Community & Consumer Relations American Council of Life Insurance
100I Pennsylvania Ave NW
Washington, DC 20004

Re: Life Insurance Information

Dear Sir or Madam:

Please send me a copy of your pamphlet regarding life insurance entitled “What You Should Know About Buying Life Insurance.” In addition, please provide copies of any other leaflets or fact sheets related to life insurance that might help me to better understand life insurance products.

If there is a charge for the service, please indicate the amount or provide a fee schedule.
Please send this information to me at the address given above.

You may contact me if you have any questions or need additional information. Thank you for your assistance.

Best regards,

______________
Signatory

Life Insurance Information
Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  This is an inquiry letter that can produce useful comparative information regarding information.  Nothing to lose; everything to gain.  So use this well care document to keep yourself informed.

WHEREAS, on ____________________, ___________________, an insurance company, was presented with a claim arising from:
________________________

under insurance coverage provided to ______________________, under its coverage for:
______________________,

and, WHEREAS, on _________________________, ___________________ paid a claim in an amount of $ ____ (________________ & ____/100 dollars), with a deductible of  $ _____(________ & ____/100 dollars), arising from the perils and covered by the policy stated above, NOW, THEREFORE:
______________________, his heirs and assigns, herewith assign and convey to ________________ and any all rights against any entity who may be liable to ______________________ for the loss stated above.
______________________ shall pursue any and all responsible parties at its own expense, and may at its option, bring such action in its own name or that of ______________________.
______________________ herewith covenants and agrees to fully assist ___________________ in pursuit of its rights of subrogation herein.
___________________ may at its option pursue the deductible loss of ______________________.

In the event that ___________________ does so, it shall notify ______________________, and, further, ______________________ agrees that if any recovery is made that it will share in all costs related thereto pro rata.

______________________ further agrees not to release or exonerate the adverse party or parties or enter into any compromise with them without the prior approval of ___________________.

______________________ shall execute any and all instruments reasonably required by ______________ in connection herewith.

Date: _____________________________________

___________________________________________________
______________________

Subrogation Agreement
Review List
This review list is provided to inform you about this document in question and assist you in its preparation.   This is a technical document that should only be executed by someone expert in the field.

Marketing Department
Moody’s Investors Service
99 Church St.
New York, NY 10007

Re: Life Insurance Information

Dear Sir or Madam:

I understand that your company provides ratings of life insurance companies.  Please explain how information may be obtained regarding a specific company and provide a brochure(s) if available.  Please indicate whether ratings information is only available in written form, or whether it can also be obtained by telephone (and if so, please provide the telephone number).

I am interested in obtaining information regarding _______________________.

If there is a charge for the service, please indicate the amount or provide a fee schedule.
Please send this information to me at the address given above.  You may contact me if you have any questions or need additional information.  Thank you for your assistance.

Best regards,

_____________
Signer

Life Insurance Information, Ratings
Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  Moody’s provides a first rate ratings system for insurance companies.  It is well worth your while, in the spirit of well care, to write them.

TO: ____________________
Regarding: __________________
Policy number: __________________
Policy period: _________________ to __________________

By the above-mentioned policy of insurance, you insured __________________, (hereinafter called the insured) against loss or damage to the automobile described as follows:
Model Year: __________________
Make: ________________
Type of body: _________________
VIN: ___________________
State/License number: _______________ _________

A loss caused by __________________ occurred on ________________, about the hour of _________________ __________, as follows:
__________________

The insured was the sole owner of the automobile at the time of the loss or damage and no other person had any interest therein, by lease, bailment, mortgage, lien or other encumbrance or otherwise except:
___________________

At the time of this loss, there was no other insurance on said automobile covering the same periods except:
__________________

At the time of this loss, the automobile was used for:
___________________

and was not being used to carry passengers or for compensation or rental or leased, or for any illegal or non-covered loss except:
__________________

The said loss or damage did not originate by any act, design or procurement on my (our) part nor on the part of anyone having an interest in the party insured, or in the said policy of insurance; not in result or consequence of any fraud done or suffered by me/us and that no property saved has been concealed.
It is expressly understood that the furnishing of this blank or the preparation of this proof by a representative of the above insurance company, ____________________, is not a waiver of any of its rights.

_______________________________________________________
__________________ By Owner

State of ________________________
County of _______________________

Sworn to and subscribed before me on ___________________________________________.

