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The DL 11Cd form, implemented by the North Carolina Division of Motor Vehicles, serves crucial functions related to automobile liability insurance requirements in the state. This form is essential for licensed insurance companies operating within North Carolina, as it outlines their obligations for reporting and record-keeping. Primarily, the DL 11Cd form encapsulates necessary information for two key types of insurance filings: the FS-1 and FS-4 forms. FS-1 acts as a certificate of insurance, proving the existence of active liability coverage, while FS-4 is employed to notify the DMV of policy terminations or changes. The form mandates detailed reporting specifications, including contact information, insurance company codes, and transmission methods, to ensure compliance with state guidelines. Moreover, it emphasizes the importance of electronic notification for insurers that collect significant annual premiums, streamlining communications between the insurance providers and the DMV. Understanding the nuances of the DL 11Cd form is vital for maintaining accurate records and ensuring the smooth operation of insurance coverage verification within North Carolina.

Dl 11Cd Example

STATE OF NORTH CAROLINA

DEPARTMENT OF TRANSPORTATION

BEVERLY EAVES PERDUE

GOVERNOR

DIVISION OF MOTOR VEHICLES

April 2011

EUGENE A. CONTI, JR.

SECRETARY

TO:

NC LICENSED INSURANCE COMPANIES

FROM:

Kathy Brannan, Manager

 

Liability Insurance Unit

RE:

North Carolina Filing Requirements regarding FS-1’s and FS-4’s Forms

The Department of Insurance has informed NCDOT of your authority to write automobile liability insurance coverage in the State of North Carolina. The Department of Transportation, Division of Motor Vehicles implemented a new computer system on August 2, 1999. This system is called LITES (Liability Insurance Tracking & Enforcement System). In an effort to assist you, the attached information has been designed to indicate our reporting specifications. Amendment to General Statute 20-309 requires notification to the Division on new policies written. The amendment also requires electronic notification if your company has $25,000,000 or more in annual vehicle insurance premium.

The individual declared as the liaison between the insurance companies and the Division of Motor Vehicles will need to complete our contact sheet (page 2) and return. Upon request, a hard copy of General Statutes, policy and procedure implementations will be forwarded to the designated contact person in your corporate, district or regional office. An e-mail address incorporates an additional way to receive Rejection/Random Sampling Reports other than by mail. Group name, if applicable, should be shown as the parent name of all associated companies authorized to write North Carolina automobile liability coverage. If you are not currently writing automobile liability coverage in our State, we would appreciate a response back. Upon your response, our records will be updated accordingly. Should you need further information, refer to the chart on Page 2.

*

DOT Contacts

Page 2

*

Company contact information to be returned to NCDMV, if applicable

Page 2

*

Regulations for filing Forms FS-4 and FS-1 in the State of North Carolina

Pages 3 - 4

*

Media / Field Requirements for Forms FS-4 and FS-1, All Media

Pages 4 - 7

*

File Layouts of Forms FS-4 and FS-1, All Media

Pages 7 - 9

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

SUBJECT

CONTACT

CONTACT INFORMATION

EDI/GXS

LITES Project Team

E-Mail:

litesprojectteam@ncdot.gov

Connect:Direct

 

 

 

FTP with SSL

 

 

 

RACF ID and ITS Billing Code

Traffic Records

Phone:

(919) 861-3062

STARS Inquiry

 

Fax:

(919) 715-9099

NC Filing Requirements

Liability Insurance Unit

Phone:

(919) 861-3832

Electronic & Tape Transfer

 

Fax:

(919) 861-3617

Test Planning

 

E-Mail:

insuranceinfo@ncdot.gov

*************************************************************************************

If you are responding for more than one parent insurance company, please list all of the North Carolina companies you represent, including the unique three (3) digit insurance company code. Also, in order to reduce the volume of future communications, advise the Division if a company is NOT currently writing automobile liability insurance policies in North Carolina. Provide this information in the table provided below. You may fax this sheet or send via e-mail to the Liability Insurance Unit as referenced in the contact information above.

