Following the instructions on each page will dynamically generate a Loss History Authorization Letter and display it onscreen for you to print on your Company Letterhead.

**Note: If you have insurance policies with multiple Insurance Companies, you will need to generate one letter per Insurance Company.

 10700 N. Freeway
 Suite 300
 Houston, TX 77037

 (800) 833-0188
 
Step 1:  Insurance Company Information
     
Insurance Company Name:  
     
     
Number of Policies: