# MS Insurance Bulletin 2012-4: Nonadmitted Insurance Form of Senate Bill 2628 (Issued May 18, 2012) > Mississippi · Agency guidance · Rescinded URL: https://www.frixlaw.com/law-library/statutes/MS_INS_B_2012-04 ## Section - **Citation:** MS Insurance Bulletin 2012-4 - **Heading:** Nonadmitted Insurance Form of Senate Bill 2628 (Issued May 18, 2012) - **Jurisdiction:** Mississippi - **Kind:** Agency guidance - **Status:** Rescinded - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Mississippi Insurance Department Bulletins / Nonadmitted Insurance Form of Senate Bill 2628 (Issued May 18, 2012) ## Text [LOGO] # MISSISSIPPI INSURANCE DEPARTMENT MIKE CHANEY Commissioner of Insurance State Fire Marshal MARK HAIRE Deputy Commissioner of Insurance 501 N. WEST STREET, SUITE 1001 WOOLFOLK BUILDING JACKSON, MISSISSIPPI 39201 www.mid.state.ms.us MAILING ADDRESS Post Office Box 79 Jackson, Mississippi 39205-0079 TELEPHONE: (601) 359-3569 FAX: (601) 359-2474 # MISSISSIPPI DEPARTMENT OF INSURANCE BULLETIN 2012-4 SENATE BILL 2628 NONADMITTED INSURANCE FORM May 18, 2012 ## I. Purpose. During the 2012 Regular Legislative Session, the Mississippi Legislature passed Senate Bill 2628, which amends Miss. Code Ann. § 83-21-23 to require surplus lines insurance producers to execute a form prescribed by the Commissioner when making a nonadmitted market placement. This Bulletin is being circulated to provide surplus lines insurance producers with guidance in complying with Senate Bill 2628. ## II. Senate Bill 2628. Senate Bill 2628 states in pertinent part, as follows: "When any policy of insurance or certificate of insurance is procured under the authority of such license, there shall be executed by the surplus lines insurance producer a form setting forth facts in complete detail as to what was done to place such kind of insurance and showing that such surplus lines insurance producer therein was unable, after diligent effort, to procure from a licensed company or companies the full amount of insurance required to protect the property, liability, or risk desired to be insured. This form shall be maintained on file with the surplus lines insurance producer and may be subject to review by the Commissioner of Insurance at any time if the commissioner deems such request advisable." ## III. Eligible Nonadmitted Insurance Form. Surplus lines insurance producers are hereby directed to use the Eligible Nonadmitted Insurance Form as prescribed by the Commissioner of Insurance and attached hereto as Attachment "A". 1 h the surplus lines insurance producer and may be subject to review by the Commissioner of Insurance at any time if the commissioner deems such request advisable." ## III. Eligible Nonadmitted Insurance Form. Surplus lines insurance producers are hereby directed to use the Eligible Nonadmitted Insurance Form as prescribed by the Commissioner of Insurance and attached hereto as Attachment "A". 1 Surplus lines insurance producers are further directed to maintain a copy of the executed form for a period of five (5) years after the termination of the policy, unless the producer has been notified that the form is subject to an examination or investigation by the Mississippi Insurance Department or the Mississippi Surplus Lines Association, or unless the producer has been notified that the form is subject to pending litigation. The form shall be subject to review upon the request of the Commissioner of Insurance. The form required herein may be produced, signed and stored electronically. # IV. Exempt Commercial Purchaser A surplus lines insurance producer is not required to perform a due diligence search when the surplus lines insurance producer is seeking to procure or place nonadmitted insurance for an exempt commercial purchaser under the conditions provided in Miss. Code Ann. § 83-21-23(2), and such a transaction is not subject to the provisions of this Bulletin. # V. Effective Date. The provisions contained within this Bulletin and in Senate Bill 2628 will become effective on and after July 1, 2012. If there are any questions concerning this Bulletin, please contact the Mississippi Department of Insurance at (601) 359-3569. MIKE CHANEY COMMISSIONER OF INSURANCE 2 ## MISSISSIPPI DEPARTMENT OF INSURANCE ## ELIGIBLE NONADMITTED INSURANCE FORM Bulletin. # V. Effective Date. The provisions contained within this Bulletin and in Senate Bill 2628 will become effective on and after July 1, 2012. If there are any questions concerning this Bulletin, please contact the Mississippi Department of Insurance at (601) 359-3569. MIKE CHANEY COMMISSIONER OF INSURANCE 2 ## MISSISSIPPI DEPARTMENT OF INSURANCE ## ELIGIBLE NONADMITTED INSURANCE FORM