Fill Your Delaware Sl Template Customize Form

Fill Your Delaware Sl Template

The Delaware SL form, officially known as Form SL-1904, is a crucial document in the insurance field, designed for licensed producing agents and surplus lines brokers. It serves as a record of diligent effort to procure insurance coverage from licensed insurers before resorting to companies not authorized in Delaware, thus ensuring compliance with state laws. The form, which must be accessible for examination by the Commissioner for five years post-issuance, illustrates a transparent process in securing insurance, underscoring the insured's understanding that the coverage comes from an insurer outside of the Delaware Insurance Department's jurisdiction.

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In an increasingly complex regulatory landscape, the Delaware SL form represents a critical document for surplus lines brokers and insurance producers who navigate the nuanced area of procuring insurance for risks that licensed carriers are unwilling to insure. Essential for maintaining compliance with Delaware's insurance regulations, particularly section 18 Del. C., §1915, this form serves as a testament to the diligent efforts made by a producer or broker to seek coverage through licensed insurers before turning to the surplus lines market. Designed to be kept within the broker's records for a span of five years post-issuance of the related coverage, it underscores the transparency and accountability expected in the insurance industry. The form details the unsuccessful attempts to place insurance with licensed carriers, providing names, reasons for refusal, and contact information, thereby justifying the eventual placement with an unauthorized insurer. Moreover, it emphasizes the critical disclosure to the insured about the insurer's status outside the Delaware Insurance Department's jurisdiction and its exemption from the Delaware Insurance Guaracy Association, highlighting consumer protection concerns. By mandating the retention of this document for scrutiny by the Commissioner, Delaware enforces a stringent oversight mechanism, ensuring that the shift to surplus lines is both justified and transparently documented.

Delaware Sl Preview

THIS FORM MUST SIGNED BY THE LICENSED PRODUCING AGENT AND FORWARDED TO THE LICENSED SURPLUS LINES BROKER OR SIGNED AND RETAINED BY THE SL BROKER

RETAIN AS PART OF SURPLUS LINES BROKER RECORDS

THIS FORM MUST BE OPEN TO EXAMINATION BY THE COMMISSIONER AT ALL TIMES FOR 5 YEARS AFTER ISSUANCE OF THE COVERAGE TO WHICH IT RELATES. (18 DEL. C., §1915)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Submitted by: (select one)

 

 

 

 

DELAWARE INSURANCE DEPARTMENT

 

 

 

 

PRODUCER

 

 

 

 

 

 

 

SURPLUS LINES

 

 

 

 

SL BROKER

 

 

 

 

 

 

STATEMENT OF DILIGENT EFFORT

 

 

 

Form SL-1904

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

v.06-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DO NOT SUBMIT THIS FORM TO THE INSURANCE DEPARTMENT

 

POLICY NUMBER

 

SURPLUS LINES INSURER NAME

 

 

 

 

NAIC #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURED'S NAME AND MAILING ADDRESS:

 

 

POLICY TERM INFORMATION

 

 

 

 

 

 

 

 

 

Name:

 

 

 

 

 

 

 

Effective Date

 

 

 

 

Expiration Date

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM/DD/YYYY Format

MM/DD/YYYY Format

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT OF INSURANCE

Property

$

 

 

Casualty

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION OF RISK

 

 

 

 

 

DESCRIPTION OF COVERAGE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I declare under the penalties provided by law that I have made a diligent effort to procure the insurance coverage described above from licensed insurers which are authorized to transact the class of insurance involved and which accept, in the usual course of business, insurance on risks of the same class as the risk described above. Having been unable to secure such coverage, I have resorted to coverage with companies not licensed to operate in the State of Delaware and which are not under the jurisdiction of the Insurance Department of the State of Delaware.

Furthermore, this insurance was not exported for the purpose of securing lower rates than would be accepted by an authorized insurer or because of the terms of the contract.

Among the licensed insurers declining to insure this risk or declining to increase the amount of insurance on this risk, are the following:

1.Name & NAIC # of Insurer: Name & Telephone # of Contact:

Reason for Declining:

2.Name & NAIC # of Insurer: Name & Telephone # of Contact: Reason for Declining:

3.Name & NAIC # of Insurer: Name & Telephone # of Contact: Reason for Declining:

I further attest that I have explained to the insured that the insurance described herein is being placed with an insurance company not authorized to do business in Delaware. The insured understands that the insurance company is not a member of the Delaware Insurance Guaranty Association and that Chapter 42 of the Delaware Insurance Code is not applicable to claimants or insureds of said company. As required in 18 Del. C., §1909, I have delivered to the insured evidence of the insurance upon which has been stamped:

This insurance contract is issued pursuant to the Delaware Insurance Laws by an insurer neither licensed by nor under the jurisdiction of the Delaware Insurance Department.”

I declare that I have the insurance coverage here described was procured pursuant to Chapter 19 of Title 18, the Delaware Insurance Code, and that the information contained in this submission is true.

Name of Producer/ SL

 

 

DE Lic # of

Agency

 

 

Agency

 

 

(Type or print name of Agency)

Name of Producer/ SL

 

 

DE Lic #

Broker

 

 

Individual

 

 

(Type or print name of Individual)

Producer/ SL Broker

 

 

 

Signature

Sign Here

 

Date:

Blank SL-1904-06

Direct any questions to: Ann.Fletcher@state.de.us

File Characteristics

I
Fact Name Detail
Mandatory Record Retention Period This form must be retained and available for examination by the Commissioner for 5 years following the issuance of the related coverage. This requirement is pursuant to 18 Del. C., §1915.
Governing Law The Delaware SL Form is governed by Chapter 19 of Title 18, the Delaware Insurance Code.
Submission Requirement The completed form should not be submitted to the Delaware Insurance Department but retained by the licensed surplus lines broker or producing agent as part of their records.
Evidence of Coverage Notification The producer/SL Broker is required to deliver to the insured evidence of the insurance coverage along with a notice that the insurance contract is issued pursuant to Delaware Insurance Laws by an insurer not licensed by or under the jurisdiction of the Delaware Insurance Department, in compliance with 18 Del. C., §190Snapshot of Diligent Effort09.
Declaration of Diligent Effort The form declares that a diligent effort was made to procure the insurance coverage from licensed insurers authorized to transact the class of insurance in Delaware. This includes listing licensed insurers that declined the risk along with their reasons for declining.
Insurance Guaranty Association Disclaimer The insured is informed that the insurance company providing coverage is not a member of the Delaware Insurance Guaranty Association and that Chapter 42 of the Delaware Insurance Code does not apply.

Delaware Sl: Usage Instruction

When insurance coverage cannot be secured from licensed insurers within the State of Delaware, the Delaware SL form becomes a necessary step. This form serves as a record of the diligent effort made to obtain such insurance and is vital for the legal operation and documentation of insurance transactions involving surplus lines brokers and producers. Here's a straightforward guide to help you fill out the Delaware SL form accurately.

  1. Choose the submitter by marking either the "DELAWARE INSURANCE DEPARTMENT PRODUCER" or "SURPLUS LINES SL BROKER" option at the top of the form.
  2. Enter the policy number in the designated space.
  3. Fill in the Surplus Lines Insurer Name and its associated NAIC # (National Association of Insurance Commissioners number).
  4. Under "INSURED'S NAME AND MAILING ADDRESS:" provide the name and complete mailing address of the insured party.
  5. For policy term information, input the effective date and expiration date in MM/DD/YYYY format.
  6. Specify the Amount of Insurance under both property and casualty, if applicable.
  7. Describe the location of the risk involved and provide a detailed description of the coverage.
  8. List at least three licensed insurers that declined to insure the risk. Include for each the insurer’s name & NAIC #, the name & telephone # of contact, and the reason for declining.
  9. Attest to the diligent effort made to procure insurance from licensed insurers and the necessity to resort to coverage with companies not licensed in Delaware by signing the statement provided.
  10. Confirm that the insured has been informed that the insurance company is not authorized in Delaware and is not covered by the Delaware Insurance Guarancy Association. This acknowledgment is vital for the insured's understanding of their coverage.
  11. Type or print the name of the Agency or Individual and the Producer/ SL DE Lic # of the agency or individual acting in the capacity of Producer or SL Broker.
  12. Secure the signature of the Producer/SL Broker on the designated "Sign Here" line and fill in the date next to it.
  13. For any questions, the form directs to contact Ann.Fletcher@state.de.us.

