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INSTRUCTIONS: CONNECTICUT CERTIFICATE OF ASSUMING INSURER (Form AR-1)

When a Connecticut insurer assumes a policy from a ceding insurer, they should complete a form AR-1. This document can be obtained from the website maintained by the government of Connecticut.

Connecticut Certificate Of Assuming Insurer AR-1 Step 1: Enter the name of the senior officer completing this form on the first blank line.

Connecticut Certificate Of Assuming Insurer AR-1 Step 2: Enter the title of the senior officer completing this form on the second blank line.

Connecticut Certificate Of Assuming Insurer AR-1 Step 3: Enter the name of the assuming insurer on the third blank line.

Connecticut Certificate Of Assuming Insurer AR-1 Step 4: Enter the name of the assuming insurer on the fourth blank line.

Connecticut Certificate Of Assuming Insurer AR-1 Step 5: The first numbered paragraph states that the assuming insurer submits to the jurisdiction of any court of competent jurisdiction within Connecticut for adjudication of any any issues arising out of reinsurance agreements and agrees to comply with all of the court's requirements.

Connecticut Certificate Of Assuming Insurer AR-1 Step 6: The second numbered paragraph states that you designate the Insurance Commissioner of the state of Connecticut as your lawful attorney upon whom may be served any lawful process in any action, suit or proceeding arising out of the reinsurance agreement.

Connecticut Certificate Of Assuming Insurer AR-1 Step 7: The third numbered paragraph states that you submit to the authority of the Insurance Commissioner to examine your books and records. This paragraph also states you agree to bear the expense of any such examination.

Connecticut Certificate Of Assuming Insurer AR-1 Step 8: The fourth numbered paragraph states that along with this form you are submitting a current list of insurers in Connecticut reinsured by your company.

Connecticut Certificate Of Assuming Insurer AR-1 Step 9: Enter the date on the first blank line at the bottom of the page. 

Connecticut Certificate Of Assuming Insurer AR-1 Step 10: Enter the name of the assuming insurer on the next blank line.

Connecticut Certificate Of Assuming Insurer AR-1 Step 11: Enter the name of the officer completing this form on the next blank line.

Connecticut Certificate Of Assuming Insurer AR-1 Step 12: Enter the title of the officer completing this form on the last blank line.