Loss Run request example letter

NAMED INSURED

ADDRESS

CITY, STATE  ZIP CODE

        DATE

        TO:

         NAME OF THE INSURANCE COMPANY

         ADDRESS

          PHONE NUMBER

          ATTENTION: LOSS RUN DEPARTMENT

          FAX NUMBER OR EMAIL ADDRESS

           RE: LOSS RUN REQUEST

           Policy type:___________________

           Policy number_________________

           Policy Period__________________

        To Whom it may concern:

          With regard to the above captioned policy, this letter authorizes and requests your company to release the complete detailed loss runs showing all experience  ( open  and  closed ) for  the periods to:

         Name of the agency , Attention to : Agent, Email address and fax number

          This authorization should remain if force for the period of 90 days starting from: Date

          I appreciate your cooperation and assistance in this matter.

          Signature

           X______________________

           Name, title, Name of Business, phone number, email address