Coverage description
An Insurance Services Office (ISO) standard form. It replaces the pollution exclusion with a total pollution exclusion that keeps only two exceptions: bodily injury inside a building from smoke or fumes of heating, cooling or dehumidifying equipment, and injury or damage from a hostile fire.
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 | 192 | 72 | 44 | Nov 2021 to Oct 2026 |
What the filings show
- Edition in use: in the past 12 months, 23 companies filed the 12 04 edition.
- CG 21 45 (Exclusion – Damage to Premises Rented to You) is filed alongside it most often, in 182 of the same filings (95%).
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Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Oct 2026, excluding withdrawn and rejected filings.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 21 65, out of 40 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Clear Blue Financial GroupClear Blue Insurance Company | 36 | 34 | 12 04 | Feb 11, 2026 |
| OBS Holdings Group2 group companies filed it, led by Obsidian Insurance Company and Obsidian Pacific Insurance Company | 36 | 36 | 12 04 | Feb 3, 2023 |
| WCF Mutual Insurance Company GroupAssociated Indemnity Corporation | 16 | 16 | 12 04 | Jan 15, 2026 |
| Markel Corporation Group2 group companies filed it, led by State National Insurance Company, Inc. and Markel Insurance Company | 10 | 5 | 12 04 | Oct 22, 2026 |
| Nationwide Corporation Group8 group companies filed it, led by Allied Insurance Company of America and Nationwide Agribusiness Insurance Company | 10 | 3 | 12 04 | Feb 12, 2025 |
| Trisura GroupTrisura Insurance Company | 9 | 6 | 12 04 | Jul 10, 2026 |
| Siriuspoint GroupSiriusPoint America Insurance Company | 7 | 3 | 12 04 | Jun 15, 2026 |
| 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 |
How the largest insurers handle CG 21 65
Groups among the largest commercial general liability insurers that filed CG 21 65 or their own version in the past five years.
- Chubb Limited GroupFiles its own version: CB CG 210011 Total Pollution Exclusion With A Building Heating, Cooling And Dehumidifying Equipment Exception And A Hostile Fire Exception (4 states)
- WR Berkley Corporation GroupUses CG 21 65 in 1 filing
- Fairfax Financial GroupUses CG 21 65 in 2 filings
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States
Number of filings that include CG 21 65 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 45Exclusion – Damage to Premises Rented to You182 filings
- CG 21 47Employment- Related Practices Exclusion179 filings
- CG 04 35Employee Benefits Liability Coverage177 filings
- IL 00 21Nuclear Energy Liability Exclusion Endorsement175 filings
- CG 20 18Additional Insured – Mortgagee, Assignee or Receiver170 filings
- CG 20 01Primary and Noncontributory – Other Insurance Condition169 filings
- CG 22 74Limited Contractual Liability Coverage for Personal and Advertising Injury169 filings
- CG 20 10Additional Insured – Owners, Lessees or Contractors – Scheduled Person or Organization168 filings
- CG 20 11Additional Insured – Managers or Lessors of Premises168 filings
- CG 20 26Additional Insured – Designated Person or Organization168 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 |
| Jul 14, 2026 | Atain Insurance Company | IL | 12 04 | ATCO-135018628 |
| Jul 10, 2026 | Trisura Insurance Company | WA | 12 04 | SHNF-134976660 |
| Jul 1, 2026 | Trisura Insurance Company | TX | 12 04 | SHNF-134977147 |
| Jun 30, 2026 | Trisura Insurance Company | IL | 12 04 | SHNF-134983369 |
| Jun 26, 2026 | Church Mutual Insurance Company, S.I. | CO | 12 04 | CHMU-134947220 |
| Jun 23, 2026 | Trisura Insurance Company | CA | 12 04 | SHNF-134961098 |
| 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 |
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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