POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM
INSURANCE COVERAGE
You are hereby notified that under the Terrorism Risk Insurance Act of 2002, as amended ("TRIA"),
that you now have a right to purchase insurance coverage for losses arising out of acts of terrorism, as
defined in Section 102(1) of the Act, as amended: The term “act of terrorism” means any act that
is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security
and the Attorney General of the United States, to be an act of terrorism; to be a violent act or an act
that is dangerous to human life, property, or infrastructure; to have resulted in damage within the
United States, or outside the United States in the case of an air carrier or vessel or the premises of a
United States mission; and to have been committed by an individual or individuals, as part of an
effort to coerce the civilian population of the United States or to influence the policy or affect the
conduct of the United States Government by coercion. Any coverage you purchase for "acts of
terrorism" shall expire at 12:00 midnight December 31, 2020, the date on which the TRIA Program is
scheduled to terminate, or the expiry date of the policy whichever occurs first, and shall not cover any
losses or events which arise after the earlier of these dates.
YOU SHOULD KNOW THAT COVERAGE PROVIDED BY THIS POLICY FOR LOSSES
CAUSED BY CERTIFIED ACTS OF TERRORISM IS PARTIALLY REIMBURSED BY THE
UNITED STATES UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER,
YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR
COVERAGE, SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THIS FORMULA,
THE UNITED STATES PAYS 85% THROUGH 2015; 84% BEGINNING ON JANUARY 1, 2016;
83% BEGINNING ON JANUARY 1, 2017; 82% BEGINNING ON JANUARY 1, 2018; 81%
BEGINNING ON JANUARY 1, 2019 AND 80% BEGINNING ON JANUARY 1, 2020; OF
COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED
DEDUCTIBLE PAID BY THE INSURER(S) PROVIDING THE COVERAGE. YOU SHOULD
ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS
A USD100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL
AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF
TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR
EXCEEDS USD100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS
EXCEED USD100 BILLION, YOUR COVERAGE MAY BE REDUCED.
THE PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT
INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL
GOVERNMENT UNDER THE ACT.
I hereby elect to purchase coverage for acts of terrorism for a prospective premium of
USD……………………………
