Filing at a Glance. General Information
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- Patience McCormick
- 9 years ago
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1 / Filing at a Glance Companies: American Zurich Insurance Company, American Guarantee and Liability Insurance Company, Zurich American Insurance Company of Illinois, Zurich American Insurance Company Contractor/ Owner Controlled SERFF Tr Num: ZURC State: Wisconsin Insurance Program - Construction (Wrap-Up) TOI: 17.0 Other Liability-Occ/Claims Made SERFF Status: Closed State Tr Num: Sub-TOI: Commercial General Liability Co Tr Num: State Status: Filing Type: Rate/Rule Co Status: Not Applicable Reviewer(s): Stephanie Cook Author: Cindy Schultz Disposition Date: 04/07/2009 Date Submitted: 04/07/2009 Disposition Status: Filed Effective Date Requested (New): 05/01/2009 Effective Date (New): Effective Date Requested (Renewal): 05/01/2009 Effective Date (Renewal): General Information Project Name: Contractor/ Owner Controlled Insurance Program - Construction (Wrap-Up) Project Number: Reference Organization: Reference Title: Filing Status Changed: 04/07/2009 State Status Changed: Corresponding Filing Tracking Number: Status of Filing in Domicile: Domicile Status Comments: Reference Number: Advisory Org. Circular: Deemer Date: Filing Description: In accordance with the filing requirements of your state, we submit for your review and approval two new usage rules to be used on a mandatory basis with all our wrap-up programs around the country. Rule 16 - Additional Interests -U-GL-1379, Named Insured Owner Controlled Insurance Program, will be issued with all owner controlled insurance programs. Rule 16 - Additional Interests - U-GL-1380, Named Insured Contractor Controlled Insurance Program, will be issued with all contractor controlled insurance programs.
2 / Both endorsements modify Section II Who Is An Insured to include the wrap up programs' enrolled contractors performing work at the "designated project". These endorsements further explain who is NOT an insured under the policy. There is no premium consideration associated with either endorsement. Company and Contact Filing Contact Information Cindy Schultz, Filing Analyst 1400 American Lane (847) [Phone] Schaumburg, IL (847) [FAX] Filing Company Information American Zurich Insurance Company CoCode: State of Domicile: Illinois 1400 American Lane Group Code: 212 Company Type: Schaumburg, IL Group Name: State ID Number: (847) ext. [Phone] FEIN Number: American Guarantee and Liability Insurance CoCode: State of Domicile: New York Company 1400 American Lane Group Code: 212 Company Type: Schaumburg, IL Group Name: State ID Number: (847) ext. [Phone] FEIN Number: Zurich American Insurance Company of Illinois CoCode: State of Domicile: Illinois 1400 American Lane Group Code: 212 Company Type: Schaumburg, IL Group Name: State ID Number: (847) ext. [Phone] FEIN Number: Zurich American Insurance Company CoCode: State of Domicile: New York 1400 American Lane Group Code: 212 Company Type: Schaumburg, IL Group Name: State ID Number:
3 / (847) ext. [Phone] FEIN Number:
4 Filing Fees / Fee Required? Retaliatory? Fee Explanation: Per Company: No No No COMPANY AMOUNT DATE PROCESSED TRANSACTION # American Zurich Insurance Company $0.00 American Guarantee and Liability Insurance $0.00 Company Zurich American Insurance Company of Illinois $0.00 Zurich American Insurance Company $0.00
5 Correspondence Summary / Dispositions Status Created By Created On Date Submitted Filed Shasta Hoffhein 04/07/ /07/2009
6 Disposition / Disposition Date: 04/07/2009 Effective Date (New): Effective Date (Renewal): Status: Filed Comment: Filed is used with rates, rules and advertisements. Rate data does NOT apply to filing. Overall Rate Information for Multiple Company Filings Overall Percentage Rate Indicated For This Filing 0.000% Overall Percentage Rate Impact For This Filing 0.000% Effect of Rate Filing-Written Premium Change For This Program $0 Effect of Rate Filing - Number of Policyholders Affected 0
7 / Item Type Item Name Item Status Public Access Supporting Document Rate Filed Yes Supporting Document Rule Filed Yes Rate Additional Interests - Named Insured - Filed Owner Controlled Insurance Program - U- GL-1379 Rate Additional Interests - Named Insured - Contractor Controlled Insurance Program - U-GL-1380 Filed Yes Yes
