Bulletin #665 dated October 7, 1994 and Bulletin #672 dated December 5, 1994 make references to mandatory revisions under Senate Bin 959 applicable to the above forms. These changes will become effective on January 1, 1995.
To assist the Membership in preparing for these upcoming changes, we are providing sample D-1 and D-2 forms which include the language and format as it is presented within Senate Bill 959 (California Insurance Code Section 1764.1(2)(b)). Please note, the 16 point boldface type is still required under the revised law.
These forms will not be supplied in quantity to the Membership by the Association; however should you require an additional specimen, please let us know.
Thank you and if you have questions or concerns on any of the above, please call the office at 415-434-4900.
James S. Pugh
Assistant Manager
JSP/imb
Attachments
NOTICE
1. THE INSURANCE POLICY THAT YOU ARE APPLYING
TO PURCHASE IS BEING ISSUED BY AN INSURER THAT IS
NOT LICENSED BY THE STATE OF CALIFORNIA. THESE
COMPANIES ARE CALLED "NONADMITTED" OR "SURPLUS
LINE" INSURERS.
2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL
SOLVENCY REGULATION AND ENFORCEMENT WHICH
APPLIES TO CALIFORNIA LICENSED INSURERS.
3. THE INSURER DOES NOT PARTICIPATE IN ANY
OF THE INSURANCE GUARANTEE FUNDS CREATED BY
CALIFORNIA LAW. kTHEREFORE, THESE FUNDS WILL NOT
PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE
INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE
PAYMENTS AS PROMISED.
4. FOR ADDITIONAL INFORMATION ABOUT THE
INSURER YOU SHOULD ASK QUESTIONS OF YOUR
INSURANCE AGENT, BROKER OR "SURPLUS LINE"
BROKER OR CONTACT THE CALIFORNIA DEPARTMENT
OF INSURANCE, AT THE FOLLOWING TOLL-FREE
TELEPHONE NUMBER: 1-800-927-4357.
_______________________
DATE
________________________
INSURED
FORM D-1 (Rev. 12/94)
NOTICE:
1. THE INSURANCE POLICY THAT YOU HAVE PURCHASED
IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY
THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED
"NONADMITTED" OR "SURPLUS LINE" INSURERS.
2. THE INSURER IS NOT SUBJECT TO THE FINANCIAL
SOLVENCY REGULATION AND ENFORCEMENT WHICH
APPLIES TO CALIFORNIA LICENSED INSURERS.
3. THE INSURER DOES NOT PARTICIPATE IN ANY OF
THE INSURANCE GUARANTEE FUNDS CREATED BY
CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT
PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE
INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE
PAYMENTS AS PROMISED.
4. FOR ADDITIONAL INFORMATION ABOUT THE
INSURER YOU SHOULD ASK QUESTIONS OF YOUR
INSURANCE AGENT, BROKER, OR "SURPLUS LINE"
BROKER OR CONTACT THE CALIFORNIA DEPARTMENT
OF INSURANCE, AT THE FOLLOWING TOLL-FREE
TELEPHONE NUMBER: 1-800-927-4357.