Form P-LSBD: Life Settlement Broker: Disclosures to Owner and Provider

This document has been approved by the Department of Insurance and it does not need to be filed with the Department. A broker may use this form to provide the owner and provider with disclosures that are required by ARS § 20-3204(C). A broker who intends to use a different form must submit the form for approval using the NAIC System for Rate and Form Filings ("SERFF"), accessible at http://www.serff.org.

Warning - Phishing Scam

We are aware of a phishing scam targeting insurance professionals claiming that the National Association of Insurance Commissioners received a complaint that the professional submitted a falsified claim. This fraudulent email displays the NAIC and CIPR logos, can originate from what appears to be an naic.org or gmail.com email account, and instructs the recipient to click on a link to download the complaint notification.

Certain antivirus products will detect this as a malicious email.  If you receive a similar email and have any concerns, contact the NAIC Service Desk at (816) 783-8500 or [email protected].