Use this form if you’re executor or personal representative (the person in charge of wrapping up the deceased person’s affairs) and the deceased person owned a home.

This form notifies the insurance company of the death and asks that you, the executor, be added as a “named insured” to the homeowner’s insurance policy.

Important to Know:

• If you are both a co-owner of the home and the executor, do not use this form. Instead, call your insurance company and tell them that the other owner has died.
• To be added to the deceased's vehicle insurance policy, use the "Notice to Deceased Vehicle Insurance Company."
• You will want to be added as a named insured to the policy for the home as soon as possible in order to obtain all the protections and rights that the deceased person had under the policy. This gives you coverage if you or anyone is injured on the premises due to your carelessness or if there is property damage.

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