Date:

_________________________________________________________________

Contact Name/Title:

_________________________________________________________________

Contact Telephone:

(______________) _________________________________________________

Contact Fax:

(______________) _________________________________________________

Contact Email:

_________________________________________________________________

Contact Address:

_________________________________________________________________

 

_________________________________________________________________

Insurance Group:

_________________________________________________________________

(if applicable)

 

Insurance Company & Assigned Company Code Used on FS-1 and FS-4 Forms

Writes in

NC

(Yes/No)

If yes, your transmission will be: (Paper, Tape, or Electronic)

If yes, your transmission will occur: (Daily, Weekly, Monthly, etc.)

2

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

FORMS FS-4 and FS-1: Regulations for Filing

I.Liability Insurance Certification

A.If the financial responsibility for a vehicle is a liability insurance policy, the owner of the vehicle

must certify to the existence of the policy and furnish sufficient information on forms provided by the Division of Motor Vehicles to enable verification of the policy‟s existence.

B.Certification shall be made at original registration and at such times as a motor vehicle registration transaction is made between the owner and the Division of Motor Vehicles.

II.Termination Notices

A.North Carolina Notice of Termination Form FS-4 shall be used to notify the Commissioner of the Division of Motor Vehicles of termination of motor vehicle liability insurance. The form shall be supplied by the insurer and must include the items in Section C below. A notice of termination for a policy covering multiple listed vehicles also requires a Form FS-4. For data transmitted by tape or electronically, a separate record for each vehicle is required; for paper submissions, please refer to page 4.

B.Insurers shall also notify the Commissioner of the North Carolina Division of Motor Vehicles immediately upon effective date of cancellation or deletion of a motor vehicle from a motor vehicle liability insurance policy. Notification to the Commissioner is NOT necessary if a vehicle is deleted from a policy and replaced with another vehicle or is insured under a fleet policy by the same insurer. A fleet policy is defined, as a policy with five or more vehicles not listed individually by year, make, model or identification number.

C.The North Carolina Notice of Termination Form FS-4 has been approved by the Commissioner of the North Carolina Division of Motor Vehicles. The form shall contain the following fields.

Name and address of the registered owner Name of insurance company and code number

Date of birth of registered owner, if available (non-fleet policies) Drivers license number of registered owner, if available

Year, make, and identification number of vehicle Termination date

Effective date of policy Date prepared

Signature of facsimile signature of authorized representative of insurance company (may be pre-printed or stamped)

III.Reinstatement and Renewal Notices

A.If a termination of liability insurance (FS-4) was issued to the North Carolina Division of Motor Vehicles and the insured was subsequently reinstated or renewed, the insurer must inform the Division with an FS-1, certificate of insurance, provided such reinstatement or renewal has occurred without any lapse in coverage.

B.FS-1‟s shall be issued upon request from the insured, request from the Division of Motor Vehicles or to reinstate with no lapse in coverage.

C.When an insurance company terminates a policy and issues another policy, without a lapse, no FS-4 is necessary. The insurance company shall issue an FS-1 showing continuous coverage. Continuous coverage for a policy covering multiple listed vehicles also requires a Form FS-1. For data transmitted by tape or electronically, a separate record for each vehicle is required, for paper submissions, please refer to page 4.

3

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

D.The certificate of insurance shall be on a form approved by the Commissioner of the North Carolina Division of Motor Vehicles. The form shall be designated an FS-1 and shall reflect the following:

Name and address of the registered owner

Name of the insurance company and code number

Date of birth of registered owner, if available (non-fleet policies) Drivers license number of registered owner, if available

Year, make, and identification number of vehicle Effective date of policy

Date prepared

Signature of facsimile signature of authorized representative of insurance company (may be pre-printed or stamped)

IV. Authorization

A.An agent representing an insurance company may issue the FS-4 or FS-1 if authorized to do so by the company.

FORMS FS-4 and FS-1: Media / Field Requirements (Paper)

Media Requirements for Paper Forms

Paper forms will no longer be scanned with the AEG PFL 6150 Form Reader. Please disregard previous requirements regarding paper, opacity, mechanical properties, paper edges, cut size and ink. Paper forms are to

conform to the design for Forms FS-4 and FS-1 included in this packet (page 8), including the size requirement of 7”w x 4 ¼”h per form. Certain items of text that appeared on the previous forms have been eliminated from the

new layout this text may be included at your discretion but must not affect the 7 x 4 ¼ size requirement. The new forms have been designed so that 2 forms will fit on one 8 ½”w x 11”h sheet of paper for the purpose of faxing.

