REGISTRATION FORM PART 1 - FRO- 01

Transcription

1 REGISTRATION FORM PART 1 - FRO- 01 The following details are required to begin the on-boarding registration process. 1. Details of the Company Note: This contact information will be used throughout the on-boarding and testing phases and when the scheme is live unless we are notified of any changes Insurer / company name Please confirm your regulator PRA/FCA/FSMA number FRN for EEA insurers Registered address Main operational address Note: If multiple locations, state which address you want to have stored on our systems Main telephone number (including country code) Main contact within your organisation for Flood Re purposes Authorised Signatory Note: this is the person who will sign legal documentation and forms for your organisation Please confirm a group address for contact by the Flood Re team? Note: this is required as this is the address Flood Re will use to inform you of rejected bordereaux errors

2 1. Details of the Company (continued) Note: This contact information will be used throughout the on-boarding and testing phases and when the scheme is live unless we are notified of any changes Underwriting contact Claims contact Finance contact IT contact Note: this contact will also be used as the main out of hours contact Test Lead Note: this contact will be sent the Test Pack Other please provide any additional contacts

3 2. About your organisation Please indicate if you are Part A UK regulated Insurer Lloyd s Managing Agent EEA Domiciled Insurer with permission to passport into UK Part B Fully delegated authority including MGAs with full delegated authority Part C Software house Insurance Intermediaries (without full delegated authority) Other (please specify) Are you intending to pass property data to a third party or are you intending to rely on a third party data supplier to provide Flood Re property data to you? Note: this may include Key Service Providers all of whom may be required to on-board with Flood Re. This will be confirmed following assessment of your Registration Form. If yes, please list all the organisations that apply (include additional list if necessary)

4 Are you intending to transfer or store data outside of the EEA? If yes, please list all countries If you have selected an organisation in Section 2 Part A, please answer the following: Note: a letter of confirmation for each fully delegated authority will be required in due course Ceding Risks Note: If you are an organisation in Section 2 Part C you will not be able to cede risks to Flood Re Do you intend to use an insurance intermediary or MGA which has fully delegated authority (ie an entity that handles both claims and underwriting activity) to cede business to Flood Re on your behalf? If the answer to this is Yes please attach a list of all the organisations that apply including the relevant FCA/FSMA number Please note that fully delegated authorities will also have to register and on-board separately with Flood Re Are you planning to cede risks at go-live? If no, are you planning to cede risks in future? If yes, what date do you plan to commence? MM/YY 3. Membership Relevant insurers can choose to be ordinary members of Flood Re Limited, the Company. As ordinary members, relevant insurers will enjoy certain voting rights (based on their gross written premium); potential refunds of Levy 2 contributions subject to conditions in the legislation and the Members Agreement. If you are a UK regulated insurer and/or an insurer with permission to passport into the UK and/or Lloyd s Managing Agent, please indicate if you wish to become a member of Flood Re Limited? Yes No

5 4. Testing Please indicate preferred testing period Note: you will only be able to cede business once testing is completed Oct-Dec 2015 Jan-Mar 2016 Apr- June 2016 July- Sept 2016 Oct-Dec Up-front Property Data As part of the on-boarding process, a one-off bulk matching facility is available. This will enable you to populate systems with the Flood Re Identification (FRid) reference, the unique property data matching code, which will facilitate future address matching and bordereaux processing. If you would like to take advantage of this please complete the table below. On-boarding up front data matching required Yes / No Size /number of policies Note: Flood Re can carry out limited upfront FRid data matching on high flood risk properties only. The FRid service will therefore only be available for the policies you are likely to cede the flood risk element of to Flood Re and not for your whole book. We will get in touch with your nominated main contact on receipt of this form to confirm requirements and agree timelines. Return to FloodReOperations@capita.co.uk or by post, to the following address, as soon as possible: Private & Confidential Flood Re Service Desk Flood Re Limited 6 th Floor 65 Gresham Street London EC2V 7NQ FOR OFFICIAL FLOOD RE USE ONLY Participant ID Reference