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Commonwealth of Kentucky Department of Insurance 215 West Main Street P.O. Box 517 Frankfort, KY 406025025646082 FAX 5025644604KENTUCKY SURPLUS LINES INSURER INFORMATION SHEETCOMPANY NAME: DBA NAME
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How to fill out surplus linesinformation sheet
How to fill out surplus linesinformation sheet
01
To fill out the surplus lines information sheet, follow these steps:
02
Start by gathering all the necessary information about the insured party, such as their name, contact information, and business details.
03
Provide details about the insurance coverage required, including the type of insurance, policy limits, and any specific endorsements or riders.
04
If the insured party is a business, provide additional information about their operations, including the industry they operate in, their annual revenues, and any previous claims history.
05
Consult with the surplus lines broker or insurance agent to ensure all the required information is included in the form.
06
Review the completed form for accuracy and completeness before submitting it to the appropriate regulatory authorities.
07
Keep a copy of the filled-out surplus lines information sheet for your records.
Who needs surplus linesinformation sheet?
01
The surplus lines information sheet is typically required by insurance agents, brokers, or companies that deal with surplus lines insurance.
02
Surplus lines insurance refers to coverage provided by non-admitted insurers when coverage is not available through admitted insurers.
03
Businesses or individuals who require specialized or hard-to-place insurance coverage may need to fill out a surplus lines information sheet.
04
For example, contractors who need coverage for high-risk projects or businesses operating in niche industries with unique insurance needs may be required to provide this information.
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What is surplus lines information sheet?
The surplus lines information sheet is a form used to report details about insurance policies that are placed through non-admitted insurers in states where the coverage is not available from licensed insurance companies.
Who is required to file surplus lines information sheet?
Insurance agents or brokers who place surplus lines coverage are required to file the surplus lines information sheet.
How to fill out surplus lines information sheet?
The surplus lines information sheet can be filled out electronically on the state insurance department's website or through paper forms provided by the department.
What is the purpose of surplus lines information sheet?
The purpose of the surplus lines information sheet is to provide regulatory authorities with information on surplus lines transactions being conducted in the state.
What information must be reported on surplus lines information sheet?
The information that must be reported on the surplus lines information sheet includes details about the insured, type of coverage, premium amount, and the non-admitted insurer.
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