Viatical Settlement Provider License Instructions

 

Effective March 12, 2020, all Viatical Settlement Provider license applications, notice of change of ownership, and/or change of officer or directors and Annual Reports must be submitted electronically to LHinbox@ncdoi.gov or Citrix Sharefile, or other secure electronic filing method, NO ZIP FILES. Payment of filing fees must be done separately via USPS or overnight at addresses shown below. Please include a copy of the cover letter, with the check, in order that payment may be attributed accurately.  Paper filings or notifications will not be accepted for the immediate future.

Viatical Provider License Requirements

Initial License

Initial License

Renewal License

Renewal License

The following documents are required only if there have been any changes during the past year.

Other General Information or Requirements

Other General Information or Requirements

  • Refer to the Transmittal document for a list of all supporting documentation required to
    be submitted electoronically, with a license application. A renewal license only requires supporting documentation that has changed throughout the year.
  • A $500 filing fee is required with both an initial application and a renewal application for viatical settlement provider license.
  • The NC Department of Insurance uses Citrix ShareFile a secure filing method for electronic filing of files and documents. Files can also
    be sent electronically to the Life and Health Inbox at LHinbox@ncdoi.gov
  • The filing fee must be sent to the following:  

Mailing Address:

Regular UPS Mail:
Life & Health Division
1201 Mail Service Center
Raleigh, NC 27699-1201
 
Overnight Mail Address (ONLY):
Life & Health Division
325 N. Salisbury Street
Raleigh, NC 27603
Viatical Settlement Contract Forms

Viatical Settlement Contract Forms

NCGS 58-58-220 requires the contract and disclosure statement provided to the viator be filed and approved by the Commissioner, prior to use.  

These forms may be sent to Citrix ShareFile or LHinbox@ncdoi.gov. Once approved we use the National Association of Insurance Commissioner's (NAIC) Search Electronic Rate & Form Filing (SERFF) for archive purposes. SERFF can be accessed through our Life and Health Public Search Portal. 

Life and Health Public Search Portal.

This Public Search Portal will be available after 11/03/2020

Should the approved forms be revised at anytime, the revised forms must be filed an approved prior to use.