The Oir B1 1560 form serves a critical role within the insurance sector, acting as an auditor's statement for property and casualty forms and rates, specifically within the realm of workers' compensation policies. This form is required by the Office of Insurance Regulation and is used to document the completion of a thorough review or audit of an insurance policy. This audit aims to confirm that the insurance carrier has charged the appropriate premium for the policy in question. The form necessitates the inclusion of detailed information such as the name of the insurance carrier, the individual or business conducting the audit if not an employee of the insurance company, the name of the insured party, policy number, and the policy period. By requiring an auditor’s printed name, title, signature, and a copy of proof of identification, the form ensures authenticity and accountability in the audit process. Its existence underscores the regulatory commitment to maintaining fairness and accuracy in the insurance industry's charging practices, safeguarding both the insurers and the insured against financial discrepancies.
| Question | Answer |
|---|---|
| Form Name | Form Oir B1 1560 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | oir-b1-1560, referenced, onsite, orir b1 1560 |
OFFICE OF INSURANCE REGULATION
Property & Casualty Forms and Rates
AUDITOR’S STATEMENT
Name of Insurance Carrier:
Name of Individual or Business Conducting the Audit:
(If other than an employee of the Insurance Company)
Name of Insured:
Policy Number: |
|
Policy Period From: |
|
to |
AUDITOR’S STATEMENT
I attest that I am authorized by the above named insurance carrier to examine the records of this insured, to perform a physical onsite inspection if necessary and to gather any and all other pertinent information to ensure that the appropriate premium is charged for the workers’ compensation policy referenced above.
Auditor’s Printed Name |
|
Title |
|
|
|
Signature (Attach copy of proof of identification) |
|
Date |
REV. 07/2003