DDF: West Virginia Surplus Lines Due Diligence Form

Form DDF PDF Details

If you answered “NO” to question number 3, complete question number 4 below.

Retained: the form must be retained in the office of the licensed surplus lines licensee and may be examined at any time by the Commissioner.

Producer: the WV licensed individual insurance producer who performed or supervised the diligent search certifies that this report is true and correct.

Notice to Insured: the insured is advised prior to the placement of the insurance that the surplus lines insurer is not an admitted authorized insurer in this State.

Insolvency notice: if the surplus lines insurer becomes insolvent, claims will not be paid nor will unearned premiums be returned by any West Virginia guaranty fund.