APPLICATIONS
Heartland Specialty Insurance will process your application as quickly as possible.
Applications Required on All Submissions:
Applications for Casualty Submissions:
- Acord 137-Commercial Auto (TX)
- Acord 126-Commercial GL Section
- Acord 131-Umbrella Section
- Acord 130-Workers Compensation
Applications for Property & Inland Marine Submissions:
When completed please email the form as an attachment to the following:
submissions@heartlandspecialty.com
-or-
When completed please fax the form to HSI @ 972.866.9430
All forms are available in Adobe PDF format. If you do not have Adobe Acrobat reader installed, you will need to download and install the program prior to loading any of the forms. Please click on the following link to get the reader program:
