Surplus lines application
The provisions of ND Century Code Chapter 26.1-44 govern the placement of surplus lines insurance in North Dakota. An insurer seeking to be registered in North Dakota as a non-admitted surplus lines carrier must submit a complete application consisting of a request letter and the following information:
- Agent for Service of Process (SFN 8330)
- Affidavit (SFN 4795) pursuant to N.D. Cent Code Section 26.1-44-02
- Data Processing Questionnaire (SFN 4792)
- For an alien insurer, a copy of the Trust Fund Agreement under which at least $1,000,000 is held in the United States for the benefit of all U.S. policyholders. Alien insurers must also have a contact office located in the United States, such as an attorney.
- Most recently filed Annual Statement, with original signatures on jurat page, and demonstrating compliance with minimum Capital and Surplus requirements:
- Stock company - not less than $500,000 of capital and $500,000 of surplus.
- Mutual company - not less than $1,000,000 surplus.
- Financial examination report, issued by the company's domiciliary state, with an "as of" date not more than five years prior to the application date (not applicable to alien companies).
- Nonrefundable application fee of $100
The Insurance Department will issue an approval letter if the application is approved. An application may be filed at any time throughout the year. All applications and fees should be directed to:
Yvonne Keniston
ytkeniston@nd.gov
ND Insurance Department
State Capitol, fifth floor
Dept. 401
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
701.328.2440
701.328.4880 fax
Annual renewal requirement
The registration of a non-admitted surplus lines carrier must be renewed by March 1 of each year by submitting a Renewal Affidavit for Non-Admitted Companies (SFN 53446) and a $10 filing fee to the Insurance Department. The surplus lines insurer's Annual Statement must be filed with the National Association of Insurance Commissioners by March 1 of each year.
A written notification of any corporate changes, such as a name change, address change, merger, or redomestication, must be sent to the Insurance Department in a timely manner. The notification should include updated documents (Service of Process, Affidavit, Data Form, Trust Agreement) to reflect the change, as applicable.
Please direct any questions to:
Yvonne Keniston
ytkeniston@nd.gov
ND Insurance Department
State Capitol, fifth floor
Dept. 401
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
701.328.2440
701.328.4880 fax
|
|
