Self-Insurance (Company)

Statutory reference: Section 303.220, RSMo.

A company with at least 26 private passenger motor vehicles registered in Missouri may apply for a certificate of self-insurance by submitting the following:

• A written request to be considered for self-insurance on company letterhead, signed by an officer of the company;
• Financial statements for the preceding three years, including balance sheets and income statements audited by an independent certified public accountant, indicating the company is solvent;
• A list of at least 26 private passenger motor vehicles registered in Missouri in the name of the company, with a description of each vehicle (year, make, VIN, and plate number); and
• A completed Agreement to Pay Judgments (Form 5317).

The above items must be submitted to:

Within two weeks of receiving your request, our staff will issue your certificate of self-insurance and identification cards, or issue a letter denying your request.