Upon completing these steps, the form should not be sent to the Insurance Department but rather retained as part of the Surplus Lines Broker's records. It's crucial for compliance and audit purposes and must be accessible for examination for five years following the issuance of the related insurance coverage. Remember, this documentation serves as evidence of the attempt to secure insurance through licensed insurers before resorting to surplus lines. It's an essential part of maintaining transparency and legality in the insurance acquisition process in Delaware.

Learn More on This Form

When it comes to navigating the nuances of insurance documentation in Delaware, especially the Delaware SL form, several common questions arise. Here is a detailed FAQ section to assist in understanding the purpose, requirements, and intricacies of the SL form.

  1. What is the Delaware SL Form?

    The Delaware SL form, known officially as Form SL-1904 v.06-2, is a statement of diligent effort required by the Delaware Insurance Department. It is primarily used by licensed producing agents and surplus lines brokers to document that a diligent effort was made to procure insurance from licensed insurers, but coverage was only available through a non-licensed or surplus lines insurer.

  2. Who needs to complete the Delaware SL Form?

    This form must be completed and signed by a licensed producing agent and forwarded to a licensed surplus lines broker, or if applicable, signed and retained by the surplus lines broker themselves. It serves as a record that the insurance sought cannot be obtained from licensed insurers and thus justifies the placement of coverage with surplus lines insurers not licensed in Delaware.

  3. Why is diligent effort important, and how is it demonstrated on the SL Form?

    Diligent effort is crucial because it demonstrates that the agent or broker sought to obtain the necessary insurance coverage from authorized insurers before resorting to the surplus lines market. This ensures the protection of policyholders and maintains the integrity of the insurance market. On the SL Form, diligent effort is shown by listing the licensed insurers that were approached, the name and telephone number of the contact person at each insurer, and the reason each insurer declined to insure the risk.

  4. What information is required on the SL Form?

    The form requires detailed information including but not limited to:

    • The policy number and term information.
    • Amount of insurance for both property and casualty.
    • Location of risk and description of coverage.
    • Details of the diligent effort made to procure insurance from licensed insurers.
    • Statement affirming the insured's understanding that the coverage is through an insurer not authorized in Delaware.

    Additionally, the producer or SL broker must attest to the accuracy of the information and that the coverage complies with Delaware insurance laws.

  5. Are there any penalties for not properly completing the SL Form?

    Yes, the form itself states that submitting it with false information or failing to comply with the diligent effort requirement may lead to penalties. It’s vital to accurately and thoroughly complete the form to avoid any potential legal or regulatory consequences.

  6. How long must the completed SL Form be retained?

    The form must be kept as part of the surplus lines broker's records and be open to examination by the Commissioner for five years after the issuance of the coverage to which it relates. This requirement ensures accountability and compliance with Delaware law.

  7. What is the Delaware Insurance Guaranty Association, and why is it mentioned?

    The Delaware Insurance Guaranty Association is a safety net for policyholders ensuring coverage of claims in cases where a licensed insurer becomes insolvent. The SL form requires informing the insured that, because the insurance is placed with a non-authorized insurer, it does not come with the protections offered by the Association. This notice is crucial for the insured's understanding of the potential risks associated with surplus lines insurance.

  8. Whom should I contact if I have questions about completing the SL Form?

    For any questions or clarifications about the SL Form, the Delaware Insurance Department provides an email contact: Ann.Fletcher@state.de.us. Reaching out can provide the necessary guidance to ensure the form is filled out correctly and all legal requirements are met.

In summary, the Delaware SL Form is an essential document for insurance agents and brokers operating within the surplus lines market in Delaware. Understanding its purpose, requirements, and the information it must contain is crucial for compliance and for the protection of all parties involved.

