A “no loss” statement is a signed form that tells the insurance company that you have not had any losses since a certain date. The document usually includes a cancellation date, expiration date, etc.

Also keep in mind that a loss is broader than being in an accident with your vehicle. This term can include your windshield cracking, you as a passenger in someone else’s vehicle that is involved in an accident, etc.

An example wording of a no loss document would state:

I certify that there have been no losses, accidents or circumstances that might give rise to a claim under the above listed insurance policy number, from 12:01 AM on (fill in cancellation date) to fill in current date and time that the form is signed.

Typically, these are used by companies when your policy has cancelled. Before deciding if they will reinstate your policy, they want to verify that no new claims or underwriting information occurred while your policy was cancelled.

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