Lost policy declaration form: Fill out & sign online

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Click ‘Get Form’ to open the lost policy declaration form in the editor.
Begin by filling in your General Information. Clearly print your last name, first name, and middle initial as the Policy Owner/Planholder. Next, enter the Policy/Plan Number or Group Contract Number.
Proceed to the Signatures section. Here, you must sign to declare that you have been unable to locate the policy/plan. Ensure that all irrevocable beneficiaries and any assignees also provide their signatures where applicable.
In the Notarization section, leave space for a notary public to complete their part once you have signed. This includes details such as the date of signing and place of signing.

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What to do if policy document is lost?

If you lose your original policy document, inform the insurer ASAP. You can visit the nearest brand office or call the agent or the customer care number. Next, you can raise a request for a duplicate policy document. For this, you will need to submit the FIR copy, advertisement and indemnity bond.

What is a release form in insurance?

It is also called a Cancellation/Lost Policy Release. This form, which the insured signs, releases the insurance company from any further responsibility. If you change auto insurance companies, you will need to sign this form in order to cancel the policy with the same effective date as the new policy.

What is a lost policy release in insurance?

A lost policy release is a statement signed by the named insured releasing the insurer from all liability under a lost or mislaid contract of insurance in cases in which the insured wishes to cancel the policy.

What does a lost policy certificate mean?

Also called a lost policy release, this document releases an insurance company from the contractual liabilities of a particular insurance policy. The insured party signs and submits the certificate to the insurer to signify that loss or destruction of the policy occurred or that the insurer is retaining the policy.

What is a lost policy release form?

Lost Policy Release is a legal document that is used when the policyholder is unable to physically present the policy document to the insurer. This could happen if the policy document was lost, stolen, or destroyed.