Common mistakes

Filling out the Delaware SL form, a critical document for surplus lines brokers and producing agents, involves various steps where errors can easily occur. These mistakes can lead to compliance issues or delays in the processing of surplus lines insurance. Here are ten common errors to avoid:

  1. Not signing the form: The form requires the signature of the licensed producing agent or surplus lines broker. Failure to sign can invalidate the submission.
  2. Incomplete Policy Information: The policy number, surplus lines insurer name, and NAIC number must be accurately filled in. Leaving these fields blank or entering incorrect information can cause significant issues.
  3. Incorrect Insured Information: The insured's name and mailing address need to be correct. Errors here can lead to miscommunication and misdirected correspondence.
  4. Policy Term Errors: The effective date and expiration date of the policy must be provided in MM/DD/YYYY format. Mistakes in this section could affect the validity of the insurance coverage.
  5. Amount of Insurance Not Specified: Failure to specify the amounts for property and casualty insurance overlooks crucial information about the coverage scope.
  6. Location of Risk Vagueness: An unclear description of the risk location can lead to ambiguity about the insurance's applicability.
  7. Description of Coverage Lacking Detail: This field requires a clear description of the coverage. Vague or incomplete descriptions can lead to misunderstandings about what is insured.
  8. Not Listing Declined Insurers: The form must include a list of licensed insurers that declined to insure the risk. Omitting this information or listing inaccuracies fails to demonstrate diligent effort.
  9. Failure to Explain Non-Membership in the Delaware Insurance Guaranty Association: It's crucial to inform the insured that the surplus lines insurer is not a member of the Delaware Insurance Guaranty Association, as it affects claimant rights.
  10. Incorrect or Missing Submission Information: The name and license number of the producer or SL broker, as well as their signature and the date, should be accurately provided. Errors or omissions can delay processing and lead to compliance issues.

Avoiding these mistakes requires careful review and adherence to the instructions provided with the form. Furthermore, maintaining accurate records and ensuring all information is current and correct before submission will facilitate a smoother process. Here are some steps to help avoid these common errors:

  • Double-check all entries for accuracy.
  • Review the form with a colleague or supervisor if possible.
  • Keep updated records of all communications with licensed insurers to accurately report efforts made to procure insurance.
  • Ensure that the insured's understanding of the coverage, including the lack of protection under the Delaware Insurance Guaranty Association, is documented.

By carefully filling out the Delaware SL form and avoiding these common pitfalls, brokers and agents can better serve their clients, maintain compliance with Delaware regulations, and facilitate the provision of necessary surplus lines insurance coverage.

Documents used along the form

When dealing with the intricacies of insurance, particularly in the specialized sphere of surplus lines, the Delaware SL form plays a crucial role. However, this document does not stand alone. Several other forms and documents often accompany it or are necessary for compliance and the thorough documentation of insurance transactions. Each of these documents serves a unique purpose, contributing to the comprehensive management and recording of surplus lines insurance policies.

  • Surplus Lines Affidavit: This document is a declaration by the surplus lines broker or agent, affirming that the insured understands the nature of the surplus lines insurance. It confirms that the insured knows the insurer is not licensed in the state and does not have the protection of the state's guaranty fund. This affidavit helps ensure transparency and informed consent from the insured party.
  • Export List: An export list is a compilation of coverages that a state's insurance department allows surplus lines brokers to place without seeking three declinations from admitted insurers. It simplifies the process for obtaining hard-to-place risks, indicating that the effort to place coverage with admitted insurers for listed items is not required. This document is crucial for streamlining the procurement of surplus lines insurance for risks that are typically hard to insure.
  • Notice of Placement: This notice is directly provided to the insured after the insurance policy is placed with a surplus lines insurer. It includes essential information such as the insurer's name, the policy number, and details about the coverage. The Notice of Placement serves as confirmation to the insured that the policy has been successfully placed with a non-admitted insurer, alongside key policy information.
  • Annual Statement: Surplus lines brokers are required to file an annual statement with the insurance department, detailing all transactions from the previous year. This statement includes information on the premiums collected, taxes paid, and details of all surplus lines policies written or renewed. The document serves as a record for regulatory purposes and ensures compliance with state insurance laws.

The Delaware SL form, along with the documents outlined above, form the backbone of surplus lines transactions in Delaware. Each one plays a specific role in ensuring that the transaction is transparent, compliant, and in the best interest of the insured. They provide a clear structure for the handling of surplus lines insurance, enhancing the understanding and management of these policies for all parties involved.

Similar forms

The Delaware SL form, specifically designed for surplus lines brokers and indicating the need for a declaration of diligent effort to obtain insurance from authorized insurers, is broadly analogous to several other insurance and regulatory documents. These documents, while catering to various facets of the insurance industry and regulatory compliance, share underlying objectives with the SL form.