Any forms not computer-generated must be typed.

See the end of the document for an example of each form.

Field Requirements for Paper Forms

1.Vehicle Year:

a.For both personal and business operating a single vehicle: Enter 4 digit year of manufacture (yyyy).

b.For business operating a schedule of vehicles: Leave blank and enter each vehicle year separately on an attached schedule, along with the corresponding VIN and vehicle make.

c.For dealership, transporter, or drive-away: Leave blank.

2.Vehicle Make:

a.For both personal and business operating a single vehicle: Enter first 4 letters of vehicle make (Ex.

“Chev”, “Buic”).

b.For business operating a schedule of vehicles: Leave blank and enter each vehicle year separately on an attached schedule, along with the corresponding VIN and vehicle year.

c.For dealership, transporter, or drive-away: Leave blank.

3.Vehicle Identification Number (VIN):

a.For both personal and business operating a single vehicle: Enter vehicle identification number obtained from vehicle registration card or from dashboard of vehicle.

b.For business operating a schedule of vehicles: Enter „See Attached Schedule‟ and enter each VIN separately on the attached schedule.

c.For dealership, transporter, or drive-away: Enter „Garage Liability Policy‟.

4

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

4.

Insurance Company Name:

Enter company name.

5.

Insurance Company Code:

Enter code assigned at the time company is licensed in state.

6.

Policy Number:

Enter policy number.

7.

Registered Owner (optional):

Personal: Enter first, middle, and last name along with any

 

 

suffix in the appropriate fields.

 

 

Business: Enter name of business.

8.

Drivers License Number (optional):

Personal: Enter drivers license of registered owner of vehicle.

 

 

Business: Enter customer ID assigned to business at time of

 

 

N.C. registration.

9.

Date of Birth (optional):

Personal: Enter date of birth of registered owner of vehicle.

 

 

Business: Leave blank.

10.

Street Address (optional):

Enter for registered owner of vehicle.

11.

City, State, Zip (optional):

Enter for registered owner of vehicle.

12.

Termination Date:

Form FS-4: Enter date policy was terminated (mmddyyyy).

 

 

Form FS-1: Leave blank.

13.

Effective Date:

Form FS-4: Enter date policy went into effect (mmddyyyy).

 

 

Form FS-1: Enter date policy was renewed (mmddyyyy).

14.

Preparation Date:

Enter today‟s date or when form was prepared (mmddyyyy).

FORMS FS-4 and FS-1: Media Requirements (Electronic)

EDI/GXS

GXS Information Exchange provides companies the ability to establish secure connections to one another by providing written permission outlining the connectivity desired by each company. Many insurance companies are currently processing forms FS-1 and FS-4 with the State of North Carolina using the product Expedite offered by GXS Information Exchange. Expedite is a mailbox-based product that allows companies with dissimilar systems to exchange files. Expedite supports OS/390, AS/400 PC/DOS, OS/2 and Windows platforms.

GXS Information Exchange can be contacted at 1-877-326-6426.

File Transfer Protocol with SSL (FTPS)

FTP is a transfer protocol that is fairly common throughout information technology companies. FTP with SSL is an extension of this that adds transport layer security (TLS) and secure socket layer (SSL) cryptographic algorithms. This ensures that the data being transmitted from one company to another is protected from any unauthorized viewing while in transit, which is critical for the sensitive nature of the FS-1 and FS-4 data.

When dealing with FTPS, it is understood that the FTP client software is very platform specific and not all software supports encryption. Because of the variety of software packages available, we require for the State of North Carolina that any company looking to utilize FTPS use the full capabilities of the encryption algorithms available. As such, the following requirements will be enforced:

1.Client software must support explicit mode FTPS by sending the command “AUTH TLS”.

5

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

2.Client software must support passive mode FTP.