8 Rate Information / Rate data does NOT apply to filing.
9 Rate/Rule Schedule / Review Status: Exhibit Name: Rule # or Page Rate Action Previous State Filing Attachments #: Number: Filed Additional Interests - Named Insured - Owner Controlled Insurance Program - U-GL New Rule pdf Filed Additional Interests - Named Insured - Contractor Controlled Insurance Program - U-GL New Rule pdf
10 1/2009 Document Edition SECTION I GENERAL RULES COMMERCIAL LINES MANUAL DIVISION SIX - COMMERCIAL GENERAL LIABILITY EXCEPTION PAGE COUNTRYWIDE RULE 16. ADDITIONAL INTERESTS Section A No Additional Charge - is amended to include the following: U-GL-1379 Named Insured Owner Controlled Insurance Program A. Use Named Insured Owner Controlled Insurance Program, form U-GL-1379, to include a contractor as a named insured subject to the contingencies as outlined in the form. B. This is a mandatory endorsement which must be used with all wrap up programs which are controlled by the owner. C. There is no premium consideration for this endorsement.
11 1/2009 Document Edition SECTION I GENERAL RULES COMMERCIAL LINES MANUAL DIVISION SIX - COMMERCIAL GENERAL LIABILITY EXCEPTION PAGE COUNTRYWIDE RULE 16. ADDITIONAL INTERESTS Section A No Additional Charge - is amended to include the following: U-GL-1380 Named Insured Contractor Controlled Insurance Program A. Use Named Insured Contractor Controlled Insurance Program, form U-GL-1380, to include a contractor as a named insured subject to the contingencies as outlined in the form. B. This is a mandatory endorsement which must be used with all wrap up programs which are controlled by the contractor. C. There is no premium consideration for this endorsement.
12 / Supporting Document Schedules Review Status: Bypassed -Name: Rate Filed 04/07/2009 Bypass Reason: N/A Comments: Review Status: Bypassed -Name: Rule Filed 04/07/2009 Bypass Reason: N/A Comments:
TOI: 19.0 Personal Auto Sub-TOI: 19.0001 Private Passenger Auto (PPA)
/ Filing at a Glance Company: National General Insurance Company SERFF Tr Num: GMMX- State: Wisconsin G127107534 TOI: 19.0 Personal Auto SERFF Status: Closed-Filed State Tr Num: Sub-TOI: 19.0001 Private
SERFF Tracking Number: AGNY-125606356 State: District of Columbia National Union Fire Insurance Company of. State Tracking Number: Pittsburgh, Pa.
SERFF Tracking Number: AGNY-125606356 State: District of Columbia Filing Company: National Union Fire Insurance Company of State Tracking Number: Pittsburgh, Pa. Company Tracking Number: AIC-08-EO-05 TOI:
Filing at a Glance. General Information. Company and Contact
Filing at a Glance Companies: Great American Alliance Insurance Company, Great American Assurance Company, Great American Insurance Company, Great American Insurance Company of New York SERFF Tr Num: GRTA-125667912
TOI: L07I Individual Life - Whole SERFF Status: Closed State Tr Num: Sub-TOI: L07I.121 Graded Premium - Single Co Tr Num: 11778
/11778 Filing at a Glance Company: CSI Life Insurance Company Graded Death Benefit Whole SERFF Tr Num: CSIN-125750219 State: Wisconsin Life Insurance TOI: L07I Individual Life - Whole SERFF Status: Closed
Filing at a Glance. General Information. Company and Contact
11.0 - Claims Filing at a Glance Company: 00006 - INSURANCE SERVICES OFFICE, INC. SERFF Tr Num: ARKS-125411752 State: Arkansas 11.0 - Claims SERFF Status: Closed State Tr Num: #104677 $250 11.0000 Med
Filing at a Glance. General Information. Company and Contact. Company: 13565 - Arkansas Mutual Insurance Company
SERFF Tracking Number: ARKS-126116216 State: Arkansas Filing Company: 13565 - Arkansas Mutual Insurance Company State Tracking Number: #1426 $25 Company Tracking Number: 2009-01 TOI: 11.2 Med Mal-Claims
