Forms/Documents Description
Policy Contract The Policy contains the definitions, terms, limits, exclusions, and conditions for each type of coverage shown on your policy declarations page.
Privacy Notice The Privacy Notice outlines the types of non-public personal information that we collect, why we collect it, how we use it, and whom we share it with.
Driver Exclusion Form A completed Driver Exclusion will allow you to exclude household members from coverage, and may reduce your premium payment.
Sole Driver Form If you are the only operator of the vehicle(s) listed on your Application please complete, sign, and return this form.
Automatic Payment Application Use this application to enroll in automatic monthly premium payments.
Physician Statement Form Print this form, bring it to your Physician and return it completed if a statement is requested by Underwriting or your Insurance Agent.
Business Use Exclusion Form A completed Business Use Exclusion is required for some occupations. Please contact your Insurance Agent for requirements.


Forms/Documents Description
Bill of sale/letter of experience Bill of sale and letter of experience notice.
Business use questionnaire Business use questionnaire.
Claimant accident report This accident report is for parties not insured by American Heartland.
Comprehensive claim questionnaire For policyholders insured by American Heartland who have filed a comprehensive claim.
Insured accident report This accident report is for policyholders that are insured by American Heartland.
Payment authorization form Authorize payment to be made directly to your repair facility.
Undisclosed driver form Undisclosed driver form.
Undisclosed resident form Undisclosed resident form.
Vehicle fire affidavit Vehicle fire affidavit.
Vehicle theft affidavit Vehicle theft affidavit.