3.Client software must be able to accept “well-known” digital certificates transmitted by the state mainframe as self-signed certificates are not permitted on these state resources.

4.Client software must be able to process Port Command Format 2 or have the ability to ignore the IP address that is provided in Port Command Format 1.

5.Client software must be able to transmit data in a file structure compatible with MVS formats as the mainframe is not setup to accept any other file structure at this time.

6.Clients must be able to open TCP Ports 50000 50040 on their firewall in order to process the data connection from the state mainframe.

7.In order to guarantee encryption for all data transmitted via FTPS, clients will only be authorized certain TCP ports that are designed for these types of transactions. The client will be notified of the approved TCP ports once the account for the client has been set up.

To help streamline the implementation of these requirements, the Office of Information Technology Services (ITS) for the State of North Carolina is prepared to assist you with establishing an FTPS account and ensure that the communication protocols are in place.

Other Electronic Media Formats

The State of North Carolina also permits the use of Connect:Direct to electronically submit insurance records. This is a mainframe to mainframe application that is available for use but requires technical effort on both ends to get set up properly. This is the only other electronic protocol that will be accepted at the NCDOT until further notice. It is anticipated that other protocols may be accepted in the future as they prove themselves to be reliable and secure.

FORMS FS-4 and FS-1: Field Requirements (Electronic)

1.

Transaction ID:

Hard code „003395‟

2.

Operation Code:

Hard code „I‟

3.

Documentation Type Code:

Hard code „01‟ for FS-1

 

 

Hard code „02‟ for FS-4

4.

Vehicle Identification Number (VIN):

For both personal and business operating a single vehicle:

 

 

Enter vehicle identification number obtained from vehicle

 

 

registration card or from dashboard of vehicle.

5.

Insurance Company Code:

Enter code assigned at the time company is licensed in state.

6.

Policy Number:

Enter policy number.

7.

Termination Date:

Form FS-4: Enter date policy was terminated (mmddyyyy).

 

 

Form FS-1: Leave blank.

8.

Effective Date:

Form FS-4: Enter date policy went into effect (mmddyyyy).

 

 

Form FS-1: Enter date policy was renewed (mmddyyyy).

9.

Preparation Date:

Enter today‟s date or when form was prepared (mmddyyyy).

10.

Vehicle Make:

Enter first 4 letters of vehicle make (Ex. “Chev”, “Buic”)

6

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

11.

Vehicle Year:

Enter 4 digit year of manufacture (yyyy)

12.

Drivers License Number (optional):

Personal: Enter drivers license of registered owner of vehicle.

 

 

Business: Enter customer ID assigned to business at time of

 

 

N.C. registration.

13.

Date of Birth (optional):

Personal: Enter date of birth of registered owner of vehicle.

 

 

Business: Leave blank.

14.

Registered Owner (optional):

Personal: Enter first, middle, and last name along with any

 

 

suffix in the appropriate fields.

 

 

Business: Enter name of business.

15.

Address 1 and Address 2 (optional):

Enter for registered owner of vehicle.

16.

City, State, Zip (optional):

Enter for registered owner of vehicle.

FORMS FS-4 and FS-1: Record Layout

Record Layout for Submission of FS-4 and FS-1 Data by Electronic Media

 

NCDOT SYSTEM:

 

Liability Insurance Tracking and Enforcement System (LITES)

 

 

BLOCKSIZE:

27,740

 

 

 

 

RECORD LENGTH:

 

380 Bytes

 

 

 

 

 

 

 

 

 

Field Name

Position Start

 

Position End

Type

Notes

Transaction ID

1

 

6

X (6): (constant)

„003395‟

Operation Code

7

 

7

X (1): (constant)

„I‟

Documentation Type

8

 

9

X (2): „01‟ or „02‟

FS-1: „01‟

Code

 

 

 

 

FS-4: „02‟

Vehicle Identification

10

 

34

X (25)

Obtained from vehicle registration

Number

 

 

 

 

card or from the dashboard of the

 

 

 

 

 

 

vehicle

Insurance Company

35

 

37

X (3)

N. C. code assigned to company by

Code

 

 

 

 

the state

Policy Number

38

 

67

X (30)

Policy number of insured

Termination Date

68

 

75

X (8): (mmddyyyy)

FS-4: Policy termination date

 

 

 

 

 

 

FS-1: Blank

Effective Date

76

 

83

X (8): (mmddyyyy)

FS-4: Policy effective date

 

 

 

 

 

 

FS-1: Policy

 

 

 

 

 

 

reinstatement/renewal date

Preparation Date

84

 

91

X (8): (mmddyyyy)

Today‟s date or date form prepared

Vehicle Make

92

 

95

X (4)

First 4 letters of vehicle make (ex.

