Report a Claim — Travellers Insurance & Surerty Corp.

Agreement:

“I hereby agree to the privacy declaration above stated and give authority to disclose and verify the information rendered.”

Declaration:

This agreement establishes the terms and conditions under which the TRAVELLERS INSURANCE & SURETY CORPORATION can acquire and use data from the other party. Either party may be a provider of data to the other, or a recipient of data from the other.

The confidentiality of data pertaining to individuals will be protected as follows:
The data recipient will not release the names of individuals, or information that could be linked to an individual, nor will the recipient present the results of data analysis in any manner that would reveal the identity of individuals.
The data recipient will not release individual addresses, nor will the recipient present the verified data in any manner that would reveal individual addresses.
Both parties shall comply with all State laws and regulations governing the confidentiality of the information that is the subject of this Agreement.
The data recipient will not release data to a third party without prior approval from the data provider.
The data recipient will not share, publish, or otherwise release any findings or conclusions derived from analysis of data obtained from the data provider without prior approval from the data provider.
The data recipient affiliates, subsidiaries, contractors, partners, agents and representatives, intermediaries, industry associations, and other third parties access to personal information of the data provider, including this form, for purposes of marketing, sales or promotional information campaigns, and provision of any products, services, or offers through mail/email/SMS/telephone, or any type of electronic facility.
Data transferred pursuant to the terms of this Agreement shall be utilized solely for the purposes set forth in the “Agreement”.

By signing this form, I hereby certify that I have read and understood the foregoing and this consent remains valid and binding unless I submit a written notice to Travellers Insurance & Surety Corporation revoking or altering the same.