Template
Loss run request letter template
A loss run request letter asks a carrier for claim history on named policies. It lists the insured, FEIN, policy numbers and terms, the years and valuation needed and the reply address, and it travels with a letter of authority signed by the insured. Both templates are below, ready to copy.
Is there an official ACORD loss run request form
Short answer, no single form is required everywhere. Most carriers accept a letter that carries the same fields an ACORD form would.
Brokers often search for an ACORD loss run request because ACORD forms are the common language of commercial submissions. In practice, carriers ask for the same handful of facts whatever the format: who the insured is, which policies and terms, which years, how the report should be valued, and proof that the requester is authorized.
Some carriers publish their own request form or route requests through an agent portal. When they do, use it. When they do not, a letter in the layout below is accepted by loss run departments because it answers every question they would otherwise email back about.
If you also need the application side of the submission, the ACORD forms software page covers ACORD 125, 126, 130 and 140.
Fields every request needs
- Named insured, exactly as on the policy
- Mailing address
- FEIN
- Carrier and policy number for each term
- Policy term start and end dates
- Lines of business
- Years requested, usually five plus current
- Valuation needed, currently valued
- Claim-level detail, or a no-loss letter
- Reply address and reference number
- Signed letter of authority if not agent of record
Loss run request letter
Replace each bracketed field. Send one letter per carrier, listing all of that carrier's policies.
[Agency letterhead]
[Date]
To: Loss Run Department
[Carrier name]
[Carrier loss run email or address]
Re: Request for currently valued loss runs
Insured: [Named insured]
Reference: [LR-XXXXXX]
To whom it may concern,
We are requesting currently valued loss runs for the insured and
policies listed below. A letter of authority signed by the insured
is attached.
INSURED
Named insured: [Legal name]
DBA: [Trade name, if any]
Mailing address: [Street, city, state, ZIP]
FEIN: [XX-XXXXXXX]
POLICIES
Line of business Policy number Term
[General liability] [GL-0000000] [MM/DD/YYYY] to [MM/DD/YYYY]
[Commercial auto] [CA-0000000] [MM/DD/YYYY] to [MM/DD/YYYY]
[Workers comp] [WC-0000000] [MM/DD/YYYY] to [MM/DD/YYYY]
REQUEST
Years: The five most recent policy years plus the current term
Valuation: Valued within the last 30 days
Detail: Claim number, date of loss, report date, claimant,
cause, status, paid indemnity, paid medical, paid
expense, reserves, recoveries and total incurred
No losses: Please provide a no-loss letter for any term
without claims
DELIVERY
Please send the reports to [agency inbound address] and keep the
reference number above in the subject line. If you require your
own form or portal submission, please let us know at the same
address.
Thank you for your help.
[Your name]
[Title], [Agency name]
[Email]
Letter of authority template
The insured signs this once. It names your agency and lets you request loss runs from every listed carrier.
LETTER OF AUTHORITY TO RELEASE LOSS INFORMATION Date: [Date] To: [Carrier name] and any insurer listed below [Named insured], FEIN [XX-XXXXXXX], authorizes [Agency name] to request and receive loss runs, claim history and related policy information for the following policies. [Carrier] [Policy number] [Term] [Carrier] [Policy number] [Term] This authorization is for the purpose of marketing and placing insurance on behalf of the insured. It does not change the agent of record. It remains valid for [12] months from the date signed unless revoked in writing. Please send all information to [agency inbound address]. Signed: _______________________________ Name: [Authorized signer] Title: [Owner, officer or risk manager] Date: [Date]
Getting it signed fast
The letter must be signed by someone who can bind the insured, usually an owner, officer or risk manager. An unsigned letter, or one signed by someone without authority, is a common reason carriers decline a request.
LossRunReports sends the insured a link to sign the letter of authority online. Once signed, it is attached automatically to every carrier request for that account. You can see who signed and when on the request itself.
| Carrier | Policy | Status | Last action |
|---|---|---|---|
| Northfield MutualCA 4471902 | CA 4471902 | Received | Oct 4 |
| Keystone CasualtyGLP 0088213 | GLP 0088213 | Follow-up 2 sent | Oct 9 |
| Granite State CompWC 2215560 | WC 2215560 | Acknowledged | Oct 7 |
| Bayline SpecialtyPKG 771045 | PKG 771045 | Sent | Oct 10 |
| Crestmark IndemnityUMB 30981 | UMB 30981 | Drafted | n/a |
After the letter goes out
Track every request until the report arrives. Follow up on day 3, 7 and 14, then check each report for valuation date, missing years and totals. The full process is in our guide on how to request loss runs.
With LossRunReports, the letter is generated per carrier from the account data, the follow-ups send themselves and replies land in your agency inbound address, where they are read into one claims table. Compare plans on the pricing page.
Questions about request letters
Do I need a letter of authority if I am the agent of record?
Usually not for policies you placed. You do need one for policies written through another agent, which is the normal case for new business and remarketing.
Can one letter of authority cover several carriers?
Yes. List each carrier and policy on the letter. Some carriers still ask for a letter addressed to them by name, so keep the carrier field editable.
Is an electronic signature accepted?
Most carriers accept electronic signatures on a letter of authority. A few ask for a wet signature or their own form, which is noted in their loss run instructions.
Should I send the request by email or fax?
Email to the loss run or policy services address is the standard. Use the agent portal if the carrier requires it and fax only when it is the published channel.
How long is a letter of authority valid?
There is no single rule. Twelve months is a common period, and the insured can revoke it in writing at any time.
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