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What forms are needed in the state of South Carolina?

The available forms and a brief description are listed below. You can open a .pdf version of the forms by clicking on the form in the 'File Attachments' section below.

Offer of Additional Uninsured Motorists Coverage and Optional Underinsured Motorists Coverage: AU SC39b 0214
Use this form if your policy declaration page indicates that the insurance company issuing your policy is 21st Century Centennial Insurance Company.

Offer of Additional Uninsured Motorists Coverage and Optional Underinsured Motorists Coverage: AU SC39c 0214
Use this form if your policy declaration page indicates that the insurance company issuing your policy is 21st Century North America Insurance Company.

Under South Carolina's insurance laws, once an insurance company agrees to underwrite your automobile liability insurance coverage, you must be offered two additional automobile insurance coverages - Uninsured Motorists Coverage and Underinsured Motorists Coverage. This form explains these coverages and allows you to select your limits of coverage or to reject the coverage entirely. If you have not previously completed and signed the Offer of Additional Uninsured Motorists Coverage and Optional Underinsured Motorists Coverage or if you want to make changes to your current coverage, please print and complete this form.

Once completed, please mail or fax the form to the address or fax number listed below.

Physical Mailing and Overnight Address:

Overnight - Correspondence
21st Century Insurance
3 Beaver Valley Rd - 4th Floor
Wilmington, DE 19803

Fax number: 1(866) 447-2611

File Attachments

Offer of Additional Uninsured Motorists Coverage and Optional Underinsured Motorists Coverage: AU SC39b 0214
Offer of Additional Uninsured Motorists Coverage and Optional Underinsured Motorists Coverage: AU SC39c 0214

Topics

General Information
Coverage
State Forms

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