Combined Certificates. Other Insurers (ie Not Underwriting Members of Lloyd's) *Permitted / Not permitted *(Delete as applicable) (and subject always to the provisions of Sub-section 20.8) IDENTITY OF OTHER INSURERS: Sub-section 21.1 Sub-section 21.1.1 AUTHORITY TO HANDLE AND/OR SETTLE CLAIMS AND PURSUE RECOVERIES: *Yes / No *(Delete as applicable) PROCEDURE FOR THE HANDLING AND SETTLEMENT OF CLAIMS AND PURSUING RECOVERIES TO REPLACE, AMEND OR SUPPLEMENT SECTION 21: PER CLAIM LIMIT OF AUTHORITY: Sub-section 21.1.6 NAMES AND ADDRESSES OF ADJUSTERS, SURVEYORS, LAWYERS OR OTHER THIRD PARTIES TO BE INSTRUCTED BY THE COVERHOLDER: Sub-section 23.1.2 RISKS WRITTEN REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF RISKS WRITTEN BORDEREAU(X): { } days Sub-section 23.2.1 BASIS OF MONITORING AGGREGATE EXPOSURES: Sub-section 23.2.2 AGGREGATE REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF AGGREGATE EXPOSURES: { } days Sub-section 23.2.3 MAXIMUM TOTAL AGGREGATE LIMIT(S): Sub-section 23.3 STATISTICAL INFORMATION REQUIRED BY THE UNDERWRITERS: REPORTING INTERVAL(S): *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS: { } days Sub-section 24.2 Sub-section 24.3 PAID PREMIUM REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) CLAIMS BORDEREAUX/REPORTING (PAID AND OUTSTANDING) TO BE PRODUCED/PROVIDED BY THE COVERHOLDER: *Yes / No CLAIMS REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) Sub-section 24.4 MAXIMUM PERIOD FOR REPORTING/SUBMISSION OF BORDEREAUX: { } days Sub-section 24.6 MAXIMUM PERIOD FOR REMITTANCE OF SETTLEMENTS: { } days Sub-section 24.7 FEES AND CHARGES TO BE DEDUCTED BY THE COVERHOLDER: Sub-section 36.1.1 Sub-section 36.2.2 NUMBER OF DAYS NOTICE OF TERMINATION: { } days NAME(S) AND ADDRESS(ES) TO WHOM COVERHOLDER SENDS NOTICE OF TERMINATION: Sub-section 42.1 JURISDICTION AND GOVERNING LAW STATE: Agreement Number:
Appears in 1 contract
Samples: Authority Agreement
Combined Certificates. Other Insurers (ie Not Underwriting Members of Lloyd'sXxxxx'x) *Permitted / Not permitted *(Delete as applicable) (and subject always to the provisions of Sub-section 20.8) IDENTITY OF OTHER INSURERS: Sub-section 21.1 Sub-section 21.1.1 AUTHORITY TO HANDLE AND/OR SETTLE CLAIMS AND PURSUE RECOVERIES: *Yes / No *(Delete as applicable) PROCEDURE FOR THE HANDLING AND SETTLEMENT OF CLAIMS AND PURSUING RECOVERIES TO REPLACE, AMEND OR SUPPLEMENT SECTION 21: PER CLAIM LIMIT OF AUTHORITY: Sub-section 21.1.6 NAMES AND ADDRESSES OF ADJUSTERS, SURVEYORS, LAWYERS OR OTHER THIRD PARTIES TO BE INSTRUCTED BY THE COVERHOLDER: Sub-section 23.1.2 RISKS WRITTEN REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF RISKS WRITTEN BORDEREAU(X): { } days Sub-section 23.2.1 BASIS OF MONITORING AGGREGATE EXPOSURES: Sub-section 23.2.2 AGGREGATE REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF AGGREGATE EXPOSURES: { } days Sub-section 23.2.3 MAXIMUM TOTAL AGGREGATE LIMIT(S): Sub-section 23.3 STATISTICAL INFORMATION REQUIRED BY THE UNDERWRITERS: REPORTING INTERVAL(S): *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS: { } days Sub-section 24.2 Sub-section 24.3 PAID PREMIUM REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) CLAIMS BORDEREAUX/REPORTING (PAID AND OUTSTANDING) TO BE PRODUCED/PROVIDED BY THE COVERHOLDER: *Yes / No CLAIMS REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) Sub-section 24.4 MAXIMUM PERIOD FOR REPORTING/SUBMISSION OF BORDEREAUX: { } days Sub-section 24.6 MAXIMUM PERIOD FOR