 

 

 

 

 

 

„Chev‟, „Buic‟)

Vehicle Year

96

 

99

X (4): (yyyy)

Year of Manufacture

Drivers License

100

 

111

X (12)

Personal: Driver license number

Number (if available)

 

 

 

 

of the registered owner of the

 

 

 

 

 

 

vehicle

 

 

 

 

 

 

Business: N. C. number assigned

 

 

 

 

 

 

to business at time of vehicle

 

 

 

 

 

 

registration obtained from

 

 

 

 

 

 

vehicle registration card

Date of Birth (if

112

 

119

X (8): (mmddyyyy)

Personal: DOB of insured

available)

 

 

 

 

Business: Blank

Registered Owner‟s

120

 

139

X (20)

Personal

7

North Carolina Department of Transportation

Division of Motor Vehicles

Liability Insurance Unit

First Name

 

 

 

 

Registered Owner‟s

140

159

X (20)

Personal

Middle Name

 

 

 

 

Registered Owner‟s

160

184

X (25)

Personal

Last name

 

 

 

 

Registered Owner‟s

185

187

X (3)

Personal

Suffix

 

 

 

 

Registered Owner‟s

188

259

X (72)

Business

Name

 

 

 

 

Address 1

260

284

X (25)

Personal or business

Address 2

285

309

X (25)

Personal or business

City

310

331

X (22)

Personal or business

State

332

333

X (2)

Personal or business

Zip Code

334

342

X (9)

Personal or business (can be 5 or 9

 

 

 

 

digit zip code)

Filler

343

380

X (38)

Reserved for DMV use

8

NOTICE OF TERMINATION OF LIABILITY INSURANCE

FS-4

 

YEAR

MAKE

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY NAME

 

 

 

 

 

 

 

COMPANY CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM

DD

YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REGISTERED OWNER NAME

 

 

 

 

 

 

TERMINATION DATE

 

 

 

 

 

 

 

MM DD YYYY

 

 

 

 

 

MM

 

DD

 

YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVERS LICENSE

 

 

DATE OF BIRTH

 

 

 

 

 

 

 

EFFECTIVE DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM

DD

YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

PREPARATION DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOWN OR CITY

 

 

 

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTHORIZED SIGNATURE

 

 

NORTH CAROLINA CERTIFICATE OF LIABILITY INSURANCE

FS-1

YEAR

MAKE

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY NAME

 

 

 

COMPANY CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM

DD

YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REGISTERED OWNER NAME

 

EFFECTIVE DATE

 

 

 

 

MM DD YYYY

 

MM

DD

 

YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVERS LICENSE

 

DATE OF BIRTH

 

 

 

PREPARATION DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

TOWN OR CITY

STATE

ZIP CODE

AUTHORIZED SIGNATURE

Form Characteristics

Fact Name Details
Governing Law North Carolina General Statute 20-309
Form Purpose This form is used for reporting insurance policies for motor vehicles in North Carolina.
Submission Requirement Insurers must notify the Division upon writing new policies.
Electronic Notification Threshold Required if the company has $25,000,000 or more in annual vehicle insurance premium.
Liaison Requirement A designated contact person must complete a contact sheet.
Form FS-4 This form notifies the Division of termination of motor vehicle liability insurance.
Form FS-1 This certificate confirms the existence of liability insurance for a vehicle.
Required Fields Forms FS-4 and FS-1 must include detailed information about the vehicle and the registered owner.
Record Keeping Insurers must maintain records of all policies, terminations, and reinstatements.
Contact Information Liability Insurance Unit can be reached at (919) 861-3832 for questions regarding the forms.

