Farm Insurance | Applications
Please find below a listing of the most frequently used insurance applications. If you are looking just for a quote complete our Quote Questionnaire below. Contact us if there are questions or you are unsure of which application to use. Please keep in mind these applications are the sole property of each individual insurance company and may not be used in anyway other than applying for insurance coverage. By completing the application does not constitute acceptance of coverage from the insurance company. Final determination of eligibility lies with each insurer.
FRAUD STATEMENTS:
PA: “Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.”
NJ: “Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. “
VA: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE IMPRISONMENT, FINES AND DENIAL OF INSURANCE BENEFITS.
OTHER STATES: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD AND INSURANCE COMPANY OR ANOTHER PERSON FILES AND APPLICATION FOR INSURANCE CONTAINING ANY MATERIALY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF INFORMATION CONCERNING ANY FACT MATERIAL THERTO, COMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND CIVIL PENALTIES. NOT APPLICABLE IN NEBRASK
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