When this form may help
Use this form to summarize the requested excess structure and the underlying liability program. Attach the underlying coverage information and loss history that apply to the account.
Authority boundary: This Hedge form is a submission-preparation resource. It is not a quote, binder, coverage commitment, market-access statement, or instruction to release a risk to a carrier.
Topics covered
- excess liability
- umbrella
- underlying limits
- requested limits
Before you send it
Complete the form with current facts from the insured. Confirm the named insured, operations, locations, requested coverage, effective date, and loss information. Include the primary application, loss runs, schedules, and other documents that apply to the account. Hedge will identify any additional market-specific requirements after review.
Download the fillable PDF
This file is published by Hedge and can be completed in a PDF editor. Review every answer before attaching it to a submission.
Download Hedge Excess and Umbrella Supplemental