UW Manuals and Forms
From time to time, Kemper Auto may require specific forms signed by policy holders. Please see the links below for frequently used policy forms. If you have any questions regarding these documents, please call the Underwriting department at (630) 645-7777.
Select the state specific document you need for Arizona, Illinois, Indiana, Nevada or Texas.
Arizona
- Underwriting Manual
- Policy Contract - New and Renewal 9/10/2022
- Policy Contract - Prior
- Application
- Coverage Waiver
- Driver Exclusion
- Notice of Adverse Underwriting Decision
- Notice of Insurance Information Practices
- Physician's Report
- Spanish Acknowledgement Form
Illinois
- Reciprocal Metro - Underwriting Manual
- Reciprocal Policy Contract
- Reciprocal Subscriber Agreement and Power of Attorney
- Reciprocal Application
- Reciprocal Driver Exclusion
- Reciprocal Notice of Adverse Underwriting Decision
- Reciprocal Notice of Insurance Information Practice
- Reciprocal Physician's Report
- Reciprocal Spanish Acknowledgement Form
- Underwriting Manual - Metro
- Underwriting Manual - Gateway
- Policy Contract - New and Renewal 1/1/2023
- Policy Contract - Prior
- Application
- Driver Exclusion
- Non Business Use Form
- Notice of Adverse Underwriting Decision
- Notice of Insurance Information Practice
- Physician's Report
- Spanish Acknowledgement Form
Indiana
- Underwriting Manual
- Policy Contract - New and Renewal 8/6/2022
- Policy Contract - Prior
- Application
- Non Business Use Form
- Driver Exclusion
- Innocent Prior Form
- Notice of Adverse Underwriting Decision
- Notice of Insurance Information Practice
- Physician's Report
- Spanish Acknowledgement Form
- Coverage Waiver
Nevada
- Standard 2.0 Underwriting Manual
- Policy Contract - New and Renewal 8/20/2022
- Policy Contract - Prior
- Application
- Coverage Waiver Form
- Driver Exclusion
- Nevada Notice Explaining Premium Increases
- No Loss Statement Form
- Notice of Adverse Underwriting Decision
- Notice of Insurance Information Practice
- Physician's Report
- Spanish Acknowledgement Form
Texas
- Underwriting Manual
- Policy Contract - New and Renewal 1/1/2024
- Policy Contract - Prior
- Application
- Consumer Bill of Rights
- Driver Exclusion
- Non-Owner Endorsement
- Notice of Adverse Underwriting Decision
- Notice of Insurance Information Practice
- Physician's Report
- Rejection of Coverage
- Spanish Acknowledgement Form