INDIANA BASIC PROPERTY INSURANCE UNDERWRITING ASSOCIATION

New Agent Registration Form

Agent access to online quote functions is available upon completing and submitting this online registration form.

Full agent online access, including policy status and other online information relating to your FAIR Plan customers, is available only when the agent has completed all requirements, including submission of taxpayer identification numbers. Also commissions on issued policies cannot be paid until the taxpayer identification information is provided to us.

The new business application and W-9 form can be printed from “Printable Applications” tab.

Applications and W-9 form should be faxed to 317-264-2395.

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Agent/Agency Information