Risk, Claims & Loss History — Update / setup form (auth-only) for Insurance. Embeddable version — a transparent, chrome-free form that floats over your own website design (pair with the standalone version for a hosted page).

A clear loss history helps us place you with the right carrier at the best rate. Summaries and counts only — no policy or account numbers.

What it collects (by section):

• Claims history — Claims in Last 5 Years (count) [number]; Claims Summary (last 5 years) [long text]; Loss Runs Status [dropdown: Not requested / Requested / Received - clean / Received - with losses / Under review / …].
• Underwriting questions — Underwriting Questions Outstanding [long text].
• Pre-bind inspection — Pre-Bind Inspection Required [dropdown: No / Possible / Yes / Unknown]; Inspection Scheduled Date [date]; Inspection Outcome (summary) [long text].
• Quote & carrier status — Quote Status (insurance) [dropdown: Discovery / Submissions sent / Quoted / Bound / Declined by carrier / …]; Carrier Appetite Notes [long text].

Form type: Update / setup (up), auth-only. Niche: Insurance. Deployment: embed.

Best for / surface when: Insurance client workflow — risk, claims & loss history.