REMITTANCE OF SETTLEMENTS: { } days Sub-section 24.7 FEES AND CHARGES TO BE DEDUCTED BY THE COVERHOLDER: Sub-section 36.1.1 Sub-section 36.2.2 NUMBER OF DAYS NOTICE OF TERMINATION: { } days NAME(S) AND ADDRESS(ES) TO WHOM COVERHOLDER SENDS NOTICE OF TERMINATION: Sub-section 42.1 JURISDICTION AND GOVERNING LAW STATE: Agreement Number:: Unique Market Reference Number: SIGNATURE OF THE COVERHOLDER In accordance with Section 1 of LMA3114M, the Agreement is signed on behalf of the Coverholder as acceptance of the terms and conditions of the Agreement inclusive of any attachments identified in the Schedule. Signed and accepted on behalf of the Coverholder Name and Position of Signatory Date of Signature LMA3114M
Appears in 1 contract
Samples: Authority Agreement
Combined Certificates. Other Insurers (ie Not Underwriting Members of Lloyd'sXxxxx'x) *Permitted / Not permitted *(Delete as applicable) (and subject always to the provisions of Sub-section 20.8) IDENTITY OF OTHER INSURERS: Sub-section 21.1 Sub-section 21.1.1 AUTHORITY TO HANDLE AND/OR SETTLE CLAIMS AND PURSUE RECOVERIES: *Yes / No *(Delete as applicable) PROCEDURE FOR THE HANDLING AND SETTLEMENT OF CLAIMS AND PURSUING RECOVERIES TO REPLACE, AMEND OR SUPPLEMENT SECTION 21: PER CLAIM LIMIT OF AUTHORITY: Sub-section 21.1.6 NAMES AND ADDRESSES OF ADJUSTERS, SURVEYORS, LAWYERS OR OTHER THIRD PARTIES TO BE INSTRUCTED BY THE COVERHOLDER: Sub-section 23.1.2 RISKS WRITTEN REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF RISKS WRITTEN BORDEREAU(X): { } days Sub-section 23.2.1 BASIS OF MONITORING AGGREGATE EXPOSURES: Sub-section 23.2.2 AGGREGATE REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF AGGREGATE EXPOSURES: { } days Sub-section 23.2.3 MAXIMUM TOTAL AGGREGATE LIMIT(S): Sub-section 23.3 STATISTICAL INFORMATION REQUIRED BY THE UNDERWRITERS: REPORTING INTERVAL(S): *monthly / quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS: { } days Sub-section 24.2 Sub-section 24.3 PAID PREMIUM REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) CLAIMS BORDEREAUX/REPORTING (PAID AND OUTSTANDING) TO BE PRODUCED/PROVIDED BY THE COVERHOLDER: *Yes / No CLAIMS REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) Sub-section 24.4 MAXIMUM PERIOD FOR REPORTING/SUBMISSION OF BORDEREAUX: { } days Sub-section 24.6 MAXIMUM PERIOD FOR REMITTANCE OF SETTLEMENTS: { } days Sub-section 24.7 FEES AND CHARGES TO BE DEDUCTED BY THE COVERHOLDER: Sub-section 36.1.1 Sub-section 36.2.2 NUMBER OF DAYS NOTICE OF TERMINATION: { } days NAME(S) AND ADDRESS(ES) TO WHOM COVERHOLDER SENDS NOTICE OF TERMINATION: Sub-section 42.1 JURISDICTION AND GOVERNING LAW STATE: Agreement Number:
Appears in 1 contract
Samples: Authority Agreement
Combined Certificates. Other Insurers (ie Not Underwriting Members of other Lloyd's) ’s Underwriters - *Permitted / Not permitted non-Underwriting Members of Xxxxx'x - *Permitted / Not permitted (Subject always to the provisions of Section 22) *(Delete as applicable) (and subject always to the provisions of Sub-section 20.8) 22.2.1 IDENTITY OF OTHER INSURERS: Sub-section 21.1 24.1.1 PER CLAIM LIMIT OF AUTHORITY: Sub-section 21.1.1 24.1.3 ANY CLAIM EXCEEDING OR LIKELY TO EXCEED THE AUTHORITY LIMIT SHALL BE NOTIFIED TO HANDLE AND/THE UNDERWRITERS WITHIN THE FOLLOWING PERIOD AFTER THE COVERHOLDER IS NOTIFIED OF THE CLAIM: ( ) * hours / days *(Delete as applicable) Sub-section 24.1.5 TIME LIMIT FOR NOTIFYING THE UNDERWRITERS OF A CLAIM OR SETTLE CLAIMS AND