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REGISTRATION FORM PART 1 - FRO- 01

The following details are required to begin the on-boarding registration process. 1. Details of the Company

Note: This contact information will be used throughout the on-boarding and testing phases and when the scheme is live unless we are notified of any changes

Insurer / company name Please confirm your regulator PRA/FCA/FSMA number FRN for EEA insurers Registered address

Main operational address

Note: If multiple locations, state which address you want to have stored on our systems

Main telephone number (including country code)

Main contact within your organisation for

Flood Re purposes Name:

Role:

Telephone number (including country code): Email address:

Authorised Signatory

Note: this is the person who will sign legal documentation and forms for your organisation

Name: Role:

Please confirm a group email address for contact by the Flood Re team?

Note: this is required as this is the email address Flood Re will use to inform you of rejected bordereaux errors

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1. Details of the Company (continued)

Note: This contact information will be used throughout the on-boarding and testing phases and when the scheme is live unless we are notified of any changes

Underwriting contact Name:

Role:

Telephone number (including country code): Email address:

Claims contact Name:

Role:

Telephone number (including country code): Email address:

Finance contact Name:

Role:

Telephone number (including country code): Email address:

IT contact

Note: this contact will also be used as the main out of hours contact

Name: Role:

Telephone number (including country code): Email address:

Test Lead

Note: this contact will be sent the Test Pack

Name: Role:

Telephone number (including country code): Email address:

Other – please provide any additional

contacts Name:

Role:

Telephone number (including country code): Email address:

Name: Role:

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Telephone number (including country code): Email address:

2. About your organisation

Please indicate if you are Part A

• UK regulated Insurer • Lloyd’s Managing Agent

• EEA Domiciled Insurer with permission to passport into UK

Part B

• Fully delegated authority including MGAs with full delegated authority

Part C

• Software house

• Insurance Intermediaries (without full delegated authority)

• Other (please specify)

Are you intending to pass property data to a third party or are you intending to rely on a third party data supplier to provide Flood Re property data to you?

Note: this may include Key Service Providers all of whom may be required to on-board with Flood Re. This will be confirmed following assessment of your Registration Form.

If yes, please list all the

organisations that apply (include additional list if necessary)

Yes/No No

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Are you intending to transfer or store data outside of the EEA? If yes, please list all countries

Yes/No

If you have selected an organisation in Section 2 Part A, please answer the following:

Note: a letter of confirmation for each fully delegated authority will be required in due course

Do you intend to use an insurance intermediary or MGA which has fully delegated authority (ie an entity that handles both claims and underwriting activity) to cede business to Flood Re on your behalf?

If the answer to this is ‘Yes’ please attach a list of all the organisations that apply including the relevant FCA/FSMA number

Please note that fully delegated authorities will also have to register and on-board separately with Flood Re

Yes/No

Ceding Risks

Note: If you are an organisation in Section 2 Part C you will not be able to cede risks to Flood Re

Are you planning to cede risks at go-live? If no, are you planning to cede risks in future? If yes, what date do you plan to commence?

Yes/No Yes/No MM/YY

3. Membership

Relevant insurers can choose to be ordinary members of Flood Re Limited, the Company. As ordinary members, relevant insurers will enjoy certain voting rights (based on their gross written premium); potential refunds of Levy 2 contributions subject to conditions in the legislation and the Members’ Agreement.

If you are a UK regulated insurer and/or an insurer with permission to passport into the UK and/or Lloyd’s Managing Agent, please indicate if you wish to become a member of Flood Re Limited? Yes No

No No No No

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4. Testing

Please indicate preferred testing period

Note: you will only be able to cede business once testing is completed

Oct-Dec 2015 Jan-Mar 2016 Apr- June 2016 July- Sept 2016 Oct-Dec 2016

5. Up-front Property Data

As part of the on-boarding process, a one-off bulk matching facility is available. This will enable you to populate systems with the Flood Re Identification (FRid) reference, the unique property data matching code, which will facilitate future address matching and bordereaux processing. If you would like to take advantage of this please complete the table below.

On-boarding up front data matching required Yes / No

Size /number of policies

Note: Flood Re can carry out limited upfront FRid data matching on high flood risk properties only. The FRid service will therefore only be available for the policies you are likely to cede the flood risk element of to Flood Re and not for your whole book. We will get in touch with your nominated main contact on receipt of this form to confirm requirements and agree timelines.

Return to [email protected] or by post, to the following address, as soon as possible: Private & Confidential

Flood Re Service Desk Flood Re Limited 6th Floor

65 Gresham Street London

EC2V 7NQ

FOR OFFICIAL FLOOD RE USE ONLY Participant ID Reference

References

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