§ 8208. Form of notice of transfer
NOTICE OF TRANSFER
IMPORTANT: THIS NOTICE AFFECTS YOUR CONTRACT
RIGHTS. PLEASE READ IT CAREFULLY.
Transfer of Policy
The AB Insurance company has agreed to replace us as your insurer under (insert policy/certificate
name and number) effective (insert date). The AB Insurance Company’s principal place
of business is (insert address). Financial information concerning both companies is
attached, including (1) ratings for the last five years, if available, or for such
lesser period as is available from two nationally recognized insurance rating services;
(2) balance sheets for the previous three years, if available, or for such lesser
period as is available and as of the date of the most recent quarterly statement;
(3) a copy of the Management’s Discussion and Analysis that was filed as a supplement
to the previous year’s annual statement; and (4) an explanation of the reason for
the transfer. You may obtain additional information concerning AB Insurance Company
from reference materials in your local library or by contacting your Insurance Commissioner
at (insert address and phone number).
The AB Insurance Company is licensed to write this coverage in your state. The Commissioner
of Insurance in your state has reviewed the potential effect of the proposed transaction,
and has approved the transaction (if the commissioner has approved the transaction).
Your Rights
You may choose to consent to or reject the transfer of your policy to AB Insurance
Company. If you want your policy transferred, you may notify us in writing by signing
and returning the enclosed pre-addressed, postage-paid card.
Payment of your premium to the AB Insurance Company will also constitute consent to
the transfer of your policy unless you reject or reserve the right to reject the transfer
when you make your payment. Your next premium notice will tell you how to pay the
premium and keep your policy in force while reserving your right to reject the transfer.
If you do not want your policy transferred, you must notify us in writing that you
reject the transfer. You may use the enclosed pre-addressed, postage-paid card to
notify us that you reject the transfer.
If you reject the transfer, you may keep your policy with us or exercise any option
under your policy. If we do not receive notice of rejection, you will, as a matter
of law, be deemed to have consented to the transfer effective (insert date). However,
before this consent is final you will be provided a second notice of the transfer
12 months from now. After the second notice is provided, you will have two months
to reply. If you pay your premium to the AB Insurance Company without reserving your
right to reject the transfer, you will not receive a second notice.
You may also notify us of your consent to or rejection of the transfer of your policy
by writing to us at:
Insert name, address and facsimile number of contact person.
Effect of Transfer
If you accept this transfer, AB Insurance Company will be your insurer. It will have
direct responsibility to you for the payment of all claims, benefits and for all other
policy obligations. We will no longer have any obligations to you.
If you accept this transfer, you should make all premium payments and claims submissions
to AB Insurance Company and direct all questions to AB Insurance Company.
If you have any further questions about this agreement, you may contact XY Insurance
(the transferring insurer) or AB Insurance Company.
Sincerely,
| XY Insurance Company |
AB Insurance Company |
| address |
address |
| toll-free telephone number |
toll-free telephone number |
For your convenience, we have enclosed a pre-addressed postage-paid response card.
Please take time now to read the enclosed notice and complete and return the response
card to us.
[Notice Date]
| RESPONSE CARD |
|
| ___________ |
|
Yes, I accept the transfer of my policy from XY Insurance |
| |
|
Company (transferring company) to AB Insurance Company |
| |
|
(assuming company). |
| ___________ |
|
No, I reject the proposed transfer of my policy from XY |
| |
|
Insurance Company to AB Insurance Company and wish to |
| |
|
retain or exercise my rights under my policy with XY Insurance |
| |
|
Company. |
| Date: _________________________________________ |
|
Signature: _______________________________________ |
|
| Name: |
|
|
|
|
| Street Address: |
|
|
|
|
| City, State, Zip: |
|
|
|
|
(Added 1993, No. 235 (Adj. Sess.), § 7.)