Coverage description
An Insurance Services Office (ISO) standard form. It replaces the general liability pollution exclusion with a version that gives back coverage for a short-term pollution event caused by a named peril, such as lightning, windstorm or a tank explosion, that ends within 48 hours and is reported within 14 days.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 12 04Dec 2004Latest | 75 | 50 | 9 | Dec 2021 to Oct 2026 |
2 other edition dates appear in one or two filings each, often carrier-specific versions: 09 22, 09 97.
What the filings show
- Edition in use: in the past 12 months, 18 companies filed the 12 04 edition.
- CG 21 34 (Exclusion - Designated Work (for Use with Cgl and Products Policies)) is filed alongside it most often, in 76 of the same filings (99%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Oct 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include CG 04 28, out of 29 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Markel Corporation Group2 group companies filed it, led by State National Insurance Company, Inc. and Markel Insurance Company | 8 | 4 | 12 04 | Oct 22, 2026 |
| Siriuspoint GroupSiriusPoint America Insurance Company | 7 | 3 | 12 04 | Jun 15, 2026 |
| Nationwide Corporation Group7 group companies filed it, led by Allied Insurance Company of America and Nationwide Agribusiness Insurance Company | 6 | 3 | 12 04 | Feb 12, 2025 |
| Church Mutual GroupChurch Mutual Insurance Company, S.I. | 5 | 2 | 12 04 | Jun 26, 2026 |
| Sompo GroupSompo America Insurance Company | 5 | 1 | 12 04 | Jun 18, 2026 |
| Tokio Marine Holdings Incorporated GroupSafety National Casualty Corporation | 5 | 1 | 12 04 | Feb 17, 2026 |
| ACP Insurance Mgmt LLC GroupAccelerant National Insurance Company | 4 | 2 | 12 04 | Dec 8, 2025 |
| AU Holding Company Group2 group companies filed it, led by Continental Indemnity Company and Pennsylvania Insurance Company | 4 | 4 | 12 04 | May 3, 2024 |
| CNA Insurance Group6 group companies filed it, led by American Casualty Company of Reading, Pennsylvania and Continental Casualty Company | 3 | 3 | 12 04 | Oct 6, 2026 |
| Clear Blue Financial GroupClear Blue Insurance Company | 3 | 2 | 12 04 | Nov 12, 2025 |
How the largest insurers handle CG 04 28
Groups among the largest commercial general liability insurers that filed CG 04 28 or their own version in the past five years.
- WR Berkley Corporation GroupUses CG 04 28 in 1 filing
- Fairfax Financial GroupUses CG 04 28 in 1 filing
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States
Number of filings that include CG 04 28 in each state, Oct 2021 to Oct 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- CG 21 34Exclusion - Designated Work (for Use with Cgl and Products Policies)76 filings
- CG 21 45Exclusion - Damage to Premises Rented to You76 filings
- CG 21 53Exclusion - Designated Ongoing Operations76 filings
- CG 25 04Designated Location(S) General Aggregate Limit76 filings
- CG 02 24Earlier Notice of Cancellation Provided by Us (for Use with Cgl, Liquor, Pollution and Products Policies)75 filings
- CG 03 00Deductible Liability Insurance (for Use with Cgl and Products Policies)75 filings
- CG 20 02Additional Insured - Club Members75 filings
- CG 20 04Additional Insured - Condominium Unit Owners75 filings
- CG 21 16Exclusion - Designated Professional Services75 filings
- CG 21 35Exclusion - Coverage C - Medical Payments75 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Oct 22, 2026 | State National Insurance Company, Inc. | CO | 12 04 | STNA-135128706 |
| Oct 6, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CA | 12 04 | CNAB-135091690 |
| Jun 26, 2026 | Church Mutual Insurance Company, S.I. | CO | 12 04 | CHMU-134947220 |
| Jun 18, 2026 | Sompo America Insurance Company | CO | 12 04 | SMPJ-134985965 |
| Jun 17, 2026 | Atlantic Specialty Insurance Company | NM | 12 04 | BEAC-134983795 |
| Jun 15, 2026 | SiriusPoint America Insurance Company | CO | 12 04 | MRTN-134978899 |
| Jun 15, 2026 | SiriusPoint America Insurance Company | CO | 12 04 | MRTN-134978902 |
| Jun 1, 2026 | CopperPoint Casualty Insurance Companyand 1 more | SC | 12 04 | COPP-134966665 |
| Mar 20, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | 12 04 | CNAB-134872676 |
| Feb 24, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | SC | 12 04 | CNAB-134851008 |
| Feb 17, 2026 | Safety National Casualty Corporation | CO | 12 04 | SFCC-134814522 |
| Feb 6, 2026 | Crum and Forster Indemnity Company | CA | 12 04 | CRUM-134831877 |
Most filed ISO CG forms
- CG 40 32 Exclusion - Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS)
- CG 21 06 Exclusion - Access Or Disclosure Of Confidential Or Personal Material Or Information
- CG 20 10 Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization Endorsement
- CG DS 01 Commercial General Liability Declarations
- CG 20 26 Additional Insured - Designated Person or Organization Endorsement
- CG 00 01 Commercial General Liability Coverage Form
- CG 20 37 Additional Insured - Owners, Lessees or Contractors - Completed Operations Endorsement
- CG 40 28 Broad Abuse or Molestation Exclusion
- CG 20 28 Additional Insured - Lessor of Leased Equipment
- CG 20 11 Additional Insured - Managers or Lessors of Premises
- CG 21 47 Employment-Related Practices Exclusion
- CG 04 35 Employee Benefits Liability Coverage
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