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Policy Forms
Submit your billing form by choosing the document you need below. The forms are in a fillable PDF format and should be completed, saved, then submitted via email.
Billing Forms Details
Agency ACH Enrollment Form AC 09 09/09 
Policyholder ACH Enrollment Form AC 03 04 14
Policyholder ACH Withdrawal Form AC 13 09/09

ICC periodically obtains lists of liquor license holders from the state regulatory agencies. These lists are available, free of charge, to our agents. The lists contain DBA name and address, and where available, phone numbers and liquor license expiration dates. The lists are available as an Excel spreadsheet, and are “scrubbed” of current ICC policyholders (current policyholders are removed from the list). Lead lists may be requested by county. You can specify up to ten counties, total. Questions regarding Lead Lists should be directed to the Marketing Department:

Your claim information has been submitted. A representative from ICC will be in contact with you shortly to follow-up on the information you provided.

To upload and submit an existing loss notice, please click the “Browse” button and locate the file on your computer or network. Once you select the file, click “Open.” You will return to this page. Add comments if you wish and click “Upload” to complete the process.
By uploading a form, you acknowledge that the information you have submitted regarding your claim or loss notice is accurate and detailed to the best of your knowledge. 

Email the claims department.
Your claim information has been submitted. A representative from ICC will be in contact with you shortly to follow up on the information you provided.
Your payment has been deleted. Confirmation should appear on your account shortly. Contact with any questions.
Thank you for submitting your ePayment. The transaction should appear on your account shortly. If you have any questions, please contact our billing department at

Your order has been placed and will be filled out by Illinois Casualty Company. Items will arrive within 7-10 days to the address provided. Further questions, please contact

Click on a bulletin link to view:

03/27/2017 Press Release May, 2015
Changes to Hired and Non-Owned Auto May, 2015
Current A.M. Best Standings February, 2015
Contingent Bonus Incentive  January, 2015
Underwriting Will Consider BOP for Bowling Centers November, 2014
BOP Property Changes September, 2014
ICC's Market Niche May, 2014


Year in Review: Trials (and Tribulations) of 2014 February, 2015
Structured Settlements: Advantages to Accepting a Structured Settlement November, 2014
The Agent's Cameo in Claims Handling: A Legal Study of Why Agents Should Never Play the Lead August, 2014
Water, Water, Everywhere: Understanding Water Losses May, 2014
Year in Review: Trials (and Tribulations) of 2013 February, 2014

Use our marketing materials to help communicate policy and coverage options to potential customers and clients. You can download a PDF of these forms, or order printed copies through the form below.

Click on a Newsletter link to view:

Second Quarter Edition May, 2015
First Quarter Edition February, 2015
Fourth Quarter Edition November, 2014
Third Quarter Edition August, 2014
Second Quarter Edition May, 2014
First Quarter Edition February, 2014


June Edition June, 2015
April Edition April, 2015
March Edition March, 2015
January Edition January, 2015
September Edition September, 2014
Jun/July Edition July, 2014
April Edition April, 2014
March Edition March, 2014


Cheers for the New Year December, 2014

Download the policy form you need by searching the form category or by searching for your state. All forms can be downloaded as PDF documents. Email with any questions.

Search function that allows searching by type of policy form or by state. Thirty-five forms in total that are organized into the following seven categories and five states (

Categories of Form:

  • Businessowners’ Common Policy Forms
  • Businessowners’ Liability Policy Forms
  • Businessowners’ Property Policy Forms
  • Commercial Umbrella Policy Forms
  • General Liability Policy Forms
  • Liquor Liability Policy Forms
  • Workers Compensation Policy Forms


  • Illinois
  • Indiana
  • Iowa
  • Minnesota
  • Missouri

ICC to verify for any duplication among forms to see if list can be cut down at all (i.e. – do Iowa and Minnesota use the same form, etc.)

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