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Begin with Part A: About You. Fill in your title, surname, first name(s), date of birth, driver number, address, telephone numbers, and email using BLOCK CAPITAL letters.
Move to Part B: About Your GP and Your Consultant. Enter your GP’s name and address, along with your consultant's details. Include their contact numbers and the dates you last saw them.
In Part C, provide information about any other clinics you are attending. List the clinic names, reasons for attendance, and relevant dates.
Proceed to the questionnaire section. Answer all questions regarding alcohol and drug use honestly. Provide specific dates where applicable.
Complete the Driver Declaration by signing and dating it to confirm that all information is accurate.
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Use this form to report these medical conditions: narcolepsy. cataplexy. sleepiness. obstructive sleep apnoea.
What is a D-2 form?
Every policy issued by a nonadmitted insurer and every certificate evidencing the placement of insurance must contain or have affixed on its front by the insurer or surplus line broker the D-2 disclosure statement, in 16-point bold type, which contains substantially the same wording as the D-1 statement above but does
What is a diligent search report?
The Diligent Search Report commonly known as the SL-2 form documents the brokers or agents effort to obtain coverage for a particular risk in the admitted market before placing the risk with a non-admitted insurer.
What is an SL-1 form?
The SL-1 form is a one-page form that identifies the broker who placed the risk, the insured covered by the policy, and the surplus line insurer or insurers who wrote the policy. The purpose of this guide is to deconstruct the SL-1 form in its parts and focus on what is required for each section.
What is an SL-2 form in insurance?
The SL-2 form gives information about the coverage being placed and also details your efforts to place the risk with an admitted (licensed) California insurer.
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