Dwelling Fire Application

Please note the following exclusions for coverage under the F.A.I.R. Plan.

  • Property which is vacant;
  • Property within 50 miles of an active wild fire;
  • Property in an active arson investigation;
  • Property in extreme disrepair;
  • Properties in excess of 25 acres; and
  • Applicants with a history of arson.

You must also include:

  • Color photos of All sides of ALL structures being insured. Please include photos of the roof whenever possible. (please send via email)
  • Check or money order for at least 25% of the annual premium (mandatory)
  • Original signatures of both applicant and agent
  • Quick Quote page

PRODUCER INFORMATION
APPLICANT INFORMATION
PREVIOUS COVERAGE

List all losses in the past 3 (three) years.

PROPERTY INFORMATION

Protection classes are determined by the distance from the property to a fire hydrant or fire station. In some circumstances NMPIP’s guidelines will supersede ISO guidelines.

PC 1 - 8

Indicates a hydrant has been located within 1,000 feet

PC 8B, 9 and ending with an X

Indicates a hydrant has NOT been located within 1,000 feet

PC 10 and ending with a Y

Indicates there is not a fire station within 5 miles

A minimum of 80% coinsurance of ACV is required an ALL buildings.

MOBILE HOME INFORMATION

NMPIP guidelines state that unless a home is built from the ground up on the site being insured it will be considered a mobile or modular home.

BUILDERS RISK INFORMATION

NMPIP guidelines will only accept brand new construction as a builder’s risk. Construction that has already started is not eligible for this discount.

NOTE: NMPIP does not insure vacant properties!

PAYMENT INFORMATION

All payments must be made to NMPIP in the form of money order or check (personal, company, agency or cashier’s).

No other payments options are available. We do not accept payment via credit cards, electronic payment via phone nor do we auto-debit accounts.

Payments are due on the day of the month the policy became effective. For example: if a policy became effective June 12 quarterly payments would be due on the 12th of the month in June, September, December and March. Insureds do not have the option of choosing their own due date.

Note: the quarterly and semi-annual payments option is available for insured pay only. Mortgagees, escrow and title companies may only be set up for annual payments.

MORTGAGE INFORMATION

Mortgage 1

Click here to add another mortgage
LOSS PAYEE INFORMATION

Contract of Sale (COS)


Additional Insured (AI)

Would you like to add another Additional Insured?
COVERAGE INFORMATION

NMPIP offers the option of entering specific amounts of coverage for the dwelling, contents and additional structures.

We do not automatically calculate other coverages based on a percentage of the dwelling amount.

  • The maximum combined coverage for protected areas (PC 2-8) is $250,000.
  • The maximum combined coverage for unprotected areas (PC B, X, Y, 9, 10) is $150,000.
INSUREDS STATEMENT
1

If yes, please provide expiring/cancellation date and reason.

2

If yes, please explain.

3
4
5

If yes, how long and why?

6
7
8
9

If yes, please explain

10
11

If yes, what is the total acreage?