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["Company/Syndicate"]
["Alien Number (AA)"]
["Questionnaire Contact"]
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["Question #1 - Operational Impact","Indicate the level of impact COVID-19 has had on operations. Briefly summarize the company/syndicate's ability to carry out its day-to-day operations with its policyholders, agents & brokers, third-party service providers, reinsurers, and other individuals/entities relied upon."]
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[null,"(Provide a detailed summary)"]
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[null,null," "]
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["Question #2 - Financial Market Impact","Indicate the level of impact the downturn of the financial markets has had on invested assets. Discuss the impact and any contingency plans to ensure that adequate liquidity is available to meet claims obligations."]
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[null,"(Provide a detailed summary)"]
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[null,null," "]
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["Question #3 - Policy Exposure","As of May 1, 2020, provide the percentage of total direct and assumed premiums written, on an aggregate basis, that are or have the potential to be subjected to claims payments due to COVID-19 exposures and provide a brief summary of the exposure."]
[null,"(Provide Percentage)"]
[null,"(Provide a detailed summary)"]
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["Question #4 - Claims Exposure","Explain any individual claims exposure or potential exposure that is greater than 10% of equity, include details regarding the dollar amount and percentage of exposure along with the line(s) of business and related programs exposed."]
[null,"(Provide a detailed summary)"]
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["Question #5 - Claims Exposure","As of May 1, 2020, provide the aggregate total number of claims and the dollar value of claims submitted due to COVID-19."]
[null,"(Provide a detailed summary)"]
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["Question #6 - Equity Impact","COMPANIES ONLY\nIf the company has experienced a 10% or greater decline in equity as of May 1, 2020, provide the percentage decline, a detailed summary of the why equity declined, and how it will be remediated along with the timeframe. Ref. NAIC International Insurers Department, Plan of Operation, Section IV. Ongoing Quarterly Listing Eligibility, A. Core Areas of Compliance, Decline in Equity."]
[null,"(Provide a detailed summary)"]
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["Question #7 - Domiciliary Survey","If your domiciliary regulator has asked you to complete a COVID-19 survey, please attach a copy to the email when responding with the completed survey form. If you are unable to provide a copy of the domiciliary survey, please provide an explanation below."]
[null,"(Provide a detailed summary)"]