Coverage description
An Insurance Services Office (ISO) standard form. It removes the umbrella's automatic insured status for organizations you newly acquire or form.
How the form has changed
The 03 05 edition updates the paragraph reference to the umbrella's Who Is An Insured section. The coverage is the same as 09 00.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 03 05Mar 2005Latest | 49 | 33 | 9 | May 2022 to Aug 2026 |
| 09 00Sep 2000 | 6 | 3 | 4 | Nov 2022 to Apr 2023 |
1 other edition date appears in one or two filings each, often carrier-specific versions: 04 92.
What the filings show
- Edition in use: in the past 12 months, 14 companies filed the 03 05 edition.
- CU 21 43 (Exclusion - Designated Products) is filed alongside it most often, in 56 of the same filings (100%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Aug 2026, excluding withdrawn and rejected filings.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 CU 21 04, out of 24 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Nationwide Corporation Group4 group companies filed it, led by Nationwide Agribusiness Insurance Company and Crestbrook Insurance Company | 8 | 3 | 03 05 | Jun 30, 2026 |
| Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety National Casualty Corporation and Philadelphia Indemnity Insurance Company | 7 | 3 | 03 05 | Aug 11, 2026 |
| Church Mutual GroupChurch Mutual Insurance Company, S.I. | 5 | 2 | 03 05 | Jun 26, 2026 |
| Sompo GroupSompo America Insurance Company | 5 | 1 | 03 05 | Jun 15, 2026 |
| James River GroupFalls Lake National Insurance Company | 4 | 4 | 09 00 | Jan 13, 2023 |
| AU Holding Company GroupContinental Indemnity Company | 3 | 3 | 03 05 | May 3, 2024 |
| Ally Insurance Holdings GroupMotors Insurance Corporation | 2 | 2 | 03 05 | Mar 19, 2024 |
| American European Group2 group companies filed it, led by American European Insurance Company and Rutgers Casualty Ins Co | 2 | 2 | 09 00 | Apr 17, 2023 |
| American Family Insurance GroupMidvale Indemnity Company | 2 | 2 | 03 05 | Sep 28, 2023 |
| Encova Mutual Insurance Group3 group companies filed it, led by Motorists Mutual Insurance Company and Wilson Mutual Insurance Company | 2 | 2 | 03 05 | Jun 25, 2024 |
How the largest insurers handle CU 21 04
Groups among the largest commercial umbrella and excess insurers that filed CU 21 04 or their own version in the past five years.
- Chubb Limited GroupUses CU 21 04 in 1 filing
- Berkshire Hathaway GroupUses CU 21 04 in 1 filing
- Fairfax Financial GroupUses CU 21 04 in 1 filing
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States
Number of filings that include CU 21 04 in each state, Oct 2021 to Aug 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- CU 21 43Exclusion - Designated Products56 filings
- CU 21 00Exclusion - All Hazards in Connection with Designated Premises55 filings
- CU 21 07Contractual Liability Limitation55 filings
- CU 21 23Nuclear Energy Liability Exclusion Endorsement55 filings
- CU 21 03Exclusion - Designated Work54 filings
- CU 21 09Exclusion - Explosion, Collapse and Underground Property Damage Hazard (Specified Operations)54 filings
- CU 21 16Exclusion - Designated Ongoing Operations54 filings
- CU 22 61Exclusion - Damage to Work Performed by Sub-Contractors on Your Behalf - Designated Sites or Operations54 filings
- CU 21 42Exclusion - Exterior Insulation and Finish Systems53 filings
- CU 22 64Exclusion - Damage to Work Performed by Subcontractors on Your Behalf53 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Aug 12, 2026 | Colonial Surety Company | SC | 03 05 | MRTN-134978915 |
| Aug 11, 2026 | Philadelphia Indemnity Insurance Company | SC | 03 05 | PHLX-135041545 |
| Jul 2, 2026 | Zenith Insurance Company | CA | 03 05 | ZICO-134998423 |
| Jun 30, 2026 | The Medical Protective Companyand 1 more | IL | 03 05 | MDPC-135002488 |
| Jun 30, 2026 | Crestbrook Insurance Companyand 1 more | CO | 03 05 | NWPP-135003098 |
| Jun 26, 2026 | Church Mutual Insurance Company, S.I. | CO | 03 05 | CHMU-134995025 |
| Jun 19, 2026 | Addison Insurance Companyand 1 more | CO | 03 05 | UNFG-134979875 |
| Jun 15, 2026 | Sompo America Insurance Company | CO | 03 05 | SMPJ-134971280 |
| Jun 2, 2026 | Philadelphia Indemnity Insurance Company | IL | 03 05 | PHLX-134967828 |
| Feb 17, 2026 | Safety National Casualty Corporation | CO | 03 05 | SFCC-134815068 |
| Jan 5, 2026 | Mississippi Farm Bureau Casualty Insurance Company | MS | 03 05 | SFBC-134775309 |
| Nov 11, 2025 | Southern Farm Bureau Casualty Insurance Company | LA | 03 05 | SFBC-134733493 |
Most filed ISO CU forms
- CU 34 54 Exclusion - Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS)
- CU 21 86 Exclusion – Access Or Disclosure Of Confidential Or Personal Material Or Information
- CU 00 05 Exclusion - Violation of Law Addressing Data Privacy
- CU 34 56 Exclusion – Cyber Incident
- CU DS 01 Commercial Liability Umbrella Declarations
- CU 21 88 Exclusion - Access Or Disclosure Of Confidential Or Personal Material Or Information (Coverage B Only)
- CU 34 44 Broad Abuse or Molestation Exclusion
- CU 34 55 Exclusion - Electronic Data - Deletion Of Bodily Injury Exception
- CU 22 37 Motor Carrier Endorsement
- CU 21 87 Exclusion - Access Or Disclosure Of Confidential Or Personal Information and Data-Related Liability - Limited Bodily Injury Exception Not Included
- CU 04 02 Loss Of Electronic Data Resulting From Physical Injury To Tangible Property Liability Coverage - Subject To Cyber Incident Exclusion
- CU 04 54 Loss of Electronic Data Resulting From Physical Injury To Tangible Property Liability Coverage - Subject To Cyber Incident Exclusion - Deletion Of Bodily Injury Exception
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