Ill. Admin. Code tit. 50, pt. 3801, ILLUSTRATION B

Current through Register Vol. 49, No. 2, January 10, 2025
Statement of the Company Officer

The following illustrates an acceptable statement to be filed when the opining actuary or pre-approved individual has indicated reliance on data provided by company personnel:

I [name of officer], [title], of [name of carrier], hereby affirm that the listings (summaries, rate manuals, etc.) of relevant data prepared for and submitted to [name of appointed actuary] were prepared under my direction and, to the best of my knowledge and belief, are substantially accurate and complete.

_________________________________

Name of Officer of the Carrier (typewritten)

_________________________________

Signature of Officer of the Carrier

_________________________________

Date

Ill. Admin. Code tit. 50, pt. 3801, ILLUSTRATION B

Recodified from ILLUSTRATION B at 40 Ill. Reg. 16164.