A Notice of Cancellation form, commonly used in the insurance sector, shares similarities with the SL form by necessitating clear communication to involved parties. Just as the SL form must clearly communicate the securing of insurance from a non-licensed entity, a Notice of Cancellation must clearly inform the insured about the cancellation of a policy, ensuring procedural transparency.

The Certificate of Insurance (COI), which provides proof of insurance coverage, parallels the SL form in its role as evidence of an insurance relationship. Both documents serve to confirm specific details about insurance coverage, though the SL form is more specific to surplus lines insurance procurement.

Applications for Insurance, whether for personal or commercial lines, bear resemblance to the SL form in the requirement for accurate and thorough reporting of information. Similar to how the SL form requires detailing of efforts to secure insurance and the resulting coverage, insurance applications necessitate the provision of detailed information to assess risk and determine eligibility for coverage.

Risk Assessment Forms utilized by insurers to evaluate the level of risk associated with a potential insured entity share objectives with the SL form. Both require a detailed description of the risk (for the SL form, the location of risk and description of coverage) to make informed decisions regarding insurance underwriting and coverage.

A Surplus Lines License Application, required for brokers dealing in surplus lines insurance, parallels the SL form in its focus on surplus lines market. Both documents are integral to the regulation and operation within the surplus lines industry, ensuring that brokers and their procured insurance policies comply with state regulations.

The Policy Renewal Notice, advising insured parties of the impending end of their insurance policy term and offering renewal, shares its informative role with the SL form. While the SL form informs about the procurement of surplus lines coverage, the Policy Renewal Notice informs about the continuation of existing coverage.

Export List Declarations, especially pertinent in states with specific lists for risks that can be immediately placed in the surplus lines market, share a regulatory and procedural similarity with the Delaware SL form. Both are concerned with the proper and regulated placement of insurance risks outside of the traditional, authorized insurance market.

Financial Responsibility Forms required by various regulatory bodies to prove the capability to cover potential liabilities, albeit broader in context, share a common ground with the SL form in ensuring adequate insurance coverage is in place for particular risks, thus upholding financial stability and compliance.

Endorsement Forms that modify the terms or coverage of an insurance policy resonate with the diligent effort declaration required in the SL form. Both document types demand precise articulation of changes or conditions affecting insurance coverage, ensuring that all parties are accurately informed.

Last, the Loss Run Requests, which detail the claim history of an insured party, while not directly parallel, complement the information requirement seen in the SL form. Understanding past claims is integral to assessing risk, similar to how the SL form's diligent effort declaration assesses the availability of coverage in the authorized market.

Dos and Don'ts

When handling the Delaware SL form, a critical document for surplus lines insurance, it's important to adhere to certain practices for accuracy, compliance, and to ensure the prompt and proper placement of insurance coverage. Below are key dos and don'ts to consider:

Do:

  1. Ensure that the form is signed by the licensed producing agent before it's forwarded to the licensed surplus lines broker, or, if you are the SL broker, make sure it is signed and retained as part of your records. This step is non-negotiable for compliance with Delaware legislation.
  2. Keep this form readily accessible for examination by the Commissioner for at least five years after the issuance of the related coverage, as stipulated in 18 Del. C., §1915. This is crucial for regulatory compliance and audits.
  3. Carefully review all sections of the form for accuracy, including the insured's information, policy number, insurer name, NAIC #, and, importantly, the diligent effort declaration. Mistakes or omissions could lead to regulatory issues or delays in coverage.
  4. Document the licensed insurers that declined to insure the risk, including their names, NAIC #, contact information, and reasons for declining. This information validates the need to resort to surplus lines insurance.
  5. Clearly explain to the insured that the insurance is being placed with an insurer not authorized in Delaware and the implications thereof, such as no protection under the Delaware Insurance Guaranty Association.
  6. Make sure the statement “This insurance contract is issued pursuant to the Delaware Insurance Laws by an insurer neither licensed by nor under the jurisdiction of the Delaware Insurance Department” is stamped on the evidence of the insurance delivered to the insured, as required by 18 Del. C., §1909.