Filing at a Glance. General Information
SERFF Tracking Number: ZURC-126193280 State: Wisconsin First Filing Company: American Zurich Insurance Company,... State Tracking Number: Company Tracking Number: CW-GL-28564 TOI: 17.1 Other Liability-Occ
SERFF Tracking #: SMPJ-129807620 State Tracking #: Company Tracking #: 14-IR-WC-9018R
Product Name: Employers Liability WC Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Sompo Japan Insurance Company of America Employers Liability WC District of Columbia 16.0
SERFF Tracking #: ZURC-128805817 State Tracking #: Company Tracking #: CW OL 35534
Product Name: Primary Health Care Liability Policy Endorsements Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Zurich American Insurance Company Primary Health Care Liability
TOI: 17.0 Other Liability-Occ/Claims Made Sub-TOI: 17.0001 Commercial General Liability
Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Filing at a Glance Companies: American Home Assurance Company, American International South Insurance Company, AIG Casualty Company, Commerce
SERFF Tracking #: HNVX-G129898950 State Tracking #: Company Tracking #: DC150350100010
Product Name: *MPL- Miscellaneous Professional Liability Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: The Hanover Insurance Company *MPL- Miscellaneous Professional Liability
SERFF Tracking Number: PHAR-125833359 State: District of Columbia Filing Company: Pharmacists Mutual Insurance Company State Tracking Number:
SERFF Tracking Number: PHAR-125833359 State: District of Columbia Filing Company: Pharmacists Mutual Insurance Company State Tracking Number: Company Tracking Number: DC-PHL/CSP-01-09-R TOI: 11.2 Medical
Filing at a Glance. General Information
InnKeepers Liability Coverage Endorsement (Bailment Coverage) 64002 (6/08)/ Filing at a Glance Companies: American Home Assurance Company, American International South Insurance Company, AIG Casualty Company,
SERFF Tracking Number: LMUG-125263431 State: Arkansas First Filing Company: Liberty Insurance Corporation,... State Tracking Number: AR-PC-07-025842
LC Tobacco Exclusion - LC 21 54 08 07/ Filing at a Glance Companies: Liberty Insurance Corporation, Liberty Mutual Fire Insurance Company, LM Insurance Corporation, Liberty Mutual Insurance Company, The
TOI: 17.2 Other Liability-Occ Only Sub-TOI: 17.2001 Commercial General Liability
/ Filing at a Glance Company: Great American Spirit Insurance Company SERFF Tr Num: GRTA-125596599 State: Wisconsin TOI: 17.2 Other Liability-Occ Only SERFF Status: Closed State Tr Num: Sub-TOI: 17.2001
Filing at a Glance. General Information
Filing at a Glance Company: Freedom Life Insurance Company of America FLICA Individual SERFF Tr Num: USHG-125738978 State: ArkansasLH First Occurrence Heart Attack/Cancer TOI: H07I Individual Health -
SERFF Tracking #: SMPJ-130229500 State Tracking #: Company Tracking #: 15-I-GL-9011
SERFF Tracking #: SMPJ-130229500 State Tracking #: Company Tracking #: 15-I-GL-9011 State: District of Columbia Filing Company: Sompo Japan Insurance Company of America TOI/Sub-TOI: 17.0 Other Liability-Occ/Claims
Filing at a Glance. The Guardian Life Insurance Company of America. Product Name: DC 3/5/14 CI Filing
SERFF Tracking #: GARD-129444557 State Tracking #: Company Tracking #: State: District of Columbia Filing Company: The Guardian Life Insurance Company of America TOI/Sub-TOI: H07G Group Health - Specified
SERFF Tracking #: USAA-130216478 State Tracking #: Company Tracking #: PA1520097
State: Pennsylvania First Filing Company: Garrison Property and Casualty Insurance Company,... Filing at a Glance Companies: State: TOI: Sub-TOI: Filing Type: Garrison Property and Casualty Insurance Company
