Surplus Lines Disclosure

Effective January 1, 2022, most coverages now require a disclosure statement to be signed or acknowledged by the insured. Wet marine, transportation, and aviation risks that fall under F.S. 626.917 are the only exceptions to the new law.

You are agreeing to place coverage in the surplus lines market. Coverage may be available in the admitted market. Persons insured by surplus lines carriers are not protected under the Florida Insurance Guaranty Act with respect to any right of recovery for the obligation of an insolvent unlicensed insurer. Additionally, surplus lines insurers' policy rates and forms are not approved by any Florida regulatory agency.

This form is designed to provide guidance based on the statutory requirements for such form and it has not been approved by the Florida Department of Financial Services.


Download Surplus Lines Disclosure Form