George W. Blaisdell, Insurance Broker
(as of 01/01/2007)
PURPOSE OF THIS NOTICE
Title V of the Gramm-Leach-Bliley Act (GLBA) generally prohibits any financial institution, directly or through its affiliates, from sharing nonpublic personal information about you with a non-affiliated third party unless the institution provides you with a notice of its privacy policies and practices, such as the type of information that it collects about you and the categories or persons or entities to whom it may be disclosed. In compliance with the GLBA, we are providing you with this document, which notifies you of the privacy policies and practices of George W. Blaisdell, Insurance Broker.
OUR PRIVACY POLICIES AND PRACTICES
1. Information we collect:
We collect nonpublic personal information about you from the following sources:
Information we receive from you on applications or other forms.
Information about your transactions with us, or affiliates or others.
Information we receive from medical records or medical professionals.
Information we receive from previous insurance carriers.
2. Information we may disclose to third parties;
We may disclose the following kinds of nonpublic personal information about you:
Information we receive from you on applications or other forms such as; your name, address, social security number.
Information about your transactions with us, our affiliates or others, such as; your policy coverage, premiums and payment history.
3. Our practices regarding information confidentially and security:
We restrict access to nonpublic personal information about you to those employees who need to know that information in order to provide products or services to you. We maintain physical, electronic and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
4. Our policy regarding dispute resolution:
5. Reservation of the right to disclose information in unforeseen circumstances:
In connection with the potential sale or transfer of its interests, George W. Blaisdell, Insurance Broker, and its affiliates, if any, reserves the right to sell or transfer your information (including but not limited to your address, name, age, sex, zip code, state and country of residency and other information that you provide through other communications) to a third party entity that (1) concentrates its business in a similar practice or service; (2) agrees to be George W. Blaisdell, Insurance Broker, successor in interest with regard to the maintenance and protection of the information collected; and (3) agrees to the obligations of this privacy statement.
6. Your right to access and amend your personal information:
You have the right to request access to the personal information that we record about you. Your right includes the right to know the source of the information and the identity of the persons, institutions or types of institutions to whom we have disclosed such information within 2 years prior to your request. Your right includes the right to view such information and copy it in person, or request that a copy of it be sent to you by mail (for which we may charge you a reasonable fee to cover our costs). Your right also includes the right to request corrections, amendments or deletions of any information in our possession. The procedures that you must follow to request access to our amendment of your information are as follows:
To obtain access to your information; you should submit a request in writing to George W. Blaisdell, Insurance Broker, P.O. Box 644, Hampton Falls, NH 03844. The request should include your name, address, social security number, telephone number, and the recorded information to which you would like access. The request should state whether you would like access in person or a copy of the information sent to you by mail. Upon receipt of your request, we will contact you within 30 business days to arrange providing you with access in person or the copies that you have requested.
To correct, amend or delete any of your information: you should submit a request in writing to George W. Blaisdell, Insurance Broker, P.O. Box 644, Hampton Falls, NH 03844. The request should include your name, address, social security number, telephone number, the specific information in dispute and the identity of document or record that contains the disputed information. Upon receipt of your request, we will contact you within 30 business days to notify you either that we have made the correction, amendment or deletion, or that we refuse to do so and the reasons for the refusal, which you will have an opportunity to challenge.