DEPARTMENT OF INSURANCE
Insurer Details
NAMESECURA Supreme Insurance Company
DOI ID645533
FEIN #391833417
ALIEN #
State of DomicileWI
Domicile CountryUSA
Merged Into
NAIC #10239
NAIC Group #96
Entity TypeInsurer
Admitted12/1/2006
AM Best Rating
PresidentGarth Paul Wicinsky
Process AgentDaniel P. Ferris
Date Assigned : 2/21/2023
(See address table below for process agent address)

Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.
Line(s) of Authority
Health
Property
Surety
Casualty
Vehicle Insurance
Liability Insurance
Workers' Compensation & Employer's Liability
Burglary & Theft
Personal Property Floater
Glass
Boiler & Machinery
Leakage & Fire Extinguishing Equipment
Malpractice
Elevator
Congenital Defects
Livestock
Entertainments
Failure of Certain Institutions to Record Documents
Automobile Guaranty
Miscellaneous
TypeAddress
Agent Licensing Address1500 Mutual Way Appleton, WI 54912
Annual StatementPO Box 819 Appleton, WI 549120819
Catastrophe/Disaster Coordinator Address1500 Mutual Way Appleton, WI 54912
Company Licenses/Fee Contact Address1500 Mutual Way Appleton, WI 54912
Deposits Contact Address1500 Mutual Way Appleton, WI 54912
MailingPO Box 819 Appleton, WI 549120819
Managing General Agent1500 Mutual Way Appleton, WI 54912
P & C Form and Rate Filing1500 Mutual Way Appleton, WI 54912
Policyholder Information Contact Address1500 Mutual Way Appleton, WI 54912
Premium Tax Address1500 Mutual Way Appleton, WI 54912
Process Agent1500 Mutual Way Neenah, WI 54956
Regulatory Compliance/Gvmt Relations Contact Address1500 Mutual Way Appleton, WI 54912
Statutory Home Office1500 Mutual Way Neenah, WI 54956
U.S. Legal Counsel for Aliens1500 Mutual Way Appleton, WI 54912
TypeNumber
Business / Home Office(920) 739-3161
Catastrophe/Disaster Coordination Contact - Business / Home Office(920) 996-6308
Claim Information Contact - Business / Home Office(920) 830-4373
Deposits Contact - Business / Home Office(920) 224-7350
P & C Form and Rate Filing - Business / Home Office(920) 830-4398
U.S. Legal Counsel for aliens - Business / Home Office(920) 830-4468
Managing General Agent - Business / Home Office(920) 830-4468
Policyholder Information Contact - Business / Home Office(920) 996-6397
Regulatory Compliance/Gvmt Relations Contact - Business / Home Office(920) 830-4468
Annual Statement - Fax(920) 739-2384
Licensing - Agent Licensing Phone(920) 830-4636
Annual Statement - Annual Statement(920) 830-4373
Premium Tax Contact - Premium Tax (920) 830-4373
TypeInternet Information
Annual Statement - Business Emailstacy_nett@secura.net
Catastrophe/Disaster Coordination Contact - Business Emailbsalm@secura.net
Claim Information Contact - Business Emailstacy_nett@secura.net
Deposits Contact - Business Emailmstindt@secura.net
P & C Form and Rate Filing - Business Emailjennifer_haas@secura.net
U.S. Legal Counsel for aliens - Business Emaildan_ferris@secura.net
Managing General Agent - Business Emaildan_ferris@secura.net
Policyholder Information Contact - Business Emailangela_hacker@secura.net
Premium Tax Contact - Business Emailstacy_nett@secura.net
Licensing - Business Emaildawn_mauthe@secura.net
Regulatory Compliance/Gvmt Relations Contact - Business Emaildan_ferris@secura.net

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