Arizona Statutes

§ 20-408 — Report of broker; civil penalty

Arizona·Title 20 Arizona Revised Statutes·Ch. 2 TRANSACTION OF INSURANCE BUSINESS·Art. 5 Unauthorized Insurers
A.A broker procuring surplus lines insurance on behalf of an insured whose home state is Arizona shall file with the director on or before the date specified in section 20-415, subsection B a verified report setting forth facts from which it may be determined whether the requirements of section 20-407 have been met. The report shall also contain or be accompanied by the following:
1.The name of the insurer and the identification number assigned to it by the national association of insurance commissioners.
2.The number of the policy issued.
3.The name and the city, state and zip code of the insured.
4.The premium, including taxable policy fees.
5.The identity of the specific surplus lines coverage written.
6.The policy effective dates that shall not be open to public inspection

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