Miss. Code Ann. § 83-21-19 provides that certain insurance coverages that cannot be procured from admitted insurers may be procured from eligible nonadmitted insurers. Any licensed Mississippi surplus lines insurance producer procuring coverage from an eligible nonadmitted insurer must complete this form acknowledging that the coverage has been placed with an eligible nonadmitted insurer. After completion, this form must be retained by the surplus lines insurance producer as part of the insured's file, and may be subject to review by the Commissioner of Insurance at any time if the Commissioner deems such request advisable. A licensed Mississippi surplus lines insurance producer is required to engage in a diligent effort to place the coverage with an admitted insurer. The signature of the producer appearing below shall serve as an attestation to the results of the diligent effort on the part of the producer. The licensed Mississippi surplus lines insurance producer is also required to expressly advise the insured that, in the event of the insolvency of the nonadmitted insurer, CLAIMS OR LOSSES WILL NOT BE PAID BY THE MISSISSIPPI INSURANCE GUARANTY ASSOCIATION. ### LICENSED MISSISSIPPI SURPLUS LINES INSURANCE PRODUCER CERTIFICATION As required by Miss. Code Ann. § 83-21-23, the surplus lines insurance producer signing below certifies that he or she engaged in a diligent effort to place the risk with an admitted company or companies. Please state in detail the reason for placing the coverage with an eligible nonadmitted insurer or insurers: ASSOCIATION. ### LICENSED MISSISSIPPI SURPLUS LINES INSURANCE PRODUCER CERTIFICATION As required by Miss. Code Ann. § 83-21-23, the surplus lines insurance producer signing below certifies that he or she engaged in a diligent effort to place the risk with an admitted company or companies. Please state in detail the reason for placing the coverage with an eligible nonadmitted insurer or insurers: Name of Eligible Nonadmitted Insurer(s) from which the coverage was procured: [Nonadmitted Insurer's Name(s)] Mississippi Surplus Lines Insurance Producer's Name: Surplus Lines Insurance Producer's Mississippi License Number: Insured's Name: Policy or Binder Number: Signature: (Surplus Lines Insurance Producer) Date Phone ( ) Attachment "A" 3 ## Nearby sections - [MS Insurance Bulletin 80-1 Revised Temporary Guidelines for Submission of Life Insurance Policies With Projected Premium Rates Less Than or Equal To Maximum Premium Rates](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1980-01.md) - [MS Insurance Bulletin 80-2(A) Revised Guidelines for Submission of Life Insurance Contracts That Provide Guaranteed Insurability Benefits Based Upon the Consumers Price Index](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1980-02A.md) - [MS Insurance Bulletin 91-4 Health Insurance for Persons on Active Military Duty](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1991-04.md) - [MS Insurance Bulletin 91-6 (Revised) Form for Payments to Volunteer Firefighters](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1991-06.md) - [MS Insurance Bulletin 91-2181 Comprehensive Health Insurance Risk Pool Association](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1991-2181.md) - [MS Insurance Bulletin 93-1 Voluntary Basic Health Insurance Coverage Law](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-01.md) - [MS Insurance Bulletin 93-2 Fire Safety Bulletin](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-02.md) - [MS Insurance Bulletin 93-3 Factory-Built Homes Laws](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-03.md) - [MS Insurance Bulletin 93-4 Manufactured Housing Blocking, Anchoring and Tie-Downs](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-04.md) - [MS Insurance Bulletin 93-5 Adjuster’s Continuing Education Requirements](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-05.md) - [MS Insurance Bulletin 93-6 Revised Guidelines for Contracts](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-06.md) - [MS Insurance Bulletin 93-7 Changes in Adjuster’s License Renewal Date](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-07.md) - [MS Insurance Bulletin 93-8 Withdrawal of Mississippi Insurance Department Bulletin 93-8, Fire Services Development Program Eligibility Guidelines Administered by the MS Department of Insurance](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1993-08.md) - [MS Insurance Bulletin 94-1 Health Insurance Rate Increases](https://www.frixlaw.com/law-library/statutes/MS_INS_B_1994-01.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/MS_INS_B_2012-04. Check the current official text before relying on it. Not legal advice.