market bulletin
FromManager Coverholders Department (extn 6754)

Date

18 January 2007

ReferenceY3952

SubjectCompliance questionnaire for Lloyd’s approved Coverholders

Subject areas

Ongoing coverholder suitability

Attachments

Coverholder annual compliance questionnaire

Action points

Mandatory use of the compliance questionnaire for Lloyd's Coverholders

Deadlines

18 January 2007

This bulletin imposes the use of the compliance questionnaire for Lloyd’s approved
coverholders as a replacement to the LMA 9001 from 18 January 2007.
Lloyd’s, in liaison with the LMA and LMBC, has designed this standard compliancequestionnaire for completion by Coverholders so that they may provide, in a single
document, information required by Underwriters to consider the renewal of their binding
authority(ies) and to demonstrate that they continue to meet the criteria to be a Lloyd’s
approved coverholder in accordance with the Franchise Performance Standards. Its
purpose is to eliminate the need for different questionnaires from Underwriters
asking for the same core information.
The process1

Annually, prior to renewal of a binding authority, the coverholder provides their Lloyd’s
broker(s) with a copy of the questionnaire and attachments.

2The Lloyd’s broker(s) forwards a copy of the questionnaire and attachments to theunderwriter(s) granting the binding authority.

3If the coverholder has two or more binding authorities at Lloyd’s which have different
renewal dates they will provide their Lloyd’s broker(s) with an updated copy of thequestionnaire and attachments incorporating any changes. If there are no changes

y3952.doc

Lloyd’s is authorised under the Financial Services and Markets Act 2000

Page 1 of 2

MARKET BULLETIN

since it was originally completed they may confirm this in an email or by re-signing anddating the declaration at section 8.

This bulletin has the support of the LMA delegated underwriting committee and the LMBC
binders, offslips and lineslips team.

Monique AlderManager
Coverholders Department

y3952.doc

Page 2 of 2

Compliance questionnaire for
Lloyd’s approved coverholders
1

Throughout this document the term “you” or “your” means the Lloyd’s Approved Coverholder.

2

Please complete this questionnaire annually when requested and return to your Lloyd’s broker
who will forward the information to those Underwriting Members of Lloyd’s who underwrite yourbinding authority(ies) at Lloyd’s (“the Underwriters”).

3

Lloyd’s has designed this standard compliance questionnaire for completion by you so that you
may provide, in a single document, information required by the Underwriters to consider therenewal of your binding authority(ies) and to demonstrate that you continue to meet the criteria to
be a Lloyd’s approved coverholder. Its purpose is to eliminate the need for different
questionnaires from the Underwriters asking for the same core information.

4

You are reminded that you have an obligation to notify the Underwriters, your Lloyd’s broker andLloyd’s of any material changes to information contained within this questionnaire, being mattersof which the Underwriters, your Lloyd’s broker and Lloyd’s would reasonably expect notice. In
practice this should be achieved by advising your Lloyd’s broker who will communicate theinformation to the relevant parties.

5If you have two or more binding authorities at Lloyd’s which have different renewal dates, yourLloyd’s broker may ask you to update this questionnaire for each renewal but this can be achievedby an E-mail confirmation that there are no changes to the information previously provided or by
re-signing and dating the declaration in section 8.

Section 1 – Your Details
ACoverholder name:
Physical Address:
Postal Address:

Phone:
Fax:
Website:B

Name of contact person in event of an enquiry.

E-mail:Page 1 of 6

COMPLIANCE QUESTIONNAIRE FOR LLOYD’S APPROVED COVERHOLDERS

CPlease provide details of any change to your company name, trading name, legal status or businessaddress in the last twelve months.

DPlease provide details of any change in ownership in the last twelve months. If ownership has changed
this form should relate to the coverholder following that change.

EPlease provide details of any changes to your local regulated status during the last 12 months.

Section 2 – Details about your staff
Have there been any changes to persons authorised or responsible under the Binding Authority Agreement(s),other than those already reported to and agreed by Underwriters? It is a requirement of the Binding
Authority that all such changes must be prior agreed by Underwriters. Please provide a resume / CV for
Underwriters’ consideration of any new persons identified in items A through D below:
AThe person(s) responsible for overall operation and control of the Binding
Authority Agreement?

B

The person(s) authorized to bind insurances who is(are) named in the Schedule?

CD

Yes

No

Yes

No

The person(s) with overall responsibility for the issuance of documents
evidencing insurances bound who is(are) named in the Schedule?

Yes

No

The person(s) authorized to exercise any claims authority granted by theAgreement who is(are) named in the Schedule?

Yes

No

If yes, please provide details here and enclose a resume / CV.

