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EXHIBIT C
The Surplus Lines Export List
CODE AH: Accident And Health
00.
01.
02.
03.
04.
05. Diligent Effort Completed
Accidental Death (High Limits)
Air Crew Personal Accident
Athletes, Celebrities,
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How to fill out form surplus lines export
How to fill out form surplus lines export:
01
Start by obtaining the form itself. You can usually find it on the website of the relevant insurance authority or department.
02
Read the instructions carefully. The form may require specific information or documentation, so make sure you have everything ready before starting the filling process.
03
Begin by providing your personal or business details, depending on who the form is for. This may include your name, address, contact information, and any relevant identification numbers.
04
Proceed to fill out the section regarding the surplus lines export. This might involve specifying the details of the insurance policy, including the policy number, the insurer's name, and other relevant information.
05
If there is a section for declarations or any additional information, make sure to complete it accurately and honestly. Double-check for any spelling or typographical errors before submitting the form.
06
Finally, review the completed form to ensure all necessary fields have been filled out correctly. If required, sign and date the form before sending it to the designated authority or insuring company.
Who needs form surplus lines export:
01
Insurance brokers or agents who deal with surplus lines insurance.
02
Businesses or individuals who require insurance coverage for risks that are not typically offered by standard insurers.
03
Regulatory authorities or departments responsible for overseeing the surplus lines insurance market.
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What is form surplus lines export?
Form surplus lines export is a report that needs to be filed to disclose surplus lines insurance transactions.
Who is required to file form surplus lines export?
Insurance companies and brokers who are involved in surplus lines insurance transactions are required to file form surplus lines export.
How to fill out form surplus lines export?
Form surplus lines export can be filled out online or through paper forms provided by the regulatory authority.
What is the purpose of form surplus lines export?
The purpose of form surplus lines export is to provide transparency and regulation in surplus lines insurance transactions.
What information must be reported on form surplus lines export?
Information such as the policyholder's name, policy details, premium amounts, and commissions must be reported on form surplus lines export.
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