50 Ill. Adm. Code 1104.APPENDIX
A Form AR–1 Certificate of Assuming Insurer
Section 1104
Section 1104.APPENDIX A Form
AR–1 Certificate of Assuming Insurer
FORM
AR
-
1
CERTIFICATE
OF ASSUMING INSURER
I,
,
(name
of officer)
(title
of officer)
of
,
the assuming insurer under a
(name of
assuming insurer)
reinsurance agreement(s) with
one or more insurers domiciled in Illinois, hereby certify
that
("Assuming
Insurer"):
(name of
assuming insurer)
1. Submits to the jurisdiction of any court of competent
jurisdiction in Illinois for the adjudication of any issues arising out of the
reinsurance agreement(s), agrees to comply with all requirements necessary to
give such court jurisdiction, and will abide by 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(s) to arbitrate their disputes if such an obligation is
created in the agreement(s).
2. Designates the Director of the Department of Insurance as its
lawful attorney upon whom may be served any lawful process in any action, suit
or proceeding arising out of the reinsurance agreement(s) instituted by or on
behalf of the ceding insurer.
3. Submits to the authority of the Director of the Department of
Insurance to examine its books and records and agrees to bear the expense of
any such examination.
4. Submits with this form a current list of insurers domiciled in
Illinois reinsured by Assuming Insurer and undertakes to submit additions to or
deletions from the list to the Director at least once per calendar quarter.
Date:
(name of assuming insurer)
BY:
(name of officer)
(title of officer)