PURSUE RECOVERIESA RECOVERY LIKELY TO GIVE RISE TO A COMPLAINT: ( ) *hours / days *(Delete as applicable) Sub-section 24.1.6 THE UNDERWRITERS AUTHORISE THE COVERHOLDER TO INSTRUCT ADJUSTERS, SURVEYORS OR OTHER THIRD PARTIES: *Yes / No *(Delete as applicable) PROCEDURE FOR THE HANDLING AND SETTLEMENT OF CLAIMS AND PURSUING RECOVERIES TO REPLACEIf yes, AMEND OR SUPPLEMENT SECTION 21: PER CLAIM LIMIT OF AUTHORITYsuch parties shall be where appropriate: Sub-section 21.1.6 NAMES AND ADDRESSES OF ADJUSTERS, SURVEYORS, LAWYERS OR OTHER THIRD PARTIES TO 24.1.7 THE UNDERWRITERS SHALL BE INSTRUCTED INFORMED BY THE COVERHOLDERCOVERHOLDER OF THE APPOINTMENT OF ANY XXXXX’X AGENT WITHIN: Sub-section 23.1.2 RISKS WRITTEN REPORTING INTERVAL: ( ) *monthly hours / quarterly days *(Delete as applicable) MAXIMUM NUMBER OF DAYS FOR REPORTING/SUBMISSION OF RISKS WRITTEN BORDEREAU(X): { } days Sub-section 23.2.1 BASIS OF MONITORING AGGREGATE EXPOSURES25.2 FORMAT FOR PAID PREMIUM BORDEREAUX: FORMAT FOR CLAIMS BORDEREAUX: Sub-section 23.2.2 AGGREGATE REPORTING INTERVAL: 25.3 PAID PREMIUM BORDEREAUX INTERVAL *monthly Monthly / quarterly Quarterly *(Delete as applicable) Sub-section 25.4 CLAIMS BORDEREAUX TO BE PRODUCED BY THE COVERHOLDER: *Yes / No *(Delete as applicable) CLAIMS BORDEREAUX INTERVAL: *Monthly / Quarterly *(Delete as applicable) Sub-section 25.6 MAXIMUM NUMBER OF DAYS PERIOD FOR REPORTING/SUBMISSION OF AGGREGATE EXPOSURESBORDEREAUX: { } ( ) days Sub-section 23.2.3 25.7 MAXIMUM TOTAL AGGREGATE LIMIT(S): PERIOD FOR REMITTANCE OF SETTLEMENTS WITHIN ( ) days OF THE END OF THE BORDEREAUX INTERVAL. Sub-section 23.3 STATISTICAL INFORMATION REQUIRED 25.8 FEES OR CHARGES TO BE REIMBURSED BY THE UNDERWRITERS: Sub-section 26.1 THE COVERHOLDER’S COMMISSION: Sub-section 26.2 THE TOTAL COMMISSIONS, BROKERAGE OR FEES PAYABLE: NOT EXCEEDING ( ) % OF GROSS PREMIUM INCOME Sub-section 26.3 BASIS OF CALCULATION OF CONTINGENT OR PROFIT COMMISSION: Sub-section 34.2 RECORDS, STATISTICAL INFORMATION, INSPECTIONS AND AUDITS: REPORTING INTERVAL(S): *monthly Monthly / quarterly Quarterly *(Delete as applicable) MAXIMUM NUMBER OF DAYS: { } ( ) days Sub-section 24.2 Sub-section 24.3 PAID PREMIUM REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) CLAIMS BORDEREAUX/REPORTING (PAID 35.1 THE COVERHOLDER IS AUTHORISED TO REFER TO XXXXX’X IN ACCORDANCE WITH THE RULES AND OUTSTANDING) TO BE PRODUCED/PROVIDED GUIDANCE ISSUED BY THE COVERHOLDER: LLOYD’S. *Yes / No CLAIMS REPORTING INTERVAL: *monthly / quarterly *(Delete as applicable) Sub-section 24.4 MAXIMUM PERIOD FOR REPORTING/SUBMISSION OF BORDEREAUX: { } days Sub-section 24.6 MAXIMUM PERIOD FOR REMITTANCE OF SETTLEMENTS: { } days Sub-section 24.7 FEES AND CHARGES 35.2 THE COVERHOLDER IS AUTHORISED TO BE DEDUCTED REFER TO THE UNDERWRITERS IN PROMOTIONAL MATERIAL APPROVED BY THE COVERHOLDERUNDERWRITERS. *Yes / No *(Delete as applicable) THE COVERHOLDER IS AUTHORISED TO USE ANY LOGO, EMBLEM OR SIMILAR MARK WHICH IDENTIFIES THE UNDERWRITERS. *Yes / No *(Delete as applicable) Section 38 TIME LIMIT FOR NOTIFYING THE UNDERWRITERS OF ANY POTENTIAL COMPLAINT, REGULATORY PROCEEDINGS OR LITIGATION: Sub-section 36.1.1 Sub-section 36.2.2 NUMBER OF DAYS NOTICE OF TERMINATION: { } ( ) days NAME(S) AND ADDRESS(ES) TO WHOM COVERHOLDER SENDS NOTICE OF TERMINATION: Sub-section 42.1 JURISDICTION AND GOVERNING LAW STATE: Agreement Number: Unique Market Reference Number:
Appears in 1 contract
Samples: www.lmalloyds.com