Don't:

  1. Submit the form to the Delaware Insurance Department directly, unless specifically requested, as it should be retained by the surplus lines broker or the producing agent for compliance records.
  2. Overlook the requirement to make a diligent effort to place the coverage with licensed insurers before resorting to the surplus lines market. Without this, you may fail to comply with Delaware's diligent search requirement.
  3. Forget to provide the insured with all the necessary disclosures about the surplus lines insurer, particularly regarding the lack of protection by the Delaware Insurance Guaranty Association, which could lead to misunderstandings or legal issues in the event of a claim.
  4. Skip the step of verifying the accuracy and completeness of all information entered on the form. Inaccurate or incomplete information can lead to regulatory consequences and impact the validity of the insurance coverage.
  5. Neglect to record the reasons provided by licensed insurers for declining coverage. This documentation is crucial for demonstrating compliance with the diligent search requirement.
  6. Omit any signature or date, as these elements are essential for validating the form. The absence of these can render the document non-compliant with Delaware regulations.

Misconceptions

When it comes to navigating the requirements for filing the Delaware SL form, commonly associated with surplus lines insurance, a few misconceptions frequently arise. Understanding these can help ensure compliance and smooth the procurement of necessary insurance coverage for unique or high-risk situations not covered by standard insurers. Here are five common misconceptions explained:

  • Submitting the Form to the Insurance Department: It's often misunderstood that the Delaware SL form needs to be submitted to the Insurance Department. In reality, this form should not be submitted to the department. Instead, it is retained by the surplus lines broker as part of their records, open to examination by the commissioner as required.
  • Necessity for Surplus Lines Insurance: Another misconception is about the need for diligent effort in seeking coverage from authorized insurers before resorting to surplus lines. The form specifically requires a declaration that attempts have been made to procure the insurance coverage from licensed insurers and that the coverage could not be secured from within the standard market, thus necessitating the surplus lines route.
  • Regulation by the Delaware Insurance Department: There is often confusion regarding the regulation of surplus lines insurers. Surplus lines insurance placed with insurers not authorized to operate in Delaware is not under the jurisdiction of the Delaware Insurance Department. The insured needs to understand that these insurers are not backed by the Delaware Insurance Guaranty Association, this being a crucial aspect of consumer protection to be aware of.
  • Protection Under the Delaware Insurance Guaranty Association: A significant misunderstanding revolves around the protection provided to policyholders. Policies underwritten by surplus lines insurers do not afford the insured the protections of the Delaware Insurance Guarantity Association. It's vital for the insured to know that claims against such policies may not be covered under this safety net which is designed to protect policyholders in the event of an insurance company's insolvency.
  • Purpose of Securing Surplus Lines Insurance: Lastly, there's often a mistaken belief that surplus lines insurance is sought primarily for lower premiums. While obtaining better rates can be a factor in seeking insurance, the form specifically clarifies that the insurance described therein was not exported for the sole purpose of securing lower rates or due to contract terms but rather because coverage could not be procured through licensed insurers for the risk in question.

Understanding these misconceptions can help in correctly navigating the surplus lines insurance market in Delaware, ensuring that those seeking coverage are well-informed and compliant with the state's regulatory requirements.

Key takeaways

Understanding the Delaware SL form requires attention to detail and a thorough approach. Here are five key takeaways that should guide users through the process:

  • The Delaware SL form requires signatures from either the licensed producing agent or the licensed surplus lines broker. It is crucial for record retention and must be accessible for examination by the Commissioner for five years following the issuance of the related coverage.
  • This form is designed for instances where insurance coverage must be sought outside licensed insurers in Delaware. It demands a documented effort to secure insurance from authorized sources before resorting to surplus lines insurers.
  • Completing the form includes providing detailed information about the insurer, the insured, the policy, and the risk involved. This encompasses the insured's name and address, policy term, amount of insurance, and a thorough description of the coverage and location of the risk.
  • It is mandatory to inform the insured that the coverage is being placed with an insurer not authorized in Delaware. The form requires attestation that the insured is aware that such an insurer is not covered by the Delaware Insurance Guarancy Association and that Chapter 42 of the Delaware Insurance Code does not apply.
  • For issues or questions related to the form, the Delaware Insurance Department provides a contact email (Ann.Fletcher@state.de.us), suggesting that further assistance is available and that the department prioritizes clear channels of communication for the SL form’s users.
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