GOLF COURSE INSURANCE INTAKE FORM

GOLF COURSE INSURANCE APPLICATION INSTRUCTIONS

Follow the steps 1-3 below and then when you have completed steps 1-3 come back to this page and complete the final step “4”.

Important Form Notice: This form is intended for traditional golf course and golf club insurance submissions. If you are looking for insurance for a driving range, mini-golf operation, golf simulator facility, golf entertainment venue, or a driving range plus entertainment business, please do not use this form. Those operations may require a different application and underwriting review process.

Complete, Save & Upload the Questionnaire Using the “Upload Questionnaire” Info Below

First, complete the Golf Course and Golf Club Insurance Questionnaire. It will open in a new browser tab so you can return here after saving it.

After completing the questionnaire, save the completed file to your computer. Then return to this page and upload it in Step 4.

Click Here First Open Questionnaire ➜

RED BOXES Required for all customers looking for any type of insurance for golf clubs or golf courses.

BLACK BOXES If you are only looking for Directors & Officers coverage, only the red and black boxes are required.

BLUE BOXES Only required if you select that specific coverage.

GREEN BOXES Required only if the applicable service or exposure applies to your golf club.

PINK BOX Used for additional remarks, clarification, or anything else you need us to know.

No Loss Statement

If the golf club has never experienced any claims, or if this is for a new business, complete a No Loss Statement.

You do not need to email it to us. Once submitted, it will automatically notify the Kelly Insurance Group team.

No Claims? Complete No Loss Statement ➜

Current Loss Runs

If you currently have insurance coverage, we will need copies of your current carrier loss runs.

Use the button to review what loss runs are, how to request them, and copy email wording to send to your current carrier or agent.

Loss Run Instructions

Loss runs are a statistical history of your golf course’s claim history. Most underwriters will require this information to provide a quote, even if you have had zero losses.

You may be able to retrieve your loss runs by logging into your online account with your current insurance company. Your claims history or loss runs may be available to download through the carrier portal.

If they are not available online, you can send an email to your current insurance company or your current servicing agent or broker.

Hi __________, We are currently reviewing our insurance program and we would like to have copies of our claims history, also known as Loss Runs, for our internal review. If you could provide this information for all lines we have on file with your company, that would be greatly appreciated. We are looking for our five-year Loss Run history. Thanks for your help and your quick attention to this matter.

Email wording copied.

Upload Questionnaire & Supporting Documents

After completing and saving the questionnaire, upload it below. You may also use this upload area to provide loss runs, current policy documents, schedules, or other supporting information.

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Disclaimer: Coverage availability and eligibility may depend on many factors, including underwriting review, carrier guidelines, policy terms, state requirements, business operations, risk characteristics, and other information provided during the application or quoting process. Kelly Insurance Group cannot guarantee that every individual, customer, organization, or business seeking coverage will qualify for, receive, or successfully place insurance coverage. All policy coverages, exclusions, conditions, limits, endorsements, and terms should be carefully reviewed by the consumer, insured, or applicant to confirm that the coverage requested is the coverage being quoted, offered, or provided. Insurance coverage, policy changes, endorsements, cancellations, and other policy terms are not bound, changed, confirmed, or altered unless and until written confirmation is provided by a licensed Kelly Insurance Group team member, the applicable insurance carrier, or an authorized underwriter. This page is provided for general informational purposes only and does not provide legal advice, legal opinions, insurance coverage opinions, or policy interpretations. Information on this page should not be relied upon as a substitute for reviewing the actual policy language or consulting appropriate professional advisors. Kelly Insurance Group does not employ, supervise, or direct attorneys.