State: North Carolina First Filing Company: Fidelity Fire & Casualty Company, Homeowners/ Homeowners Sub-TOI Combinations

Size: px

Start display at page:

Download "State: North Carolina First Filing Company: Fidelity Fire & Casualty Company, Homeowners/ Homeowners Sub-TOI Combinations"

Bernice Glenn
5 years ago
Views:

1 SERFF Tracking #: FIMI State Tracking #: Company Tracking #: State: North Carolina First Filing Company: Fidelity Fire & Casualty Company,... TOI/Sub-TOI: 04.0 Homeowners/ Homeowners Sub-TOI Combinations Product Name: Homeowners Project Name/Number: Rebranding/ Filing at a Glance Companies: Product Name: State: TOI: Sub-TOI: Filing Type: Fidelity Fire & Casualty Company First Protective Insurance Company Homeowners North Carolina 04.0 Homeowners Homeowners Sub-TOI Combinations Form Date Submitted: 01/09/2014 SERFF Tr Num: SERFF Status: State Tr Num: State Status: Co Tr Num: Effective Date Requested (New): Effective Date Requested (Renewal): Author(s): Reviewer(s): FIMI Closed-Approved Approved On Approval On Approval Jennifer Pighetti, Masha Martin Helen Best (primary) Disposition Date: 01/09/2014 Disposition Status: Approved Effective Date (New): 01/10/2014 Effective Date (Renewal): 01/10/2014 PDF Pipeline for SERFF Tracking Number FIMI Generated 01/09/ :45 AM

2 SERFF Tracking #: FIMI State Tracking #: Company Tracking #: State: North Carolina First Filing Company: Fidelity Fire & Casualty Company,... TOI/Sub-TOI: 04.0 Homeowners/ Homeowners Sub-TOI Combinations Product Name: Homeowners Project Name/Number: Rebranding/ General Information Project Name: Rebranding Project Number: Reference Organization: Reference Title: Filing Status Changed: 01/09/2014 State Status Changed: 01/09/2014 Created By: Jennifer Pighetti Corresponding Filing Tracking Number: State TOI: 04.0 Homeowners Status of Filing in Domicile: Pending Domicile Status Comments: Reference Number: Advisory Org. Circular: Deemer Date: Submitted By: Jennifer Pighetti State Sub-TOI: Homeowners Sub-TOI Combinations Filing Description: We are revising our Declarations Page to reflect our new logo and font revision to maintain consistency throughout our policy forms. Company and Contact Filing Contact Information Benjamin Treuil, Chief Financial Officer 7131 Business Park Ln Lake Mary, FL Filing Company Information Fidelity Fire & Casualty Company 7131 Business Park Ln Suite #300 Lake Mary, FL (407) ext. [Phone] [Phone] 8104 [Ext] CoCode: Group Code: 4773 Group Name: First Prot & Fidelity FEIN Number: State of Domicile: Florida Company Type: Property & Casualty State ID Number: First Protective Insurance Company 7131 Business Park Ln Suite #300 Lake Mary, FL (407) ext. [Phone] CoCode: Group Code: 4773 Group Name: First Prot & Fidelity FEIN Number: State of Domicile: Florida Company Type: Property & Casualty State ID Number: Filing Fees Fee Required? Retaliatory? Fee Explanation: No No PDF Pipeline for SERFF Tracking Number FIMI Generated 01/09/ :45 AM

3 SERFF Tracking #: FIMI State Tracking #: Company Tracking #: State: North Carolina First Filing Company: Fidelity Fire & Casualty Company,... TOI/Sub-TOI: 04.0 Homeowners/ Homeowners Sub-TOI Combinations Product Name: Homeowners Project Name/Number: Rebranding/ Correspondence Summary Dispositions Status Created By Created On Date Submitted Approved Helen Best 01/09/ /09/2014 PDF Pipeline for SERFF Tracking Number FIMI Generated 01/09/ :45 AM

