles.
  • Carrier underwriters and reinsurance managers who record exposure and approve wind-only terms for risk transfer.

Each party has a clear role: agents prepare, insureds review and sign, and underwriters accept or modify terms.

Core Elements Found on a Professional Wind Only Form

A professionally drafted Insurance Wind Only Form combines identification, scope, and execution details so coverage and expectations are explicit for all parties.

Policy ID

Unique policy or endorsement number plus insured name and property address to ensure the wind-only terms attach to the correct insurance agreement and avoid ambiguity during claim handling.

Coverage Period

Effective and expiration dates with time zone, clarifying when wind-only coverage starts and ends and determining which events fall inside the policy period for claims and subrogation purposes.

Wind Deductible

Specific deductible amount or percentage that applies to wind events only, including how it is calculated and any per-occurrence or annual aggregate application rules.

Geographic Scope

Clear description of covered locations, parcel identifiers, or per-building specifications so the wind-only terms apply only to intended properties and not the entire account.

Exclusions

A concise list of excluded perils and limitations (for example, water intrusion or fire following wind) so claim adjudicators understand which losses are outside wind-only coverage.

Signature Block

Designated signature lines for authorized insurer and insured representatives, with printed names, titles, dates, and space for notary or witness information if required by law or company policy.

Step-by-Step: Filling Out the Wind Only Form

Follow these sequential steps to prepare and finalize the endorsement correctly.

  • 01
    Gather Documents: Collect policy, property data, and prior endorsements.
  • 02
    Complete Fields: Fill in names, policy number, dates, addresses.
  • 03
    Review Terms: Confirm deductibles, exclusions, and scope.
  • 04
    Sign and File: Obtain authorized signatures and retain copies.

Configuring an Online Wind-Only Workflow

Key workflow settings ensure accurate routing, signer authentication, and record retention when completing the form online.

Field Configuration
Document Upload PDF or DOCX accepted; preserve original formatting.
Conditional Fields Show deductible fields only if wind-only option selected.
Signer Authentication Use email, SMS code, or stronger verification for high-value risks.
Notifications Auto-notify agent, insured, and underwriting after signing.

Where to Send or File the Completed Form

Routing the signed form depends on whether it is an internal endorsement or requires regulator filing.

  • Insurer Files: Carrier retains the endorsed policy in its policy administration system.
  • Agent Copy: Agent keeps a signed copy in client file and CRM record.
  • Reinsurer Notice: Send to reinsurer when required under reinsurance treaties.
  • Regulatory Submission: Submit to state insurer regulator only when the endorsement requires filing.

Technical Requirements for Digital Completion

Ensure the eSignature platform supports secure PDFs, strong authentication, and audit trails before collecting signatures.

  • File Formats: PDF, DOCX supported
  • Authentication: Email or SMS code
  • Integrations: CRM and cloud storage

Use a provider that supports TLS and AES encryption, audit logs, and integrations with systems like Salesforce, NetSuite, and Google Workspace to streamline filing and retention.

Risks and Legal Consequences of Errors

Coverage Denial: Incorrect scope can lead to denied claims
Premium Discrepancy: Mismatched deductibles trigger billing disputes
Regulatory Penalties: Failure to file when required may incur fines
Fraud Allegations: Material misstatements risk fraud charges
Reinsurance Issues: Improper notice can void reinsurance recoveries
Recordkeeping: Missing records hinder audits and litigation

Common Preparation Mistakes to Avoid

  • Using abbreviated or inconsistent insured names that misalign with the main policy can lead to coverage disputes and processing delays.
  • Failing to specify whether the deductible is a percentage or fixed dollar amount creates ambiguity in claim settlement calculations.
  • Omitting precise property identifiers, such as unit numbers or parcel details, which can cause the endorsement to attach to the wrong location.
  • Not verifying authorization for signatories — unsigned or improperly authorized endorsements may be invalid during claims or audits.

Comparing eSignature Vendors for Wind-Only Form Workflows

Platform choice affects per-user cost, bulk sending, HIPAA availability, and envelope limits; signNow appears first per vendor comparison 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 Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No envelope cap 100 envelopes/user/year Varies Varies Varies

Frequently Asked Questions About the Wind-Only Form

Clear answers to common legal and process questions when preparing, signing, or storing a wind-only endorsement.


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