Oregon Required Documents Checklist

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1 Accident Report for Dispute 2.0 and If the agent disputes an accident discovered from the CLUE report (or MVR for FSPA policies). The type of documentation that is needed to support an accident dispute will depend on the dispute reason that is selected. Some examples of documentation that can support a dispute include: - An experience letter from the Insured's prior carrier that shows fault; - A police report from the accident that indicates fault, or offers accident details that support a determination of fault; - Documentation which supports that the Insured just purchased the vehicle and that the loss is from the prior owner; - Documentation which shows that the Insured was not the driver of the loss. Customer's previous insurance carrier or website Loss changed to at fault OR - 10/17/2015 Page 1 of 19

2 Affinity (Business and Professional Groups ) Required when Affinity, is selected Non-Farmers Auto 2.0, 2.0, Home and Affinity Eligibility and Document Guidelines Customer needs to supply appropriate documentation validating membership in selected Affinity group Auto/Broker When requesting the discount for customers writing their primary homeowner policy through the Kraft Lake brokerage System will check Express after 45 days to see if appropriate Kraft Lake policy is in force. Appropriate Kraft Lake policies include the following product types: Homeowners Dwelling Fire Farm/Ranch (when the primary dwelling is insured) Applicable will be OR - 10/17/2015 Page 2 of 19

3 Auto/Business When requesting the discount for a customer also writing their Farmers Commercial policy System will check Express after 45 days Applicable to see if appropriate Commercial policy is in force (Workers Comp is not eligible) will be Auto/Home, Auto/Renter, Auto/Mobile Home Non-Farmers Required when Auto 2.0, Auto/Home, Auto/Renter or Auto/Mobile Home 2.0 and is selected System will check E-Home system after 30 days to see if appropriate Homeowners, Renters or Foremost Mobile Home policy is in force Auto/Home (for home only) Home Required when multi-line discount is selected for Farmers, Bristol-West, or 21st Century supporting Auto System will check Express after 30 days to see if appropriate auto policy is in force OR - 10/17/2015 Page 3 of 19

4 Auto/Umbrella When requesting the discount for customers writing their Umbrella policy with Farmers System will check Express after 45 days to see if appropriate Umbrella policy is in force Applicable will be BIPD Liability Waiver FA 2.0 and Prefilled Form Pending Required document list (Express) and Print Center Named insured or spouse Bristol West Non- Driver Non-Farmers Auto 2.0 Required when a driver is shown with a Bristol West non-driver reason code. Revalidation required at renewal. System will check the Bristol West policy for the status of the driver at the expiration of the diary period Driver Rated On Policy OR - 10/17/2015 Page 4 of 19

5 Central Station Burglar Alarm Home Required when Central Station Burglar Alarm is selected A copy of the current month burglar alarm bill Customer must provide acceptable documentation validating alarm is currently active Central Station Fire Alarm Home Required when Central Station Fire Alarm is selected A copy of the current month burglar alarm bill Customer must provide acceptable documentation validating alarm is currently active Dog Bite Exclusion, Non- Home and Home Required when input of policy shows that the insured owns a potentially dangerous dog. Pre-filled form only Company form 4152A or J6256 Pending- Required document list (Express) and Print Center Named insured or spouse Policy celled OR - 10/17/2015 Page 5 of 19

6 Electrical System Replacement Documentation Renovation-Electric and Heating s: Required when the electrical systems have been fully replaced 3rd party documentation verifying the following systems were replaced Electrical all wiring, switches, plugs, breakers and electrical fixtures must be replaced. It should also include date completed and property location. Along with proof that work was completed to code which can be verified by contractor license number or permit. Licensed contractor receipts showing systems replaced, invoices, letters from licensed contractors detailing the work completed or permits that reflect complete replacement FACET Customer Consent Form Required when a customer, requests to be rerated. Non-Farmers Auto 2.0, 2.0, non-next Gen Home, Home and Request to Rerate based on Current Score Personal Lines MenuClick the FACET FARA/FPRA link then Search for "Facet" Credit Client or Spouse No change OR - 10/17/2015 Page 6 of 19

7 Farmers Specialty 2.0 and Required when Farmers Specialty is selected System will check Foremost system after 30 days to see if appropriate Motorcycle, Family Boat and Personal Watercraft, Motor Home and Travel Trailer, or Off Road policy is in force OR - 10/17/2015 Page 7 of 19

8 Good Student Non-Farmers Auto 2.0, 2.0 and Required when Good Student is selected. Copy of grade report from the immediately preceding school semester or quarter showing: - A cumulative grade point average of at least 3.0 or higher. Progress reports are unacceptable, unless they show a cumulative GPA. - GPA of at least a B (or equivalent) or 3.0 or higher on a 4.0 system for all subjects - Ranked in the upper 20% of academic standing of class or ranked in upper 20% of nationally recognized achievement test taken within the past 12 months - Named to Dean s List or Honor Roll or other comparable designation - Web based transcripts are acceptable. Transcript MUST show the student s full name, the school s name and the school s web address. OR Completed Good Student Qualification Form Grade Report or Good Student Qualification Form (SNR ) Available on the Agency Dashboard OR - 10/17/2015 Page 8 of 19

