Form FIS0255 Report of Insurance Purchased From an Unauthorized Insurer - Michigan

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Form FIS0255 Report of Insurance Purchased From an Unauthorized Insurer - Michigan

What Is Form FIS0255?

This is a legal form that was released by the Michigan Department of Insurance and Financial Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form FIS0255?
A: Form FIS0255 is a report of insurance purchased from an unauthorized insurer in the state of Michigan.

Q: Who needs to file Form FIS0255?
A: Any person or entity that has purchased insurance from an unauthorized insurer in Michigan needs to file Form FIS0255.

Q: What is an unauthorized insurer?
A: An unauthorized insurer is an insurance company that is not licensed or approved by the state of Michigan to provide insurance coverage.

Q: What information is required on Form FIS0255?
A: Form FIS0255 requires the policyholder to provide information about the insurance policy, including the name of the unauthorized insurer, the policy number, and the amount of coverage.

Q: When is Form FIS0255 due?
A: Form FIS0255 is due within 30 days of the effective date of the insurance policy.

Q: What are the consequences of not filing Form FIS0255?
A: Failure to file Form FIS0255 may result in penalties or other enforcement actions by the state of Michigan.

Q: Do I need to file Form FIS0255 every year?
A: Form FIS0255 must be filed for each insurance policy purchased from an unauthorized insurer, but it does not need to be filed annually if the policy remains in effect.

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Form Details:

  • Released on June 1, 2014;
  • The latest edition provided by the Michigan Department of Insurance and Financial Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form FIS0255 by clicking the link below or browse more documents and templates provided by the Michigan Department of Insurance and Financial Services.

Download Form FIS0255 Report of Insurance Purchased From an Unauthorized Insurer - Michigan

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  • Form FIS0255 Report of Insurance Purchased From an Unauthorized Insurer - Michigan, Page 1
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