Guidelines on Utilizing Dl 11Cd

Completing the DL 11Cd form is essential for insurance companies operating in North Carolina. Once the form is filled out correctly and submitted, it will facilitate communication between the insurance provider and the Division of Motor Vehicles. This ensures that all necessary information regarding liability insurance policies is accurately reported and maintained.

  1. Begin by filling in the Date section at the top of the form. Use the format mm/dd/yyyy.
  2. Enter the Contact Name/Title. Make sure to provide the full name and title of the individual completing the form.
  3. Provide the Contact Telephone number. Include the area code and ensure it is accurate.
  4. Fill in the Contact Fax number along with the area code, if applicable.
  5. Enter the Contact Email address. Confirm the spelling to avoid any errors.
  6. List the Contact Address with complete details including street, city, state, and zip code.
  7. If applicable, state the Insurance Group name, which serves as the parent name for all associated companies.
  8. For each affiliated Insurance Company, provide the following details:
    • Insurance Company Name.
    • Assigned Company Code used on FS-1 and FS-4 forms.
    • Indicate whether the company writes insurance in North Carolina (Yes/No).
    • If the answer is yes, specify if the transmission will be Paper, Tape, or Electronic.
    • If yes, mention how often the transmission will occur (Daily, Weekly, Monthly, etc.).
  9. Review all entries to confirm accuracy before submission.
  10. Submit the completed form via fax or email to the Liability Insurance Unit as listed in the contact information.

What You Should Know About This Form

What is the DL 11Cd form in North Carolina?

The DL 11Cd form is a document used by the State of North Carolina's Department of Transportation, specifically within the Division of Motor Vehicles. It functions as a notification form for insurance companies regarding motor vehicle liability insurance policies and their status. The form must be completed when there are terms related to new insurance policies, policy cancellations, and reinstatements, ensuring that the Department has accurate records of insurance coverage for vehicles in the state.

Who needs to complete and submit the DL 11Cd form?

North Carolina licensed insurance companies with the authority to write automobile liability insurance are required to complete the DL 11Cd form. If your insurance company is writing new policies or if there are changes to existing policies, this form is essential for compliance with state regulations. It ensures that the Division of Motor Vehicles is informed about the coverage your company provides, helping to maintain accurate records of vehicle insurance in North Carolina.

What information is required on the DL 11Cd form?

The DL 11Cd form requires various details including, but not limited to, the name and address of the registered owner of the vehicle, the insurance company name and code, the policy number, and the vehicle identification number (VIN). Additional optional fields include the driver's license number and date of birth of the registered owner. Accurate completion of the form is crucial in tracking insurance coverage adequately and ensuring compliance with North Carolina motor vehicle laws.

Can an insurance agent sign the DL 11Cd form on behalf of the company?

Yes, an agent representing an insurance company may sign the DL 11Cd form if they have been authorized to do so by their company. This provision allows for greater flexibility in processing forms and facilitates timely communication with the Division of Motor Vehicles regarding insurance coverage updates and changes.

What happens if my insurance company is not currently writing policies in North Carolina?

If your insurance company is not actively writing automobile liability insurance policies in North Carolina, it is essential to respond to the Division of Motor Vehicles accordingly. This proactive communication helps keep state records current and prevents unnecessary future inquiries regarding your company’s licensing status. A simple notification on the DL 11Cd form indicating this status will suffice in updating the records.

Common mistakes

Filling out the DL 11CD form can seem straightforward, yet many individuals make common errors that can lead to delays or complications. One prevalent mistake involves incorrect or incomplete contact information. It's essential to provide accurate details, such as telephone numbers and email addresses, ensuring that officials can easily reach you if necessary. Skipping any of these entries can create confusion, leading to communication issues.

Another frequent error relates to the insurance company code. Each insurance company is assigned a unique code when licensed. Failing to include this code or inputting it incorrectly may result in processing delays. Always double-check this information and cross-reference it with any documentation you have from the insurance provider.

