Coverage description
An Insurance Services Office (ISO) standard form. It makes the person or organization in the schedule an insured for Coverages A and B, and for personal liability and medical payments arising from the residence premises, and requires that they be notified of cancellation or nonrenewal.
How the form has changed
The 10 00 and 03 22 editions renumber the insured definition it extends and update the form date. The coverage wording is the same.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 03 22Mar 2022Latest | 55 | 11 | 37 | May 2022 to Oct 2026 |
| 10 00Oct 2000 | 36 | 37 | 21 | Nov 2021 to Sep 2026 |
| 04 91Apr 1991 | 12 | 13 | 7 | Nov 2021 to Sep 2025 |
Filed by one company only: 02 22 (Armed Forces Insurance Exchange, 32 filings), 08 15 (Westfield Group, 6 filings), 11 14 (Utica Group, 4 filings).
3 other edition dates appear in one or two filings each, often carrier-specific versions: 01 14, 08 05, 08/01/15.
Where filings record what this form replaced, they name other forms F-491, ML 0672. Only some filings record replacements.
What the filings show
- Edition in use: in the past 12 months, 6 companies filed the 03 22 edition and 6 companies filed 10 00.
- The 02 22 edition appears only in filings from Armed Forces Insurance Exchange (32 filings in 32 states since Jan 7, 2022), which suggests a carrier-specific version.
- The 08 15 edition appears only in filings from Westfield Group (6 filings in 6 states since Jan 17, 2025), which suggests a carrier-specific version.
- HO 04 10 (Additional Interests - Residence Premises) is filed alongside it most often, in 140 of the same filings (94%).
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Oct 2026, excluding withdrawn and rejected filings.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 HO 04 41, out of 34 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Armed Forces Insurance Exchange | 32 | 32 | 02 2204 91 | Aug 27, 2026 |
| Assurant Incorporated GroupAmerican Bankers Insurance Company of Florida | 31 | 30 | 03 2210 00 | Jan 14, 2026 |
| Insurance Services Office, Inc.Advisory Organization | 9 | 9 | 03 22 | Dec 4, 2024 |
| Westfield GroupOld Guard Insurance Company | 9 | 9 | 08 1508/01/1508 05 | May 29, 2026 |
| Acuity, A Mutual Insurance Company | 8 | 8 | 03 22 | Jul 2, 2026 |
| Encova Mutual Insurance Group3 group companies filed it, led by Motorists Mutual Insurance Company and MICO | 6 | 6 | 10 00 | Apr 24, 2023 |
| Utica Group2 group companies filed it, led by Founders Insurance Company and Utica Mutual Insurance Company | 6 | 5 | 11 1403 22 | Dec 5, 2023 |
| American Family Insurance Group5 group companies filed it, led by Grain Dealers Mutual Insurance Company and American Family Insurance Company | 5 | 5 | 10 0004 9101 14 | Jun 23, 2025 |
| Berkshire Hathaway Group2 group companies filed it, led by United States Liability Insurance Company and Mount Vernon Fire Insurance Company | 5 | 5 | 10 00 | Nov 1, 2022 |
| THE Hanover Insurance Group3 group companies filed it, led by Massachusetts Bay Insurance Company and The Hanover Insurance Company | 5 | 3 | 04 9110 00 | Feb 3, 2026 |
How the largest insurers handle HO 04 41
Groups among the largest homeowners insurers that filed HO 04 41 or their own version in the past five years.
- Allstate Insurance GroupFiles its own version: SH 04 41 Additional Insured - Residence Premises (1 state)
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States
Number of filings that include HO 04 41 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.
- HO 04 10Additional Interests - Residence Premises140 filings
- HO 00 03Homeowners 3 - Special Form130 filings
- HO 04 40Structures Rented to Others - Residence Premises122 filings
- HO 04 48Other Structures on the Residence Premises - Increased Limits119 filings
- HO 04 35Supplemental Loss Assessment Coverage118 filings
- HO 04 77Ordinance or Law Increased Amount of Coverage118 filings
- HO 04 90Personal Property Replacement Cost Loss Settlement113 filings
- HO 04 16Premises Alarm, Water Leak Detection or Fire Protection System110 filings
- HO 00 06Unit-Owners 6 - Broad Form93 filings
- HO 24 71Designated Business Pursuits Liability Coverage93 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Oct 5, 2026 | BrightShore Insurance Company | RI | 03 22 | CUAN-135072480 |
| Sep 14, 2026 | American Modern Select Insurance Company | CA | 10 00 | TRUW-135088756 |
| Aug 28, 2026 | Kentucky National Insurance Company | KY | 10 00 | KNIC-135068802 |
| Aug 27, 2026 | Armed Forces Insurance Exchange | CA | 02 22 | ARMD-134961669 |
| Aug 14, 2026 | Builder Reciprocal Insurance Exchange | NM | 10 00 | BRIE-135052376 |
| Jul 2, 2026 | Acuity, A Mutual Insurance Company | IL | 03 22 | ACUT-134943551 |
| Jun 24, 2026 | Acuity, A Mutual Insurance Company | IN | 03 22 | ACUT-134949931 |
| Jun 10, 2026 | Acuity, A Mutual Insurance Company | AZ | 03 22 | ACUT-134943550 |
| Jun 10, 2026 | Acuity, A Mutual Insurance Company | WI | 03 22 | ACUT-134943553 |
| Jun 9, 2026 | Acuity, A Mutual Insurance Company | IA | 03 22 | ACUT-134943552 |
| Jun 9, 2026 | Acuity, A Mutual Insurance Company | KS | 03 22 | ACUT-134949932 |
| Jun 9, 2026 | Acuity, A Mutual Insurance Company | MO | 03 22 | ACUT-134949934 |
Most filed ISO HO forms
- HO 00 03 Homeowners 3 Special Form
- HO 04 90 Personal Property Replacement Cost Loss Settlement
- HO 04 10 Additional Interests - Residence Premises
- HO 04 48 Other Structures on the Residence Premises - Increased Limits
- HO 04 16 Premises Alarm Water Leak Detection or Fire Protection System
- HO 04 98 Refrigerated Property Coverage
- HO 04 35 Supplemental Loss Assessment Coverage
- HO 04 77 Ordinance or Law Increased Amount of Coverage
- HO 00 06 Homeowners 6 - Unit- Owners Form
- HO 24 13 Incidental Low Power Recreational Motor Vehicle Liability Coverage Endorsement
- HO 04 40 Structures Rented to Others - Residence Premises
- HO 03 12 Windstorm or Hail Percentage Deductible
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