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Keeping your single most important investment safe means trusting people that care for your wellbeing. At Great Lakes Mutual, we’ve been insuring our policy-holders homes and honoring their trust for over a century.

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Flexible insurance. It’s what you expect and what Great
Lakes Mutual offers – because no two pieces of property are the same. Contact a GLM agent today to get started on your tailored market value policy.

Learn More

Flexible insurance. It’s what you expect and what Great
Lakes Mutual offers – because no two pieces of property are the same. Contact a GLM agent today to get started on your tailored market value policy.

Learn More

Protecting your personal property shouldn’t cost a small
fortune. Whether you rent a home, duplex or apartment,
affordable contents insurance is right around the corner.

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Great Lakes Mutual

 

 

All form fields must be completed except where noted. Incomplete form fields will not allow the form to be submitted to Great Lakes Mutual Insurance.

Statement of No Loss

Policy/Agency Information:

 

Policy Number:

 

 

Agency Name (optional):

Agency Code (optional):

Insured Information:  

 

First Name:

Last Name:

Property Address:

Property Address Line 2 (optional):

City:

Zip Code:

   

Phone Number:

Email Address:

 

Certification Information:

 

AS THE NAMED INSURED, BY CHECKING THIS BOX, I CERTIFY THAT THERE HAVE BEEN NO LOSSES, ACCIDENTS, OR CIRCUMSTANCES THAT MIGHT GIVE RISE TO A CLAIM UNDER THE INSURANCE POLICY WHOSE NUMBER IS SHOWN ABOVE FROM 12:01 AM ON


(cancellation date)

TO


(date and time submitted)

 

 

Verification Code:

Retype Code:

 

 
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