Many individuals forget to specify whether they currently write automobile liability coverage in North Carolina. This is a critical component, as it impacts how the Division of Motor Vehicles processes the information. Leaving this section blank or failing to indicate “Yes” or “No” can lead to unnecessary follow-up requests.

Inaccuracies in the vehicle identification number (VIN) can also lead to issues. Ensure you obtain the VIN directly from the vehicle registration card or the vehicle's dashboard. Mistakes here can result in the denial of coverage or complications when trying to validate the insurance policy.

Some people overlook the requirement to provide dates accurately. It is crucial to input the termination and effective dates following the correct format. Make sure the format aligns with what is stated in the form instructions, as incorrect dates can hinder the form's acceptance.

Another typical mistake is failing to sign the form. While many insurers might use a facsimile signature, ensure it's included to avoid delays in processing. A missing signature can often confuse those reviewing the form, leading to unnecessary back-and-forth communication.

Formatting issues can sometimes arise, especially when using paper forms. Adhering strictly to the size requirements of the forms is essential. If the dimensions are not correct, the submission may be rejected. Moreover, having two forms fit on one page is a practical tip that can minimize paper use while ensuring clarity.

Finally, individuals often misinterpret optional fields as unnecessary. While some fields, such as the driver’s license number and date of birth, are marked optional, providing this information where applicable can facilitate smoother processing. It might assist in confirming identity or ownership if questions arise later.

Documents used along the form

The DL 11Cd form is commonly associated with several other documents within the North Carolina Department of Transportation's Division of Motor Vehicles. Each document plays a specific role in ensuring compliance with liability insurance requirements. Below are the key forms and documents often linked to the DL 11Cd form, along with their descriptions.

  • Form FS-1: This is the Certificate of Insurance form used to certify that a policyholder has valid automobile liability coverage. It must be issued upon request and confirms the effective date and scope of the insurance.
  • Form FS-4: Known as the Notice of Termination, this form notifies the Division of Motor Vehicles of the termination of a motor vehicle liability insurance policy. It provides essential details about the policy and the insured vehicle.
  • Contact Sheet: A document that insurance companies must fill out to provide contact information for liaisons dealing with the Division of Motor Vehicles. It ensures direct communication regarding insurance matters.
  • Hard Copy of General Statutes: Upon request, the Division will provide a printed version of relevant General Statutes, offering additional context and legal framework concerning motor vehicle insurance.
  • Media/Field Requirements Document: This outlines the requirements for the submission of FS-1 and FS-4 forms via various media, detailing how they must be completed and transmitted.
  • File Layouts Document: This document provides the necessary specifications and layouts for electronic submissions of FS-1 and FS-4 forms, ensuring data is processed correctly.
  • Electronic Notification Guidelines: These guidelines explain the process for electronic communications regarding new policy filings, particularly for companies with significant vehicle insurance premiums.
  • Rejection/Random Sampling Reports: Reports generated to notify companies about various submissions that have been rejected or selected for random sampling by the Division.
  • Test Planning Document: A guide for insurance companies on how to prepare for testing their electronic submissions, ensuring compliance with state standards.
  • Termination Notice Rules: This set of rules provides specific instructions on how and when to inform the Division of terminations or changes in vehicle insurance policies.

Each of these documents plays a vital role in maintaining accurate records and communication between insurance companies and the North Carolina Division of Motor Vehicles. It is essential for companies to understand and correctly utilize these forms to ensure compliance with state regulations.

Similar forms

  • FS-1 Form: This certification form is similar to the DL 11CD as both documents serve to verify the existence of an automobile liability insurance policy. They are required when a policy is issued or renewed, ensuring compliance with state regulations.
  • FS-4 Form: Like the DL 11CD, the FS-4 serves as a notification form used to inform the Division of Motor Vehicles about the cancellation or termination of an insurance policy. Both forms involve critical communication between insurers and the regulatory body.
  • Liability Insurance Certification: This document parallels the DL 11CD in that it certifies the existence of insurance coverage. Both require similar information from policyholders to confirm compliance with financial responsibility laws.
  • Insurance Company Contact Sheet: This document is akin to the DL 11CD, as it requires insurance companies to provide their contact details. Both facilitate communication between the insurance companies and the North Carolina Division of Motor Vehicles.
  • Policy Reinstatement Form: This form shares characteristics with the DL 11CD by documenting the reinstatement of liability coverage. Both involve the reporting of critical policy changes that affect compliance and insurance records.
  • Hard Copy of General Statutes: Similar to the DL 11CD, this document outlines the legal requirements for insurance coverage in North Carolina. Both serve as informative resources to ensure that insurers are aware of their obligations under the law.
  • Media/Field Requirements Document: This document mirrors the DL 11CD in its intention to provide clarity on filing requirements and regulations. Both serve to guide insurance companies in meeting necessary standards for compliance.

