Statement of Understanding -- Terms and Conditions
"We accept payments as a courtesy to our customers. If your policy is cancelled for any reason, payment of this premium does not necessarily reinstate your policy. Your company will notify you of any reinstatement, or if not reinstated, refund any unearned premium within 30 days. Statement (Affidavit) of No Loss In the event my policy has lapsed or was cancelled due to non-payment and my insurer is willing and/or able to reinstate my policy I agree to the following terms and are making the following statement to be true: I, the insured, understand my policy was cancelled on the cancellation date, which was mailed to me, and that my coverage terminated at 12:01 a.m. on that day. I understand if my policy is reinstated no losses or claim(s) will be covered by my company (carrier) from my cancellation date to the reinstatement date or time in which my carrier has bound coverage. I further hold harmless the agency and its agents, my company, company�s representatives and/or agents of any loss that occurred during this time. I certify that I am NOT aware of any losses, accidents or circumstances that might give rise to any claim under the insurance policy whose number is shown above from my cancellation date at 12:01AM to being fully reinstated by my company.