Reliable Policy Management South Carolina Product Listing, Forms and Documentation

The following products are available:

• Manufactured/Mobile Home Insurance - not writing new business in all counties
• Prime AD and Family Plan Accidental Death & Dismemberment (AD&D)
• Hospital Indemnity Travel Plan
• Motor Club Membership
• Travel Trailer Insurance

Forms and Documentation:
     The date following the product is the last update.

     Aegis Security Insurance Company (Manufactured/Mobile Home & Travel Trailer Insurance - not writing new business in all counties)

• Aegis SC Manufactured Home Insurance:

Underwriting Edition 8-(5/08)

• Rates Pages:

Rates (pages 1 - 25) (8/08)
Rates (pages 26 - 52) (7/08)

• Special Forms: 

Special Forms (7/08)
Agency/Agent Licensing Forms Package (8/08)
Acknowledgment of No Coverage Bound
Acknowledgment/Personal Liability Exclusion
Affidavit of Inspection and No Existing Damage
Agency Fact Sheet (8/08)
Agent Appointment Form (8/08)
Cancellation Form (8/08)
Checklist for Manufactured Home Components
General Change Form (8/08)
Manufactured Home Quote Sheet (8/08)
Manufactured Home/Loss Claim Form (8/08)
No Loss Statement (8/08)
Permission to Check Credit History Form
Rental Unit Description Form
Rule A Questionnaire
SC Manufactured Home Application (8/08)
Supplemental Heating Device and Wood/Coal Burning Stove Report
Supply Order Form (8/08)
W-9 Form

• Policy Forms:

Policy Forms (8/08)
Additional Insured
All Terrain Vehicle Exclusion
Amendment of Policy Provisions (8/08)
Animal Injury Exclusion
Arbitration Agreement
Exclusion - Mold Liability
Exclusion of Certain Computer - Related Losses
Fire Department Service Coverage
Full Repair Cost Endorsement
Hurricane, Tropical Cyclone or Tropical Storm Deductible
Manufactured Home Policy
Mold - Extension of Coverage
Outside Radio or Television Antennas
Personal Property Replacement Cost
Premises Liability - Rented to Others
Replacement Cost Coverage (home)
Scheduled Personal Property Endorsement
Secured Interest Protection Endorsement
Special Limit for Animal Liability
Trampoline Exclusion
$500 Water Damage Deductible
$500 Windstorm/Tornado and Hail Deductible
Windstorm/Tornado/Hail Exclusion

• SC Travel Trailers: 

Travel Trailers (1/05)
Insurance Application (8/08)
Rates & Underwriting
Special Provisions
Trail-Blazer Policy Deletion of Collision or Roll Over Coverage
Your Aegis Trail-Blazer Policy


Life of the South Insurance Company (Prime AD):

Prime AD - Agent Guidelines Edition 8-(7/08)
Agency/Agent Licensing Forms Package (8/08)
Accidental Death, Dismemberment or Loss of Sight Claim Form (8/08)
Cancellation Request Form (8/08)
Endorsement Form (8/08)
Life of the South Agent Profile/Background Authorization & Disclosure Form (8/08)
Supply Order Form (8/08)

 Lyndon Southern Insurance Company (Family Plan):

Family Plan- Agent Guidelines Edition 8-(7/08)
Agency/Agent Licensing Forms Package (8/08)
Accidental Death, Dismemberment or Loss of Sight Claim Form (8/08)
Cancellation Request Form (8/08)
Endorsement Form (8/08)
Life of the South Agent Profile/Background Authorization & Disclosure Form (8/08)
Supply Order Form (8/08)

 Nation Safe Drivers (HITP):

Nation Safe Drivers (HITP) Agent Guidelines (8/08)
Agency/Agent Licensing Forms Package (8/08)
Cancellation Request Form (8/08)
Endorsement Form (8/08)
Forms to Order from Nation Safe Drivers (8/08)
Supply Order Form
(8/08)

• SC Roadmaster (Motor Club) - underwritten by Nation Safe Drivers:

Motor Club Plan Edition 2-(7/08)
Agency/Agent Licensing Forms Package (8/08)
Agency Fact Sheet (8/08)
Agent Application
Agent License/Appt. Cancellation
Cancellation Request Form (8/08)
Claim Form
Member Address Change Form (8/08)
SC Roadmaster Forms package (8/08)
Supply Order Form (8/08)
Transmittal Form
W-9 Form    

Note: Adobe Reader version 6.0 or later is required to view and print  these forms.