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IDOI > Financial Services > Forms > Fidelity Bond Compliance Fidelity Bond Compliance

Fidelity Bonds protect policyholders and businesses from dishonest behavior by employees or officers.

In addition to the bond IDOI needs a Fidelity Bond Cancellation Rider.

The amount of the bond is determined by the formula included in the NAIC Examiners Handbook. 

The cancellation rider is a form for IDOI that illustrates in writing the bonding company and insured must notify IDOI upon cancellation of the bond. 

To complete a Cancellation Rider form you will need to know and provide the information below on the Cancellation Rider form in the following order:

  • Company or corporation being insured (shown on the declaration page of the fidelity bond).
  • Fidelity bond number
  • The carrier's name
  • Date
  • Amount of fidelity bond 
  • The name of the company being insured - not the corporation name (if the corporation name must be in this blank, the company name must be under it) i.e.: XYZ Corp. is the parent or corporate name (from blank #1) and ABC Ins. Co. is a subsidiary and the company Indiana would be concerned with for coverage. ABC Ins. Co. would go in the seventh blank. 
  • All signatures must be original, even if the rider itself is a copy. 

Download the Fidelity Bond Cancellation Rider.

If you have any questions, please contact:
Kathleen Mathis
317-232-1991
kmathis@idoi.in.gov.

Return Cancellation Rider to:
Kathleen J. Mathis
Indiana Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204-2787