Get the free Surplus Lines Statement (Form SL-8) - Connecticut

Reset Form Control No. Surplus Lines Statement (Form SL8) State of Connecticut Insurance Department (Rev. 07/2013) 1. Name and Address of Surplus Lines Broker Diane Lesser, 13790 E Rice Pl, Aurora

How to fill out surplus lines statement form

How to fill out surplus lines statement form

1. To fill out the surplus lines statement form, follow these steps:
2. Start by entering the name and contact information of the insured individual or company.
3. Provide the policy number and effective dates of the insurance policy.
4. Fill in the details of the surplus lines insurance coverage, including the type of coverage, limits, and deductibles.
5. Specify any additional insured parties or interested parties if applicable.
6. Indicate any endorsements or riders added to the policy.
7. Include any relevant comments or additional information regarding the policy.
8. Ensure all the information provided is accurate and complete.
9. Review the form for any errors or missing information.
10. Sign and date the statement form.
11. Submit the completed form to the relevant authority or insurance company.

Who needs surplus lines statement form?

1. Any individual or company dealing with surplus lines insurance policies may need to fill out a surplus lines statement form. This includes insurance brokers, agents, and insured individuals or companies who choose to purchase insurance coverage from non-admitted (surplus lines) insurance companies. The form helps ensure compliance with regulatory requirements and provides a record of the insurance coverage obtained.

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What is surplus lines statement form?

The surplus lines statement form is a document used by surplus lines brokers to report the placement of surplus lines insurance coverage, which is typically offered by non-admitted insurers.

Who is required to file surplus lines statement form?

Surplus lines brokers are required to file the surplus lines statement form when they place insurance coverage with non-admitted insurers on behalf of their clients.

How to fill out surplus lines statement form?

To fill out the surplus lines statement form, brokers must provide details such as the insured's information, the coverage amounts, the type of insurance, the non-admitted insurer's details, and any applicable premium amounts.

What is the purpose of surplus lines statement form?

The purpose of the surplus lines statement form is to provide regulatory authorities with a record of surplus lines transactions, ensuring compliance with state regulations and tax requirements.

What information must be reported on surplus lines statement form?

The information that must be reported includes the name of the insured, the types of coverage purchased, the amounts of coverage, the name of the non-admitted insurer, and the premium charged.