4 SERFF Tracking #: FIMI State Tracking #: Company Tracking #: State: North Carolina First Filing Company: Fidelity Fire & Casualty Company,... TOI/Sub-TOI: 04.0 Homeowners/ Homeowners Sub-TOI Combinations Product Name: Homeowners Project Name/Number: Rebranding/ Disposition Disposition Date: 01/09/2014 Effective Date (New): 01/10/2014 Effective Date (Renewal): 01/10/2014 Status: Approved Comment: This references the captioned filing. Your policy form filing is hereby approved in accordance with North Carolina General Statute (a). If the effective dates are changed, you must notify us in writing prior to the effective date. 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 Schedule Schedule Item Schedule Item Status Public Access Supporting Document Form Filing Questionnaire FC-048 Yes Supporting Document Form Revision Yes Form Declarations Page Yes PDF Pipeline for SERFF Tracking Number FIMI Generated 01/09/ :45 AM

5 SERFF Tracking #: FIMI State Tracking #: Company Tracking #: State: North Carolina First Filing Company: Fidelity Fire & Casualty Company,... TOI/Sub-TOI: 04.0 Homeowners/ Homeowners Sub-TOI Combinations Product Name: Homeowners Project Name/Number: Rebranding/ Form Schedule Item Schedule Item Form Form No. Status Name Number 1 Declarations Page FIM-NC- HO-DEC Edition Form Form Action Specific Date Type Action Data 01/14 DEC Replaced Previous Filing Number: Replaced Form Number: FIMI FIM-DEC-NC Readability Score Attachments FIM-NC-HO-DEC pdf Form Type Legend: ABE Application/Binder/Enrollment ADV Advertising BND Bond CER Certificate CNR Canc/NonRen Notice DEC Declarations/Schedule DSC Disclosure/Notice END Endorsement/Amendment/Conditions ERS Election/Rejection/Supplemental Applications OTH Other PDF Pipeline for SERFF Tracking Number FIMI Generated 01/09/ :45 AM

6 HOMEOWNERS POLICY NEW BUSINESS DECLARATIONS DATE ISSUED: <XX/XX/XX> Underwritten by: <COMPANY> PO Box Lake Mary, FL POLICY NUMBER POLICY PERIOD From: To: 12:01 AM Standard Time IF YOU HAVE QUESTIONS ABOUT YOUR POLICY, PLEASE CONTACT YOUR AGENT AT XXX-XXX-XXXX. TO REPORT A CLAIM, CALL XXX-XXX-XXXX. INSURED: AGENCY: XXX-XX-XXXXX Telephone: LOCATION OF PROPERTY Telephone: COVERAGE IS PROVIDED WHERE LIMIT OF LIABILITY AND PREMIUM ARE SHOWN. POLICY COVERAGES: SECTION I PROPERTY A. DWELLING B. OTHER STRUCTURES C. PERSONAL PROPERTY D. LOSS OF USE SECTION II LIABILITY E. PERSONAL LIABILITY F. MEDICAL PAYMENTS TO OTHERS OPTIONAL COVERAGES: LIMIT OF LIABILITY SECTION I LOSSES ARE SUBJECT TO THE FOLLOWING: DEDUCTIBLE FOR ALL PERILS: $X,XXX [NAMED STORM DEDUCTIBLE: $XX,XXX (XX% OF COVERAGE A)] [WIND/HAIL DEDUCTIBLE: $XX,XXX (XX% OF COVERAGE A)] PREMIUM POLICY CREDITS AND CHARGES PREMIUM SUMMARY: * * * THIS IS NOT A BILL AN INVOICE WILL BE MAILED SEPARATELY * * * POLICY COVERAGES: OPTIONAL COVERAGES: POLICY CREDITS AND CHARGES TOTAL ANNUAL PREMIUM: FIM-NC-HO-DEC (01/14) INSURED COPY Page 1 of 4

