Selection/Rejection Forms

Selection/Rejection Forms

The laws of your state require that certain coverages be included in your policy unless specifically rejected/declined by you in writing. Please scroll down to the state where your vehicle is located (this can be found on your declarations page). Depending on your state, you may have 1-3 required forms.

Please read the entire document carefully before making any selections or rejections. Upon completion, the forms may be faxed to 262-548-3288, scanned and emailed to customerservice@markelcorp.com, or mailed to xxxxx.

If you do not return the completed forms or return incomplete forms, we are legally required to add or increase the coverage in your policy, which will increase your premium.

If you have any questions, please call 1-800-236-2453 to speak with a customer service representative.

Rhode Island
Medical Expense Coverage Selection/Rejection Form

Uninsured/Underinsured Motorists Coverage Property Damage Selection/Rejection Form

Uninsured/Underinsured Motorists Bodily Injury Coverage Selection/Rejection Form

Illinois
Selection/Rejection of Increased Limits Uninsured/Underinsured Motorist Bodily Injury Coverage

 

Alabama
Instructions
Uninsured Motorists Bodily Injury Coverage

Alaska
Instructions
Uninsured/Underinsured Motorists Bodily Injury and Property Damage Coverage

Arizona
Instructions
Uninsured and Underinsured Motorists Bodily Injury Coverage

Arkansas
Instructions
Uninsured Motorists Bodily Injury and Property Damage Coverage
Underinsured Motorists Bodily Injury Coverage
Personal Injury Protection Coverages

California
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage
Uninsured Motorists Property Damage Coverage
Uninsured Motorists Collision Deductible Coverage

Colorado
Instructions
Uninsured Motorists Bodily Injury Coverage

Connecticut
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage

Delaware
Instructions
Uninsured Motorists Bodily Injury and Property Damage Coverage

Florida
Instructions
Selection/Rejection Form

Georgia
Instructions
Uninsured Motorists Bodily Injury and Property Damage Coverage

Idaho
Instructions
Uninsured and Underinsured Motorists Bodily Injury Coverage

Illinois
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage

Indiana
Instructions
Uninsured Motorists Bodily Injury Coverage
Uninsured Motorists Property Damage Coverage
Underinsured Motorists Bodily Injury Coverage

Iowa
Instructions
Uninsured Motorists Bodily Injury Coverage
Underinsured Motorists Bodily Injury Coverage

Kansas
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage

Kentucky
Instructions
Selection/Rejection Form

Louisiana
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage
Uninsured/Underinsured Motorists Property Damage Coverage

Maine
Instructions
Selection/Rejection Form

Maryland
Instructions
Uninsured Motorists Bodily Injury and Property Damage Coverage

Mississippi
Instructions
Uninsured Motorists Bodily Injury and Property Damage Coverage

Nevada
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage

New Mexico
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage and Uninsured Motorists Property Damage Coverage

Oklahoma
Instructions
Uninsured Motorists Bodily Injury Coverage

Oregon
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage

Pennsylvania
Instructions
Uninsured Motorists Bodily Injury Coverage
Underinsured Motorists Bodily Injury Coverage

Rhode Island
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage
Uninsured/Underinsured Motorists Property Damage Coverage
Medical Expense Coverage

South Carolina
Instructions
Selection/Rejection Form

Tennessee
Instructions
Uninsured/Underinsured Motorists Bodily Injury and Property Damage Coverage

Texas
Instructions
Uninsured/Underinsured Motorists Bodily Injury and Property Damage Coverage
Personal Injury Protection Coverages

Utah
Instructions
Uninsured and Underinsured Motorists Bodily Injury Coverage

Vermont
Instructions
Uninsured/Underinsured Motorists Bodily Injury Coverage

Virginia
Instructions
Uninsured Motorists Bodily Injury and Property Damage Coverage

Washington
Instructions
Uninsured/Underinsured Motorists Bodily Injury and Property Damage Coverage

West Virginia
Instructions
Selection/Rejection Form

1-800-236-2453
Markel Customer Service
Hours of operation:
Mon.–Fri., 7:00 a.m.–8:00 p.m. CST
Sat., 9:00 a.m.–5:00 p.m. CST

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