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Arkansas Claim Office / Administrator / Underwriter Designation Form

State:
Arkansas
Control #:
AR-00O-WC
Format:
PDF
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Description

Claim Office / Administrator / Underwriter Designation Form The Arkansas Claim Office/Administrator/Underwriter Designation Form is a document used by insurance companies to designate a person or entity as the responsible party for handling and processing claims in the state of Arkansas. This form is required by the Arkansas Insurance Department and must be completed and submitted for approval before a person or entity can handle insurance claims in the state. There are two types of Arkansas Claim Office/Administrator/Underwriter Designation Forms: one for claim office designations and one for administrator/underwriter designations. The claim office designation form requires information about the business, including its name, address, contact information, and the names of its officers and directors. The administrator/underwriter designation form requires similar information, as well as additional information such as the type of business entity, the name of the administrative/underwriting contact, and the name of the designated agent. Both forms must be completed and signed by an authorized agent of the insurance company.

The Arkansas Claim Office/Administrator/Underwriter Designation Form is a document used by insurance companies to designate a person or entity as the responsible party for handling and processing claims in the state of Arkansas. This form is required by the Arkansas Insurance Department and must be completed and submitted for approval before a person or entity can handle insurance claims in the state. There are two types of Arkansas Claim Office/Administrator/Underwriter Designation Forms: one for claim office designations and one for administrator/underwriter designations. The claim office designation form requires information about the business, including its name, address, contact information, and the names of its officers and directors. The administrator/underwriter designation form requires similar information, as well as additional information such as the type of business entity, the name of the administrative/underwriting contact, and the name of the designated agent. Both forms must be completed and signed by an authorized agent of the insurance company.

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Arkansas Claim Office / Administrator / Underwriter Designation Form