Captive Reinsurance

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Captive Reinsurance

Multi-State Captive Reinsurance Settlement
Chicago Title Insurance Company, Fidelity National Title Insurance Company, Fidelity National Title Insurance Company of New York, Security Union Title Insurance Company and Ticor Title Insurance Company have entered into an agreement with the Insurance Commissioner of each of the states identified below to issue refunds to consumers who purchased property in that state for which a portion of the consumer paid title insurance premium was paid to a reinsurer in certain reinsurance arrangements. To determine whether you are eligible for a refund under the Multi-State Captive Reinsurance Settlement please review the following:

The list below is not complete. Please check back if your state is not listed.
PARTICIPATING STATES: Arizona California Colorado DC Florida Kansas Kentucky Louisiana Maine Missouri Nebraska New Hampshire North Carolina North Dakota Ohio Rhode Island Tennessee Utah West Virginia

Although providing the following information through the online form below is the most efficient way we can process your inquiry, we are also available to collect your data by phone .

Online:	Please provide the information requested below to help us most efficiently process your inquiry.
By Phone:	(800) 694-9787
	9 am to 5 pm CST
By Fax:	Print Form
	Send completed form to (800) 688-1885

Disclaimer: This site is not designed for the transmission of highly confidential customer, non-public personal information, and should therefore not be used to enter or transmit data such as customer Social Security Numbers or Driver's License Numbers.

MULTI-STATE CAPTIVE REINSURANCE SETTLEMENT FORM

	* Bold fields are required
	First Name:
	Last Name:
	Contact Phone:	Format: ###-###-####
	Email Address:
	Mortgage Lender:
	Builder:
	Insurance Underwriter:
	Insurance Agency:
	Amount of Premium:
	Were you the:	Buyer Seller
	Purchase Date:	(mm/dd/yyyy)
INSURED PROPERTY INFORMATION
	Insured Property Address:
	(if applicable)
	Insured Property City:
	Insured Property State:
	Insured Property Zip:
	Insured Property County:
MAILING ADDRESS
	Same as above	(Fields below are required if unchecked)

	Address:
	(if applicable)
	City:
	State:
	Zip:

QUESTIONS & COMMENTS

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