9 Heating, Ventilation & Air ing (HVAC) System Replacement/Ren ovation Documentation Required when the heating/ac systems have been fully replaced 3rd party documentation verifying the following systems were replaced Heating/AC the heating and airconditioning systems must be replaced (includes replacement of the burners and compressors). It should also include date completed and property location. Along with proof that work was completed to code which can be verified by contractor license number or permit. Licensed contractor receipts showing systems replaced, invoices, letters from licensed contractors detailing the work completed or permits that reflect complete replacement Home/Business When requesting the discount for a customer also writing their Farmers Commercial policy System will check Express daily to see if Applicable appropriate Commercial policy is in force (Workers Comp is not eligible) will be Home / Farmers Specialty (Boat/Watercraft) Required when Farmers Specialty (Boat/Watercraft) is selected System will check Foremost system daily to see if appropriate Family Boat and Personal Watercraft policy is in force OR - 10/17/2015 Page 9 of 19

10 Home / Farmers Specialty - Motor Home and Tvl Tr Required when Farmers Specialty - Motor Home and Tvl Tr is selected System will check Foremost system daily to see if appropriate Motor Home and Travel Trailer policy is in force Home / Farmers Specialty - Off Road & Other Required when Farmers Specialty - Off Road & Other is selected System will check Foremost system daily to see if appropriate Motorcycle or Off Road policy is in force Home Safety Home Required when the dwelling is equipped with one of the following features: Energy Star/EPA Certified Home, LEED Certified Home, Fortified Home, le House Water Leak Detection, Automatic Gas Shutoff Valve, All Electric/All Solar Home Proof of Energy Star/EPA certification; Fortified Home certification; LEED certification; Proof of whole house water leak system installed at the home. Presence of Automatic Gas Shutoff valve will be verified by a property inspection of the home; if an inspection fails to verify the feature, documentation verifying installation by a certified contractor will be required. All Electric/All Solar homes require systems installation documentation by a certified contractor confirming there are no external fuel lines. Appropriate certifying agency, home purchase or installation documents reflecting the type or source of heating and/or electrical system for the home. OR - 10/17/2015 Page 10 of 19

11 Home Protection and Loss Prevention Documentation Required when the dwelling is equipped with one of the following features: Energy Star/EPA Certified Home, LEED Certified Home, Fortified Home, le House Water Leak Detection Proof of Energy Star/EPA certification; Fortified Home certification; LEED certification; Proof of whole house water leak system installed at the home. Appropriate certifying agency, home purchase or installation documents reflecting the type or source of heating and/or electrical system for the home. Home/Umbrella Homeownership 2.0 When requesting the discount for customers writing their Umbrella policy with Farmers Required on policies when selecting the Homeownership System will check Express daily to see if appropriate Umbrella policy is in force Scanned proof of homeowner's insurance declaration or mortgage statement or tax bill or homestead exemption Applicable Customer needs to supply appropriate documentation validating home ownership will be OR - 10/17/2015 Page 11 of 19

12 Homeownership Mature Driver Memorandum of Insurance, Non-Farmers Auto 2.0, 2.0, Non-Next Gen Home, Home and When the Named Insured/Spouse owns and lives in a home, townhouse or condominium (see the FSPA Reference Guide for additional eligibility criteria) When requesting the discount (for customers 60 years of age and older) who have completed a mature driver safety course Required on policies at time of New Business or reinstatement over 60 days. System will attempt to verify discount eligibility based on third party reports. If unable to validate automatically, proof of homeownership must be submitted. See the FSPA Reference Guide for eligible documentation. Certificate of completion Must be obtained from the customer if automatic validation is not available Must be obtained from the customer; the customer should receive this document upon successful completion of the Pre-filled form only Pending Required document list (Express) and Print Center Named insured or spouse will be will be OR - 10/17/2015 Page 12 of 19

13 Named Driver Exclusion Non-Farmers Auto 2.0, 2.0 and Required when a driver is excluded from coverage on the policy Pre-filled form only Pending Required document list (Express) and Print Center Named insured or spouse Driver Rated On Policy New Roof, Home 2.0 Required when the roof year is less than the age of the home and is considered eligible for the discount - Contractor receipts showing a roof replacement - Permits showing a roof replacement - Escrow documents showing completion of roof replacement as a condition of sale - Inspection report for home purchases showing the roof in new condition, or the estimated year of replacement - Contracts, estimates, or proposals for a total roof replacement with a proof of payment for the work done. - Receipts or invoices for materials purchased for a total roof replacement, reflecting not less than10 squares of shingle materials or $3,500 of roofing materials Customer needs to supply appropriate documentation to validate the roof year. OR - 10/17/2015 Page 13 of 19

