Massachusetts Insurance Certification Request Form

State:
Massachusetts
Control #:
MA-SKU-1114
Format:
PDF
Instant download
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Description

Insurance Certification Request Form

The Massachusetts Insurance Certification Request Form is an official document issued by the Commonwealth of Massachusetts. It is used to request a certification of insurance from an insurance company or producer that offers insurance in the state. The form must be completed by the applicant and submitted to the Massachusetts Division of Insurance (DOI) for approval. The form requests information related to the type of insurance, limits of liability, deductibles, and other pertinent information. It must be submitted along with any required documents, such as a Certificate of Insurance, a Financial Responsibility Statement, and evidence of coverage. There are two types of Massachusetts Insurance Certification Request Form: one for personal lines of insurance, and one for commercial lines of insurance. The form for personal lines of insurance includes information related to auto insurance, homeowner’s insurance, and other types of personal insurance. The form for commercial lines of insurance includes information related to business auto insurance, commercial property insurance, and other types of commercial insurance.

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Massachusetts Insurance Certification Request Form