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.