Admission Surplus Requirements and Fees
Admissions Instructions
Missouri is a "Uniform State" and uses the UCAA application. You will also need to submit these additional Missouri-specific items:
- Appointment of Director to accept
service of process
.
- Either: Life, Accident and Health policy forms (completed in "John
Doe" manner),
or
All policy forms which your company proposes to use in the State of Missouri,
or
A sworn affidavit of the company's president or chief executive officer stating that- the company has not filed any policy forms with the application and
- it will not issue insurance policies or contracts in this state until it gets approved by Insurance of all policy forms
- Check our schedule for surplus requirements, deposits and fees. (Retaliatory Statement)
- Business Character Reports:
The NAIC Biographical Affidavit is accepted as a Business Character Report if an independent third party, in the business of providing background investigations and with no affiliation with the applicant or the subject of the investigation, certifies that the Biographical Affidavit has no inaccurate or conflicting information and no material omissions.
- Additional Requirement for the Department of Revenue
Check our Insurer FAQ page for details on changing your company's address, lines of authority or domestication state.
Please direct all applications and questions to:
Admissions Specialist
Division of Financial Regulation
Missouri Department of Insurance, Financial Institutions & Professional Registration
PO Box 690
Jefferson City, MO 65101
573 751-4362
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