7 HOMEOWNERS POLICY NEW BUSINESS DECLARATIONS DATE ISSUED: <XX/XX/XX> Underwritten by: <COMPANY> PO Box Lake Mary, FL POLICY NUMBER POLICY PERIOD From: To: 12:01 AM Standard Time INSURED: AGENCY: XXX-XX-XXXXX Telephone: LOCATION OF PROPERTY Telephone: ADDITIONAL INTERESTS: TYPE: ESCROW BILLED: RATING INFORMATION: FORM TYPE: PROTECTION CLASS: CONSTRUCTION TYPE: NUMBER OF FAMILIES: TERRITORY: USAGE: YEAR BUILT: OCCUPANCY: PROTECTIVE DEVICE CREDIT: BURGLAR ALARM FIRE ALARM: SPRINKLERS: AUTOMATIC SMOKE DETECTORS: FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY AUTHORIZED SIGNATURE: DATE SIGNED: FRONTLINE WEBSITE: FRONTLINE FIM-NC-HO-DEC (01/14) INSURED COPY Page 2 of 4

HOMEOWNERS POLICY NEW BUSINESS DECLARATIONS DATE ISSUED: <XX/XX/XX> Underwritten by: <COMPANY> PO Box 958405 Lake Mary, FL 32795 POLICY NUMBER POLICY PERIOD From: To: 12:01 AM Standard Time INSURED:

8 HOMEOWNERS POLICY NEW BUSINESS DECLARATIONS DATE ISSUED: <XX/XX/XX> Underwritten by: <COMPANY> PO Box Lake Mary, FL POLICY NUMBER POLICY PERIOD From: To: 12:01 AM Standard Time INSURED: AGENCY: XXX-XX-XXXXX Telephone: LOCATION OF PROPERTY Telephone: THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR [WIND/HAIL / NAMED STORM] LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. WARNING: THE PROPERTY INSURANCE POLICY DOES NOT PROTECT YOU AGAINST LOSSES FROM FLOODS, EARTHQUAKES, MUDSLIDES, MUDFLOR, OR LANDSLIDES. YOU SHOULD CONTACT YOUR INSURANCE COMPANY OR AGENT TO DISCUSS YOUR OPTIONS FOR OBTAINING COVERAGE FOR THESE LOSSES. THIS IS NOT A COMPLETE LISTING OF ALL OF THE CAUSES OF LOSSES NOT COVERED UNDER YOUR POLICY. YOU SHOULD READ YOUR ENTIRE POLICY TO UNDERSTAND WHAT IS COVERED AND WHAT IS NOT COVERED. FIM-NC-HO-DEC (01/14) INSURED COPY Page 3 of 4

9 INSURED NAME INSURED ADDRESS INSURED ADDRESS INSURED ADDRESS

10 SERFF Tracking #: FIMI State Tracking #: Company Tracking #: State: North Carolina First Filing Company: Fidelity Fire & Casualty Company,... TOI/Sub-TOI: 04.0 Homeowners/ Homeowners Sub-TOI Combinations Product Name: Homeowners Project Name/Number: Rebranding/ Supporting Document Schedules Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Bypassed - Item: Bypass Reason: Attachment(s): Item Status: Status Date: Form Filing Questionnaire FC-048 Filing Questionnaire.pdf Form Revision There are no material changes that can be highlighted. The only changes were to the logo and the font type. PDF Pipeline for SERFF Tracking Number FIMI Generated 01/09/ :45 AM

SERFF Tracking #: AGIA State Tracking #: Company Tracking #: UNAIC-NC-HO3-FF 1213

SERFF Tracking #: AGIA State Tracking #: Company Tracking #: UNAIC-NC-HO3-FF 1213 SERFF Tracking #: AGIA-129343072 State Tracking #: Company Tracking #: UNAIC-NC-HO3-FF 1213 State: North Carolina Filing Company: Universal North America Insurance Company TOI/Sub-TOI: 04.0 Homeowners/04.0000