14 Other Insurance Non-Driver Non-Farmers Auto 2.0 Required when a household member is assigned the non-driver reason Other Insurance Declaration page, Experience letter, Evidence of Insurance card from current insurance carrier. Documentation must show the customer's name, the policy effective dates, and must be printed on the company's letter head or stationary. Non-drivers current insurance carrier or website Driver Rated On Policy Plumbing System Replacement Documentation Required when the plumbing system has been fully replaced. 3rd party documentation verifying the following systems were replaced Plumbing all water lines (supply and drain) both in and under the structure and all plumbing fixtures must be replaced. It should also include date completed and property location. Along with proof that work was completed to code which can be verified by contractor license number or permit. Licensed contractor receipts showing systems replaced, invoices, letters from licensed contractors detailing the work completed or permits that reflect complete replacement Premium Determination / Antique / Restricted Use Non-Farmers Auto 2.0 and 2.0 J6282/J6482 E1151/Normal Use E1252/Restricted Use Pending Required document list (Express) and Print Center Named insured or spouse OR - 10/17/2015 Page 14 of 19

15 Prior Insurance - Standard Carrier Prior Insurance (FNA) and Required when the Transfer is applied to the policy and there is a discrepancy between customer provided prior carrier information and the prior insurance vendor report. Required when there is a discrepancy between customer provided prior carrier coverage history and/or limit information and the prior insurance vendor report. Documentation should demonstrate 6 months of continuous coverage from an eligible carrier as identified on the "Preferred Carrier List". A company issued Letter of Experience is required to dispute a lapse in coverage. Documentation should demonstrate 6 months of continuous coverage with no more than a 30 day lapse in coverage prior to Farmers effective date, and display coverage limits carried. A company issued Letter of Experience is required to dispute a lapse in coverage. For Innocent No Prior please refer to the Guide Acceptable documentation can be provided by the most recent carrier and may inlcude a Declaration page, Letter of Experience, or Evidence of Insurance card from current insurance carrier. Acceptable documentation can be provided by the most recent carrier and may inlcude a Declaration page, Letter of Experience, or Evidence of Insurance card from current insurance carrier. Premium increased from quoted amount OR - 10/17/2015 Page 15 of 19

16 Rewrite, When rewriting an existing policy to a Smart Plan product type Company form (Policyholder Rewrite Agreement) Print Center Named Insured Rewrite not permitted Proof of Prior Insurance 2.0 and Required when there is a discrepancy between customer provided prior carrier coverage history and the prior insurance vendor report. Documentation should demonstrate 6 months of continuous coverage with no more than a 30 day lapse in coverage prior to Farmers effective date, and display coverage limits carried. A company issued Letter of Experience is required to dispute a lapse in coverage if the prior carrier contributes to the Current Carrier Database (CCDB). For Innocent No Prior please refer to the Guide Acceptable documentation can be provided by the most recent carrier and may inlcude a Declaration page, Letter of Experience, or Evidence of Insurance card from current insurance carrier. Policy cellation OR - 10/17/2015 Page 16 of 19

17 Renovation - Electrical and Heating Home Renovation-Electric and Heating s: Required when the electrical and heating/ac systems have been fully replaced 3rd party documentation verifying the following systems were replaced Electrical all wiring, switches, plugs, breakers and electrical fixtures must be replaced. Heating/AC the heating and airconditioning systems must be replaced (includes replacement of the burners and compressors). It should also include date completed and property location. Along with proof that work was completed to code which can be verified by contractor license number or permit. Licensed contractor receipts showing systems replaced, invoices, letters from licensed contractors detailing the work completed or permits that reflect complete replacement OR - 10/17/2015 Page 17 of 19

18 Renovation - Plumbing Home Renovation-Plumbing discount: Required when the plumbing system has been fully replaced 3rd party documentation verifying the following systems were replaced Plumbing all water lines (supply and drain) both in and under the structure and all plumbing fixtures must be replaced. It should also include date completed and property location. Along with proof that work was completed to code which can be verified by contractor license number or permit. Licensed contractor receipts showing systems replaced, invoices, letters from licensed contractors detailing the work completed or permits that reflect complete replacement UL Approved Roof Rating Home, Required when Roof Surfacing is selected A copy of the building permit or contractors billing showing the roofing materials installed at the property location have an impact rating of UL3 or UL4. A manufacturer warranty brochure is not acceptable Customer must provide acceptable documentation validating roofing materials installed on the insured dwelling meet the UL3 or UL4 rating OR - 10/17/2015 Page 18 of 19

19 Subscription Agreement Any Exchange Policy Required when an Exchange Policy is written Fully Executed Subscription Agreement or Application/Memorandum of Insurance with a Subscription Agreement attached. To review the required information refer to BNB Pending Required document list (Express) and Print Center Named insured or spouse Policy cellation For additional information refer to the Subscription Agreement Landing page. UM/UIM Agreement Non-Farmers Auto 2.0, 2.0 and Required when UM/UIM limits are selected that are lower than the BIPD limits on the policy or coverage has been rejected Pre-filled Form Only Pending Required document list (Express) and Print Center Named insured or spouse Limits changed OR - 10/17/2015 Page 19 of 19

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