Page 2 of 6

COMPLIANCE QUESTIONNAIRE FOR LLOYD’S APPROVED COVERHOLDERS

Section 3 – Your professional indemnity (PI) orerrors and omissions (E&O) insurance
Please enclose a copy of your current Professional Indemnity, E&O and (where relevant) Fidelity insurance
policy(ies) or declarations page(s) (this should include limit(s), deductible(s)/excess(es), insurer and period ofcover).
ADo your policies extend to acts of dishonesty of employees?

B

If not, do you purchase a separate Fidelity insurance policy?

CDo your policies cover all your activities on behalf of Lloyd’s underwriters?

DHave you had a claim under your E&O/Fidelity/Dishonesty policy(ies) in the last
12 months?

Yes

NoYes

NoYes

NoYes

NoIf ‘Yes’, please explain below.

Section 4 – Your banking arrangements
Your Binding Authority Agreement sets out the Underwriters’ requirements in respect of holding insurers’ monies,
in particular the requirement for insurers’ monies to be held in a separate bank account from your general oroperating account.
Please provide the following information
Bank:Bank address:

Account name:Account number:
Please confirm that you keep insurers’ monies in a separate account.

Yes

NoPage 3 of 6

COMPLIANCE QUESTIONNAIRE FOR LLOYD’S APPROVED COVERHOLDERS

Please confirm that insurers’ monies are held in a fiduciary capacity (i.e. in trust
on behalf of underwriters).

Yes

NoIf ‘No’, please explain below.

Section 5 – LicencesA

Do your company and staff hold all the licences you need to enter intocontracts of insurance on behalf of the Underwriters, act as an insuranceintermediary and act as a Lloyd’s coverholder?

B

Please supply copies of all relevant licences obtained or renewed in the last twelve months for both thecompany and members of staff.

CIn the last twelve months have you, your company or any member of yourstaff been fined, censured or subject to a formal enquiry by a regulatory body Yes(e.g, a State Insurance Department) or has any licence been suspended orterminated?

YesNoNoIf ‘Yes’, please explain below.

Section 6 – Reputation and standing
A

Have any of the company’s directors, officers, principals or partners been
charged with or convicted of a criminal offence other than a minor motoring
offence in the last twelve months?

Yes

No

If yes, please explain below.

Page 4 of 6

COMPLIANCE QUESTIONNAIRE FOR LLOYD’S APPROVED COVERHOLDERSB

Has your company been a party to any legal action, have any legal
Yes
proceedings been commenced to which your company is a party or are any
such actions pending in which your company has been named as a defendantin the last twelve months?

NoIf yes, please explain below.

CD

Have you or any of your company’s directors, officers, principals or partners or any organisations inwhich you or they have held a managerial position in the last twelve months:i

Been subject to any application for liquidations, receiverships,
bankruptcy or similar proceedings?

Yes

Noii

Been subject to an administrative order?

Yes

Noiii

Entered into or propose to enter into an agreement or assignment
with creditors or otherwise acknowledge insolvency?

YesNoYes

NoYes

No

Is any such matter pending in respect to Section 6C above?
If yes, please explain below.

EHave there been any other changes in your company or its circumstances
which may be relevant for the Underwriters and which they should be madeaware of?
If yes, please explain below.

Page 5 of 6

COMPLIANCE QUESTIONNAIRE FOR LLOYD’S APPROVED COVERHOLDERS

Section 7 – Checklist of additional documentation(Please tick if attached)
The completed questionnaire should have the following documents attached.
AA copy of your latest accounts and annual report.

B

A copy of your current Professional Indemnity or Errors and Omissions
insurance.

C

A copy of any applicable current Fidelity insurance.

The completed questionnaire must also have the following documents attached where additions orchanges have occurred in the last twelve months.
D

A copy of your new or renewed licences.

EResume / CV of any individual listed in Section 2.

F

If your company is one of a group of companies with common ownership(total or partial), a chart showing the relationship and ownership of allcompanies in the group.

Section 8 – DECLARATION
I / We hereby declare that the information given in this compliance questionnaire for binding authorities is trueand complete and agree to it being provided to the Underwriters.
I / We also undertake to immediately advise my/our Lloyd’s broker of any material changes to the enclosed
information per paragraph 4 on page 1. This undertaking is to be a continuous obligation.
I / We hereby declare to abide by all terms and conditions stated in all Binding Authority Agreement(s) issued
by Lloyd's Underwriters during their period of cover.
Authorised signatory
Signature

Name (in BLOCK CAPITALS):
Position in your company:

Date (day/month/year)://Page 6 of 6