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Items 1-6 must be completed for a Reinsurance Broker License.
Items 1-11 must be completed for a Reinsurance Manager License.
To complete your application, please submit the following items. Materials should be tabbed in the order below.
1. Filing fee in the amount of: $100
2. Written contract, accompanied by the reinsurer's Board of Directors Resolution approving the contract. Contract compliance checklists with a copy of a contract with the code citations highlighted. (Broker Checklist) Contract provisions for Reinsurance Broker must be in compliance with IC 27-6-9-18; (Manager Checklist) Reinsurance Manager must be in compliance with IC 27-6-9-21.
3. Copy of organizational chart.
4. Non-resident broker or alien manager must submit a power of attorney appointing Commissioner for service of process. (UCAA form)
5. Alien manager or broker must provide name and address of Indiana appointed agent.
6. Proof of licensure as an Indiana producer.
7. List of current officers and directors.
8. Statement of financial condition prepared by an independent Certified Accountant. This statement may be in the form of a compilation report, a report of review or audit report. RM - IC 27-6-9-23(b) & 760 IAC 1-51-6. If RM establishes loss reserves, actuarial opinion attesting to the adequacy of loss reserves incurred and outstanding on business produced by RM in accordance with IC 27-6-9-23.
9. Biographical affidavits on all authorized persons.
10. Errors and Omissions Policy in the amount of $ __________________ (see 760 IAC 1-51-5)
11. Fidelty Bond from an insurer in the amount of $___________________ (see 760 IAC 1-51-4)
All applications and materials must be received via postal mail, no faxes or emails will be accepted.
The information requested in the preceding should be delivered to the following:
Indiana Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204-2787
After we receive the proper filing and review is completed, we will prepare a letter of registration and send it to the contact person listed on the application.
*All applicants must correct any omissions or deficiencies in the application within thirty (30) days of the date of the latest notice of the department of insurance of such omissions or deficiencies. If the applicant fails to do so, the application file will be closed as an incomplete application. The application fee is not refundable.