_______________________________________________________
Notary Public
My Commission Expires:

Sworn Statement of Loss, Vehicle
Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  This statement is useful both for insurance claims and tax deductions for loss on your IRS and state forms.

Use a notary.  Large organizations like the niceties of this approach.

Date policy issued: ___________________
Date policy expires: __________________

To the ___________________________________.  At time of loss, by the above indicated policy of insurance you insured:
_________________________________________________________ against loss by __________________________, upon the property described by the under Schedule “A,” according to the terms and conditions of the same policy and all forms, endorsements, transfers and assignments attached thereto.

Time and origin: A ____ loss occurred about the hour of ____ __m., on the _______.  The cause and origin of said loss were:
_______________________________________________________________

Occupancy: The building described or containing the property described, was occupied at the time of the loss as follows, and for no other purpose whatever:
_____________________________________________________________

Title and Interest: At the time of the loss the interest of your insured in the property described therein was _________.

Changes: Since the said policy was issued there has been no assignment thereof, or change of interest, use, occupancy, location or exposure of the property described, except: ______.

Total insurance: The total amount of insurance upon the property described by this policy was, at the time of the loss, $ _______ (____________&___/100 Dollars) as more particularly specified in the apportionment attached under Schedule “C,” besides which there was no policy or other contact of insurance, written or oral, valid or invalid.

The actual cash value of said property at the time of the loss was $ _______ (____________&___/100 Dollars).  The Whole Loss and Damage was $ ________ (___________ & ___/100 Dollars)

The amount claimed under the above numbered policy is $ _________ (____________&___/100 Dollars) The said loss did not originate by any act, design or procurement on the part of your insured, or this affiant; nothing has been done by or with the privity or consent of your insured or this affiant, to violate the conditions of the policy, or render it void; no articles are mentioned herein or in annexed schedules but such as were destroyed or damaged at the time of said loss; no property saved has in any manner been concealed, and no attempt to deceive the said company as to the extent of said loss, has in any manner been made. Any other information that may be required will be furnished and considered a part of this proof.  The furnishing of this blank or the preparation of proofs by a representative of the above insurance company is not a waiver of any of its rights.

State of ___________
County of __________

Subscribed and sworn to before me this ______ day of __________ 19______.

_____________________________________________
Notary
My Commission Expires:

Sworn Statement of Loss
Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  This document is necessary on occasion to get paid on an insurance claim.  It is also of use if you are self-insured and want to collect a deduction on your tax form from the IRS and your state authorities.

1. Make multiple copies.  Get them notarized.  Official bodies like the IRS and insurance companies like official looking documents.  So do it.

______________, referred to as DEBTOR, and __________, referred to as CREDITOR, agree:

______________ is indebted to CREDITOR in the amount of $_____(_________________________&___/100 dollars) by virtue of _________________ dated ____________. DEBTOR assigns to CREDITOR the following policy of life insurance:
Policy number: _______________________________________
Face amount: $_____(_______________________&____/100 dollars)
Amount of loans/charges against policy: $_____(__________________&____/100 dollars)
as collateral for the debt.

Any and all proceeds from the policy are assigned to the CREDITOR, to the extent of principal and interest due upon the debt, and any renewals and extensions thereof. The DEBTOR shall prepare any further instruments required to effect this pledge.

Dated: _________________________

____________________________________________
Debtor
Insurance Policy Number:

_____________________________________________
___________________, by an authorized officer of Creditor
Pledge of Life Insurance Policy to a Creditor

Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  A pledge of life insurance proceeds is a common request by major creditors including financial institutions buying stock from the Company.  It secures their interest should a key principal die.

Date:

RE:    Insurance Policy Number:
Insured:
Owner:

Dear Sir or Madam:

I am writing to instruct you to make the following change(s) to the above policy.  I would like to change a primary beneficiary.

The new primary beneficiary should be: ___________________.

Please send me a confirmation letter and, if necessary, a form to make this change.

Thank you for your assistance.

Best regards,

_____________
Insurance Policy Owner

Change of Beneficiary
Review List

This review list is provided to inform you about this document in question and assist you with its preparation.  This letter should be sent out promptly if your life circumstances change such as through death of a former beneficiary, your divorce, or other such circumstance.

1. Make multiple copies.  Send one to the insurance company and your agent, if you have one.  Keep one in the transaction file.

2. Make a note to follow-up with in two weeks if you do not hear back.  And keep after it until you implement the change you desire.