Wisconsin Administrative Code › Office of the Commissioner of Insurance › Appendix B - FORM CR-1

Current through June 24, 2024
CERTIFICATE OF CERTIFIED REINSURER
I, _____________________________________________,
(name of officer)
____________________________________________________
(title of officer)
of
			 _________________________________________________________________________,
(name of assuming insurer)
the assuming insurer under a reinsurance agreement with one or
			 more insurers domiciled in _____________________________________,
(name of state)
in order to be considered for approval in this state, hereby
			 certify that
			 ______________________________________________________________(Assuming
			 Insurer):
(name of assuming insurer)
1. Submits to the jurisdiction of any court of competent
			 jurisdiction in ______________________________________
(ceding insurer's state of domicile)
for the adjudication of any issues arising out of the reinsurance
			 agreement, agrees to comply with all requirements necessary to give such court
			 jurisdiction, and will abide by the final decision of such court or any
			 appellate court in the event of an appeal. Nothing in this paragraph
			 constitutes or should be understood to constitute a waiver of Assuming
			 Insurer's rights to commence an action in any court of competent jurisdiction
			 in the United States, to remove an action to a United States District Court, or
			 to seek a transfer of a case to another court as permitted by the laws of the
			 United States or of any state in the United States. This paragraph is not
			 intended to conflict with or override the obligation of the parties to the
			 reinsurance agreement to arbitrate their disputes if such an obligation is
			 created in the agreement.
2. Designates the Insurance Commissioner of
			 _______________________________________________________
(ceding insurer's state of domicile)
as its lawful attorney upon whom may be served any lawful process
			 in any action, suit or proceeding arising out of the reinsurance agreement
			 instituted by or on behalf of the ceding insurer.
3. Agrees to provide security in an amount equal to 100% of
			 liabilities attributable to U.S. ceding insurers if it resists enforcement of a
			 final U.S. judgment or properly enforceable arbitration award.
4. Agrees to provide notification within 10 days of any
			 regulatory actions taken against it, any change in the provisions of its
			 domiciliary license or any change in its rating by an approved rating agency,
			 including a statement describing such changes and the reasons therefore.
5. Agrees to annually file information comparable to relevant
			 provisions of the NAIC financial statement for use by insurance markets in
			 accordance with section
			 Ins
			 52.02(4m) (a) 5.
6. Agrees to annually file the report of the independent auditor
			 on the financial statements of the insurance enterprise.
7. Agrees to annually file audited financial statements,
			 regulatory filings, and actuarial opinion in accordance with section
			 Ins
			 52.02(4m) (a) 5.
8. Agrees to annually file an updated list of all disputed and
			 overdue reinsurance claims regarding reinsurance assumed from U.S. domestic
			 ceding insurers.
9. Is in good standing as an insurer or reinsurer with the
			 supervisor of its domiciliary jurisdiction.
Dated: ______________________
			 _________________________________
(name of assuming insurer)
BY: __________________________________
(name of officer)
___________________________________
(title of officer)