Resident Life Settlement Provider

Resident Life Settlement Provider – Individual (Initial License)

The application is considered an initial license application even though a license may have been obtained and then inactivated pursuant to the repealed Chapter 431E, HRS.

The applicant shall submit as part of a complete application (electronic files accepted for items 1, 2, and 3):

  1. A detailed plan of operation;
  2. An anti-fraud plan that meets the requirements of the Life Settlement Act;
  3. All forms of the life settlement contract, disclosure statement, and advertising it intends to use in this State;
  4. You shall submit fingerprints even if fingerprints were submitted for another license. To obtain fingerprints, schedule an appointment online at http://www.fieldprinthawaii.com . Fees collected by FieldPrint include state and federal submission fees. Effective September 1, 2018, all applicants must enter “HI-DCCA-INS”, the code that identifies the Insurance Division as the intended recipient of your fingerprint result, when scheduling an online appointment with Fieldprint.

After the above has been completed, submit the application form, documents, electronic files, and fees.

  1. Form LSB/LSP – Hawaii Application for Life Settlement License. Submit with original signature.
  2. Licensing Fees. Make check payable to DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS.

Resident Life Settlement Provider – Legal Entity (Initial License)

The application is considered an initial license application even though a license may have been obtained and then inactivated pursuant to the repealed Chapter 431E, HRS.

The applicant shall submit as part of a complete application (electronic files accepted for items 3, 4, and 5):

  1. The entity shall designate an individual who is responsible for the actions of the entity and its employees. The designated individual shall be a licensed resident provider;
  2. The entity shall disclose the identity of its stockholders, other than stockholders owning fewer than ten per cent of the shares of an applicant whose share are publicly traded, and the identity of its partners, officers, and employees;
  3. A detailed plan of operation;
  4. An anti-fraud plan that meets the requirements of the Life Settlement Act;
  5. All forms of the life settlement contract, disclosure statement, and advertising it intends to use in this State.

After the above has been completed, submit the application form, documents, electronic files, and fees.

  1. Form LSB/LSP – Hawaii Application for Life Settlement License. Submit with original signature.
  2. Licensing Fees. Make check payable to DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS.