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Diligent effort form 2026

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  1. Click ‘Get Form’ to open the diligent effort form in the editor.
  2. Begin by entering the insured's name and mailing address in the designated fields. Ensure accuracy as this information is crucial for processing.
  3. Fill in the details of the surplus lines insurer, including their name and NAIC number. This identifies the insurance provider involved.
  4. In the 'Reason for Declining' section, provide a clear explanation for why coverage could not be secured from licensed insurers.
  5. Complete the policy term information, including effective date and expiration date, using MM/DD/YYYY format for clarity.
  6. Sign and date the form where indicated. Ensure that your signature is legible and matches your printed name.

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Related links

31 Pa. Code 124.5 - Diligent search of admitted insurers

A diligent search is made among the admitted insurers who are writing, in this Commonwealth, coverage comparable to the coverage being sought.Read more

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