Company Information

Agent Licensing & Supplies:

Phone: 800-321-0102

Marketing Support:

Phone: 866-644-3988

Claims, Underwriting, Customer Service & Commissions:

Phone: 855-664-5517

CSI Agent Portal:
[hide for=”!logged”]

Submitting Business

How to Submit Business with CSI:

  • Mail (new business)
    • Central States Indemnity Co. of Omaha
      P.O. Box 10816
      Clearwater, FL 33757-8816
  • Fax: 855-304-2855 (new business application and documents only)
    • Only applications paying the initial premium by bank draft or credit card are eligible to be faxed. Do NOT collect premium with an application that is being faxed.
    • All applications submitted with this form must be written by the same agent. No more than 5 applications are to be faxed with the cover sheet. Original copies should be maintained in case of fax transmission problems.
    • Do not mail in applications/forms once you have faxed them.
    • If commissions are to be split between two agents, both agents’ information must be listed in the Agent’s Certification section of the application.
    • It is important to include the phone/fax number. Do NOT submit pre-underwriting Issues, second applications, replacement forms, or other additional documents through the fax number.
    • Please submit a transmittal with all new business to be mailed. This transmittal may be photocopied or prepared via computer.
    • When using the monthly bank draft premium mode, ONE month’s premium must be submitted.
    • All policies and correspondence will be sent to the SUBMITTING agent. When submitting GROSS PREMIUM, the writing agent’s commission checks will be mailed on a weekly basis upon submission or issue.

Checklist for Submitting New Business:

  • Completed application (signed by all applicants and agent)
  • Completed bank draft form or credit card authorization form (if application is submitted with Mo PAC mode)
  • New business transmittal
  • Competed replacement form (if replacement is involved)