The New Hampshire Insurance Department has standardized the Consent to Rate & Individual Risk filing forms.

For all fire and certain casualty lines, both personal and commercial (classes of insurance which may be written under RSA 401:I, II, V, VI & VII) whenever a rate or form is used that is not on file with the New Hampshire Insurance Department, the insurer must complete and submit either:

• Consent to Rate Form – RSA 412:16 X
• Individual Risk Form – RSA 412:5

These forms must be signed by the policyholder.

This information must be provided by electronically submitting a confidential SERFF Filing. To speed handling, the filing should be noted as being submitted as an individual risk filing.

 Adobe Acrobat Reader format. You can download a free reader from Adobe.