SERFF Tracking Number: CNAC-125272315 State: Arkansas First Filing Company: Continental Casualty Company,... State Tracking Number: AR-PC-07-025885
SERFF Tracking Number: CNAC-125272315 State: Arkansas First Filing Company: Continental Casualty Company,... State Tracking Number: AR-PC-07-025885 Company Tracking Number: 07-F2181-UMB TOI: 17.0 Other
Status of Filing in Domicile: Not Filed
Filing at a Glance Company: MetLife Insurance Company of Connecticut SERFF Tr Num: METD-125969626 State: ArkansasLH TOI: A03I Individual Annuities - Deferred SERFF Status: Closed State Tr Num: 41346 Variable
AR-MEDAMERICA DENIED CLAIMS, LAPSE/REPLACEMENT AND SUITABILITY REPORTS
TOI: LTC6 Long Term Care - Other Sub-TOI: LTC6. Long Term Care - Other AR-MedAmerica Denied Claims, Lapse/Replacement AR- MedAmerica Denied Claims, Lapse/Replacement /AR- MedAmerica Denied Claims, Lapse/Replacement
Closed Sub-TOI: L08.000 Life - Other Co Tr Num: AR0911952 State Status: Approved-Closed
Comparison (Replacement) Questionnaire/ Filing at a Glance Company: USAA Life Insurance Company Comparison (Replacement) SERFF Tr Num: UNSA-126298161 State: Arkansas Questionnaire (life) TOI: L08 Life
Filing at a Glance. Sagicor Life Insurance Company Baltimore Life/Sagicor Assumption District of Columbia L01.000 Life - Assumption Agreement
Filing at a Glance Company: State: TOI: Sub-TOI: Filing Type: Sagicor Life Insurance Company District of Columbia L01 Life - Assumption Agreement L01.000 Life - Assumption Agreement Date Submitted: 11/12/2014
SERFF Tracking #: ICCI-129123690 State Tracking #: Company Tracking #: B-BTP ACC-13-P-R
Product Name: Pan-Am Blanket Group Accident Policy B-BTP-ACC-13-P Filing at a Glance Company: Pan-American Life Insurance Company Product Name: Pan-Am Blanket Group Accident Policy B-BTP-ACC-13-P State:
TOI: 04.0 Homeowners Sub-TOI: 04.0000 Homeowners Sub-TOI Combinations Revised Rule 521 Water Sewer Backup for HCIC
Project Name/Number: Homeowners Multi Peril/ Filing at a Glance Company: Hartford Casualty Insurance Company Revised Rule 521 Water Sewer SERFF Tr Num: HART-125929339 State: Arkansas Backup for HCIC TOI:
SERFF Tracking #: FHLA-129477086 State Tracking #: Company Tracking #: DCL6RATES
SERFF Tracking #: FHLA-129477086 State Tracking #: Company Tracking #: DCL6RATES State: District of Columbia Filing Company: Family Heritage Life Insurance Company of America TOI/Sub-TOI: Product Name:
SERFF Tracking #: SHPW-128659165 State Tracking #: Company Tracking #: INS-00071 (08/11) ADWORDS 1, 6, 7, 8, 9,...
SERFF Tracking #: SHPW-128659165 State Tracking #: Company Tracking #: INS-00071 (08/11) ADWORDS 1, 6, 7, 8, Filing at a Glance Company: Security Health Plan of Wisconsin, Inc. State: TOI: Sub-TOI: Filing
Project Number: SVF PX Date Approved in Domicile: 02/09/2010
Project Name/Number: / Filing at a Glance Company: Transamerica Financial Life Insurance Company SERFF Tr Num: AEGN-127173488 State: Arkansas TOI: A03G Group Annuities - Deferred Variable SERFF Status:
TOI: 09.0 Inland Marine Sub-TOI: 09.0005 Other Commercial Inland Marine Product Name: Transportation Rate Filing 2007
Project Name/Number: / Filing at a Glance Company: Maxum Casualty Insurance Company SERFF Tr Num: MXCC-125344646 State: Arkansas TOI: 09.0 Inland Marine SERFF Status: Closed State Tr Num: Sub-TOI: 09.0005
The requested effective date is 7/03/08. However, AAIC prefers an earlier effective date coincident with the date of your
Filing at a Glance Company: American Alternative Insurance Corp Pet Health Policies, SERFF Tr Num: FRCS-125722242 State: Arkansas Supplemental Forms and Rating TOI: 09.0 Inland Marine SERFF Status: Closed
This advertising material is new and does not replace any advertisements filed by Genworth Life Insurance Company.
