Get the free Surplus Lines Statement (form Sl-8)

This document provides detailed instructions for licensed surplus lines brokers and agents in Connecticut on how to properly complete the Surplus Lines Statement, including necessary information such as broker details, insured risk, coverage limits, premium amounts, and filing requirements along with statements of diligent effort.

How to fill out surplus lines statement form

How to fill out surplus lines statement form

1. Obtain the surplus lines statement form from the appropriate regulatory body or online portal.
2. Fill in the insured's name and address in the designated sections.
3. Provide the policy number and effective dates of the insurance coverage.
4. List the type of insurance being procured (e.g., property, liability).
5. Indicate the name and address of the surplus lines broker.
6. Include the name and address of the foreign insurer providing coverage.
7. State the gross premium amount to be charged for the policy.
8. Sign and date the form, certifying that all information is accurate.
9. Submit the completed form to the applicable state regulatory agency as required.

Who needs surplus lines statement form?

1. Businesses or individuals seeking insurance coverage that is not available from licensed insurers in their state.
2. Surplus lines brokers who are placing coverage with non-admitted carriers on behalf of clients.
3. Regulatory authorities requiring documentation to track surplus lines transactions and ensure compliance.

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What is surplus lines statement form?

The surplus lines statement form is a document used to report and document surplus lines insurance transactions. This form ensures that policies placed with non-admitted insurers comply with state regulations.

Who is required to file surplus lines statement form?

Insurance agents or brokers who place coverage with surplus lines carriers are required to file the surplus lines statement form.

How to fill out surplus lines statement form?

To fill out the surplus lines statement form, provide detailed information about the insured, the coverage being placed, the surplus lines insurer, and the specifics of the policy including premium and terms, ensuring all sections are completed accurately.

What is the purpose of surplus lines statement form?

The purpose of the surplus lines statement form is to provide regulatory oversight of surplus lines transactions, ensuring that consumers receive proper coverage and that taxes on premiums are collected by the state.

What information must be reported on surplus lines statement form?

The form must report information such as the names of the insured and the insurer, a description of the coverage, policy number, premium amount, and details about the transactions for which surplus lines insurance is procured.