Insurance Verification Form

Insurance Verification Form Template for Nigeria

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Key Requirements PROMPT example:

"I need an Insurance Verification Form for a large construction project in Lagos, where we need to verify comprehensive contractor insurance coverage for the period January 2025 to December 2025, including liability coverage of at least 500 million Naira and workers' compensation coverage."

Document background

The Insurance Verification Form is a crucial document used in the Nigerian insurance market to confirm and validate insurance coverage details. This document becomes necessary when entities need to verify the existence, extent, and validity of insurance coverage for various business, regulatory, or operational purposes. The form, designed in accordance with Nigerian insurance regulations, particularly the Insurance Act 2003 and NAICOM guidelines, includes detailed sections for capturing policyholder information, coverage details, and verification requirements. It serves as an essential tool for risk management, compliance verification, and due diligence processes, enabling parties to confirm insurance status with confidence and legal backing. The document is particularly relevant in scenarios involving contracts, business transactions, regulatory submissions, or situations requiring proof of insurance coverage.

Suggested Sections

1. Requestor Information: Details of the party requesting insurance verification, including full name, contact information, and relationship to the insured

2. Insured Party Details: Complete information about the insured individual or entity, including full name, address, and relevant identification numbers

3. Insurance Policy Information: Essential details about the insurance policy including policy number, type of coverage, effective dates, and coverage limits

4. Insurance Provider Details: Information about the insurance company, including name, license number, and contact information

5. Declaration of Authority: Statement confirming the requestor's authority to seek verification and handle the provided information

6. Verification Purpose: Clear statement of the reason for requesting insurance verification

7. Authorization for Release: Formal authorization to release insurance information, including NDPR compliance statement

Optional Sections

1. Additional Insured Parties: Section for listing multiple insured parties under the same policy, used for group or corporate policies

2. Claims History Verification: Optional section for requesting claims history verification, used when claims history is relevant to the verification purpose

3. Premium Payment Status: Section for verifying premium payment status, included when payment verification is specifically required

4. International Coverage Details: Used when verification of international coverage components is needed

5. Agent/Broker Information: Section for intermediary details, included when insurance was arranged through an agent or broker

Suggested Schedules

1. Schedule A - Required Documentation Checklist: List of required supporting documents for verification process

2. Schedule B - Verification Response Form: Standardized form for insurance providers to complete verification details

3. Schedule C - Privacy Notice: Detailed privacy notice in compliance with NDPR requirements

4. Appendix 1 - Acceptable Identification Documents: List of acceptable forms of identification for verification purposes

5. Appendix 2 - Terms and Conditions: Standard terms and conditions governing the verification process

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok��˰� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

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Healthcare

Real Estate

Construction

Transportation

Manufacturing

Financial Services

Education

Retail

Energy

Agriculture

Professional Services

Telecommunications

Hospitality

Relevant Teams

Legal

Risk Management

Compliance

Operations

Human Resources

Finance

Procurement

Facilities Management

Safety and Security

Project Management

Insurance Administration

Contract Management

Relevant Roles

Risk Manager

Compliance Officer

Insurance Coordinator

Legal Counsel

Operations Manager

Procurement Manager

Contract Administrator

Human Resources Manager

Facility Manager

Safety Officer

Claims Administrator

Project Manager

Finance Manager

Business Development Manager

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Authors

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