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REQUEST CERTIFICATE OF INSURANCE
PLEASE NOTE: You are requesting a certificate of insurance from Standard Insurance, located in Rocky Mount, North Carolina
Any person who, with the intent to defraud or deceive, submits an application or files a statement of claim containing any false, incomplete or misleading information, or helps in any manner to commit a fraud against an insurer, may be subject to civil penalties and criminal prosecution for insurance fraud.
(Established August 1, 2001. No recent updates.)
PURPOSE OF THIS NOTICE
Title V of the Gramm-Leach-Bliley Act (GLBA) and the laws of the State of North Carolina, generally prohibit us from sharing nonpublic personal information about you with a third party unless we provide you with this notice of our privacy policies and practices describing the type of information we collect about you and the categories of persons or entities to whom that information may be disclosed. In compliance with the GLBA and the laws of this state, we are providing you with this document, which notifies you of the privacy policies and practices of Standard Insurance & Realty.
The laws of this state further require that we inform you that we may not share your personal information with a non-affiliated third party for any purpose that is not specifically authorized by law unless we obtain your affirmative permission.
OUR PRIVACY POLICIES AND PRACTICES
Information We Collect and Maintain:
We collect nonpublic personal information about you from the following sources:
Information we receive from you on applications, other forms, at your request and otherwise.
Information about your transactions with us, our affiliates or others.
Information we receive from consumer-reporting agencies.
Information we receive from medical records or medical professionals.
Information from Credit Reports or Investigative Consumer Reports:
If you authorize us to do so, we may obtain information about you from credit reports or other investigative consumer reports prepared by third parties at our request. If you authorize us to request such information and we do request such information, you should be aware that:
You have the right to be requested to be interviewed in connection with the preparation of such a report.
Upon request, you are entitled to receive a copy of the report.
The information obtained from the report prepared by the third party may be retained by the third party and disclosed to other persons.
Information We May Disclose to Third Parties:
In the course of our general business practices, we may disclose the information we collect (as described above) about you or others without your permission to the following types of institutions for the reasons described:
To a third party if the disclosure will enable that party to perform a business, professional, or insurance function for us.
To an insurance institution, agent or credit reporting agency in order to detect or prevent criminal activity, fraud or misrepresentation in connection with an insurance transaction.
To an insurance institution, agent or credit reporting agency for either this agency or the entity to which we disclose the information to perform a function in with an insurance transaction involving you.connection
To a medical care institution or medical professional in order to verify coverage or benefits, inform you of a medical problem of which you may not be aware, or conduct an audit that would enable us to verify treatment.
To an insurance regulatory authority, law enforcement or other governmental authority in order to protect our interests in preventing or prosecuting fraud, or if we believe that you have conducted illegal activities.
To a group policyholder for the purpose of reporting claims experience or conducting an audit of our operations or services.
To an actuarial or research organization for the purpose of conducting actuarial or research studies.
Your Right to Access and Amend your Personal Information:
You have the right to request access to your personal information that we record about you. Your right includes the right to know the source of the information and the identity of the persons, institutions or types of institutions to whom we have disclosed such information within two (2) years prior to your request. To obtain access to your information you should submit a request in writing to: J. Buckley Strandberg, President, Standard Insurance & Realty, PO Box 8105, Rocky Mount, NC 27804-1105. The request should include your name, address, social security number, telephone number, and the recorded information to which you would like access. To correct, amend or delete any of your information you should submit a request in writing to: J. Buckley Strandberg, President, Standard Insurance & Realty, PO Box 8105, Rocky Mount, NC 27804-1105. The request should include your name, address, social security number, telephone number, the specific information in dispute, and the identity of the document or record that contains the disputed information.
How We Protect Information:
We restrict access to nonpublic information about you to those employees who need to know information in order to provide products or services to you. We maintain physical, electronic, and organizational safeguards to protect information about you.