Request for Loss History Letters/Certificate of Insurance

Request for Loss History Letters/Certificate of Insurance
Complete the form below to request a loss history letter and/or a certificate of insurance (COI). These requests are typically completed within five (5) business days of submission provided we have the appropriate authorization(s). If you do not receive a response to your request within that timeframe or have additional questions, please email us at claimreports@ismie.com.
Current policyholders: You are able to access your Loss History Letters and Certificates of Insurance online by logging in to your account at www.ismie.com.

Past policyholders: You are able to access your Loss History Letters online by logging in to your account at www.ismie.com.

If you do not have an online account, you may register for one at https://www.ismie.com/blc/registration-request.
Requestor's Name*

First NameLast Name
Requestor's Phone Number*

Area CodePhone Number
Requestor's Fax Number*

Area CodeFax Number
Requestor's Email*
example@example.com
Information Requested*

10-year Loss History LetterAll Year Loss History LetterCertificate of Insurance
Please attach a current authorization letter signed by the policyholder.

Browse Files

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Policyholder's Name*

First NameLast Name
Policy Number*
Enter the message as it's shown*
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