SERFF Tracking Number: GEFA-125987509 State: Wisconsin Filing Company: Genworth Life Insurance Company State Tracking Number: Company Tracking Number: TOI: LTC03I Individual Long Term Care Sub-TOI: LTC03I.001
SERFF Tracking #: NCCI-127176855 State Tracking #: Company Tracking #: B-1423 (MJ)
SERFF Tracking #: NCCI-127176855 State Tracking #: Company Tracking #: B-1423 (MJ) State: Missouri Filing Company: NCCI TOI/Sub-TOI: 16.0 Workers Compensation/16.0004 Standard WC Product Name: B-1423 Elimination
TOI: 35.0 Interline Filings Sub-TOI: 35.0002 Commercial Interline Filings
SERFF Tracking Number: WAUS-125566396 State: Arkansas First Filing Company: Employers Insurance Company of Wausau,... State Tracking Number: EFT $50 Company Tracking Number: MSF-CW-004-08 TOI: 35.0 Interline
SERFF Tracking #: MRTN-130013987 State Tracking #: Company Tracking #: CL DC008230200009
Product Name: Cover Pro Miscellaneous Professional Liability Short Renewal Application Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Philadelphia Indemnity Insurance Company
SERFF Tracking #: MASS-130482511 State Tracking #: Company Tracking #: 2015 ANNUAL LTC REPORTS
SERFF Tracking #: MASS-130482511 State Tracking #: Company Tracking #: 2015 ANNUAL LTC REPORTS State: District of Columbia Filing Company: Massachusetts Mutual Life Insurance Company TOI/Sub-TOI: LTC06
Company Tracking Number: 00-T1 TOI: L04I Individual Life - Term Sub-TOI: L04I.003 Single Life - Single Premium
Project Name/Number: /00-T1 Filing at a Glance Company: SERFF Tr Num: GARD-126615290 State: Arkansas TOI: L04I Individual Life - Term SERFF Status: Closed-Filed- State Tr Num: 45745 Closed Sub-TOI: L04I.003
SERFF Tracking #: CUNA-128703657 State Tracking #: Company Tracking #: 2009-SPWL MEMO
Filing at a Glance Company: State: TOI: Sub-TOI: Filing Type: CMFG Life Insurance Company Arkansas L07I Individual Life - Whole L07I.111 Single Premium - Single Life Form Date Submitted: 10/09/2012 SERFF
L09I.001 Single Life Adjustable Life Flexible Premium Adjustable Life Insurance Policy Kemper Investors Life Insurance Company/0146PAL02-08
SERFF Tracking Number: MLLM-126729865 State: Arkansas Filing Company: Kemper Investors Life Insurance Company State Tracking Number: 46401 Company Tracking Number: 0146PAL02-08 TOI: L09I Individual Life
SERFF Tracking #: MEAM-128778084 State Tracking #: Company Tracking #: DC FC ACTUARIAL ADDENDUM_DISCOUNTS
SERFF Tracking #: MEAM-128778084 State Tracking #: Company Tracking #: DC FC ACTUARIAL ADDENDUM_DISCOUNTS State: District of Columbia Filing Company: MedAmerica Insurance Company TOI/Sub-TOI: LTC06 Long
TOI: LTC03I Individual Long Term Care Sub-TOI: LTC03I.003 Other Individual Long Term Care- Other
SERFF Tracking Number: NALF-126305095 State: Arkansas Filing Company: National Life Insurance Company State Tracking Number: 43512 Company Tracking Number: TOI: LTC03I Individual Long Term Care Sub-TOI:
A02I.003 Single Premium Variable Preparing To Never Need Long-term Care Seminar/I-22163
SERFF Tracking Number: AULD-126526295 State: Arkansas Filing Company: State Life Insurance Company State Tracking Number: 45159 Company Tracking Number: TOI: A02I Individual Annuities- Deferred Non- Sub-TOI:
SERFF Status: Closed-Filed- State Tr Num: 43499 9/14/09 A156314 AR PRU
Project Name/Number: / Filing at a Glance Company: Pruco Life Insurance Company Group Filing 9/14/09 A156314 AR PRU TOI: A03I Individual Annuities - Deferred Variable Sub-TOI: A03I.002 Flexible Premium
SERFF Tracking #: AMGN-130338720 State Tracking #: Company Tracking #: 109249-DC-2015, ET AL
SERFF Tracking #: AMGN-130338720 State Tracking #: Company Tracking #: 109249-DC-2015, ET AL State: District of Columbia Filing Company: American General Life Insurance Company TOI/Sub-TOI: L07I Individual
Closed Sub-TOI: L04I.500 Other Co Tr Num: PLF11AA0AR State Status: Approved-Closed
SERFF Tracking Number: MCHX-G127138026 State: Arkansas Filing Company: Primerica Life Insurance Company State Tracking Number: 48581 Company Tracking Number: PLF11AA0AR TOI: L04I Individual Life - Term
SERFF Tracking #: CNAB-130027328 State Tracking #: Company Tracking #: 15-01041-F
SERFF Tracking #: CNAB-130027328 State Tracking #: Company Tracking #: 15-01041-F State: District of Columbia Filing Company: Continental Insurance Company TOI/Sub-TOI: 17.0 Other Liability-Occ/Claims
SERFF Tracking #: MALF-128641392 State Tracking #: Company Tracking #: 12 SSA CE-D
SERFF Tracking #: MALF-128641392 State Tracking #: Company Tracking #: 12 SSA CE-D State: Arkansas Filing Company: John Hancock Life Insurance Company (U.S.A.) TOI/Sub-TOI: A05I Individual Annuities- Immediate
