Get Lost Insurance Certificate Declaration

Completing the Lost Insurance Certificate Declaration online is essential for users who have lost their Certificate of Insurance. This guide will provide a clear and concise walkthrough to ensure you submit your declaration accurately and efficiently.

Follow the steps to complete your declaration successfully.

1. Press the ‘Get Form’ button to access the Lost Insurance Certificate Declaration form. This will open the document in an online editor for you to begin filling it out.
2. In the 'Name and Address' section, enter your full name and complete address as required. Ensure this information is accurate, as it will be used to identify your policy.
3. Locate the 'Policy Number' field and input your unique policy number associated with the lost insurance certificate. This is crucial for verifying your coverage.
4. In the 'Client Reference' section, include any reference number you have associated with your insurance policy. This may help expedite the process.
5. Under 'Reason for a LCD Request', state clearly that your Certificate of Insurance has been lost or destroyed. This concise statement aids in processing your declaration.
6. In the 'Policyholder’s Name' section, write your name again as the policyholder who is declaring the loss.
7. Fill in the full address details once more to reaffirm your contact information, as this is vital for correspondence related to your declaration.
8. In the statement provided, fill in the blanks for the 'Policy No.' and the effective period for your insurance. Clearly specify the dates to confirm your coverage period.
9. Have the declaration witnessed by another person who can confirm your identity and the loss of the certificate. They will need to sign as a witness.
10. Follow the return instructions and submit the completed form via post or fax to ensure your request is processed promptly.

Complete your Lost Insurance Certificate Declaration online today to ensure a smooth process.