Dos and Don'ts

When filling out the DL 11Cd form, it is essential to adhere to specific guidelines to ensure accuracy and compliance. Below is a list of things to do and avoid.

  • Provide Complete and Accurate Information: Ensure all fields are filled out correctly, including names, codes, and dates.
  • Use the Correct Form Version: Make sure you are using the latest version of the DL 11Cd form as per the provided specifications.
  • Double-Check Vehicle Details: Verify the vehicle identification numbers and years correspond accurately to the information on the registration card.
  • Follow Submission Guidelines: Adhere to the specified method for submitting the form, whether electronically, by fax, or via mail.
  • Maintain a Copy for Your Records: Keep a copy of the completed form for your own records in case of future reference.
  • Do Not Leave Required Fields Blank: Ensure all necessary fields are completed; leaving blanks can lead to delays or rejections.
  • Avoid Providing Inaccurate Information: Incorrect data can result in penalties or complications with your filing.
  • Don't Ignore Submission Deadlines: Be aware of any deadlines for filing to avoid penalties.
  • Do Not Use Outdated Versions: Verify you are using the most recent version of the form to comply with current regulations.
  • Refrain from Making Handwritten Changes: Typed or printed information is preferred; handwritten alterations may not be accepted.

Misconceptions

Here are some common misconceptions about the DL-11CD form:

  • It is only for insurance companies. The DL-11CD form is used by both insurance companies and vehicle owners to certify insurance policies and must be completed correctly to ensure compliance.
  • Filing the form is optional. Filing is mandatory under North Carolina law for vehicle registration and for notifying the Division of Motor Vehicles about policy changes.
  • Only one form is needed per policy. If multiple vehicles are listed on an insurance policy, each vehicle requires a separate record when submitting electronically or by paper.
  • Insurance agents cannot file the form. An authorized agent can submit the DL-11CD form on behalf of the insurance company if they have proper permission to do so.
  • The form must be mailed in. Companies can electronically submit the form through their chosen method, like FTP with SSL, making it easier and quicker than traditional mail.
  • There is no deadline for submitting the form. Timely submission is required, especially within specific periods after policy establishment or termination to avoid penalties.
  • Inaccuracies on the form are acceptable. Completing the DL-11CD form accurately is crucial. Errors can lead to compliance issues and additional correspondence with the Division of Motor Vehicles.
  • The form does not need to be updated if a policy changes. Any changes in coverage or status must be communicated by maintaining updated information on the DL-11CD form.
  • Proof of insurance is the same as submitting the form. While the form is a declaration, proper documentation of insurance must be maintained separately and presented as required by law.

Key takeaways

Filling out and using the DL 11CD form, which pertains to the reporting of automobile liability insurance in North Carolina, requires careful attention to detail. Here are some key takeaways:

  • Policy Notification: Insurance companies must inform the North Carolina Division of Motor Vehicles about any new policies written, as outlined by General Statute 20-309.
  • Electronic Notification: Companies with an annual vehicle insurance premium of $25,000,000 or more must provide notifications electronically.
  • Form FS-4 for Termination: If an insurance policy is terminated, the FS-4 form needs to be submitted to notify the Division about the termination of motor vehicle liability insurance.
  • Form FS-1 for Reinstatement: For reinstatements or renewals without a lapse in coverage, the FS-1 form is required to certify the existence of the new policy.
  • Contact Information Submission: Each insurance company must designate a liaison and complete the contact sheet, providing essential company information to facilitate communication with the Division.