Agreement to Provide Accidental Physical Damage Insurance

When a consumer finances a vehicle through a dealer, the dealer will usually assign the loan to a finance company or bank. In order for the finance company or bank to accept the assignment it will want the purchaser to acknowledge responsibility to insure the vehicle for damage of loss and have the dealer confirm coverage prior to delivery. The Agreement to Provide Accidental Physical Damage Insurance form is a convenient way for the dealer to obtain insurance information from the customer and confirm coverage with the insurance agent or company. Form has been updated at dealers’ request to include the Financial Institution’s name and address.