Commercial Lines Insurance Companies - Excel

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Commercial Lines Insurance Companies - Excel Powered By Docstoc
					                                                 CALIFORNIA DEPARTMENT OF INSURANCE
                                     California Earthquake Insurance Premium & Policy Count Data Call


                                               DATA COLLECTION WORKBOOK
             The purpose of this workbook is to collect written premium and policies in-force data for homeowners multi-peril, fire, and
             commercial multi-peril lines of business.

             This data is being collected pursuant to California Insurance Code Section 10089.13 (a).

             Regardless of whether your company offers earthquake insurance, this data is required from ALL companies
             writing new and/or renewal business in homeowners multi-peril, fire, and commercial multi-peril as defined in the
             Annual Statement.


                               DATA IS DUE NO LATER THAN MARCH 10, 2006


                           Company Name

                           NAIC Number                                                Group Code

                           Address

                           City

                           State                                                             ZIP

                           Contact Person

                           Title

                           E-mail Address

                           Telephone No.                                                     Ext.

                           Fax No.

                           Date Completed

                           FOR GROUP SUBMISSIONS ONLY - Enter individual NAIC code and company name for each company
                           represented in this group submission
                           NAIC          Company Name                                   NAIC            Company Name




California Department of Insurance                                                                                  EQ-EXP 2004 Premium and Policy Count
Rate Specialist Bureau                                                                                                                        11/22/2010
                                            EARTHQUAKE INSURANCE
                                     PREMIUM & POLICY COUNT (For the Year 2005)
  Group/Company: 0
         Group #: 0000                                                                                      NAIC #: 0
(If reporting by Group, please provide a list of individual companies within your Group on the Company Contact Worksheet).
                                                   Column 1                 Column 2                 Column 3                 Column 4
                                                                            Total No. of                                   No. of EQ Policies &
                                                    Total Direct          Policies In-Force         Direct Written           Endorsements In-
                                                   Written Prem.            as of 12/31/05          EQ Premiums            Force as of 12/31/05
                                                (EXCLUDING EQ):         (EXCLUDING EQ):           (INCLUDING CEA):        (INCLUDING CEA):
1. Total Personal Lines:                                           $0                         0                      $0                           0
   a. Homeowners
   b. Rental
   c. Condo Unit Owners
   d. Dwelling Fire
   e. Mobilehome
2. Total Commercial Lines:                                         $0                         0                      $0                           0
   a. Commercial Fire
   b. Commercial Multiple Peril
      (Non-Liab.)
3. Sub-Totals for Personal + Commercial Lines:
                                                                   $0                         0                      $0                           0

4. Reconciliation of Data with Annual Statement-Calif. State Page Exhibit:
   a. Total Business                                               $0    [DWP for Non-EQ (Item 3, Col. 1) + DWP for EQ (Item 3, Col. 3)]

   b. CA Page Exhibit, Line 1, DWP*                                      * DWP stands for Direct Written Premiums
   c. CA Page Exhibit, Line 4, DWP*                                        CEA stands for California Earthquake Authority
   d. CA Page Exhibit, Line 5.1, DWP*
   e. CA Page Exhibit, Line 12, DWP*
   f. Total (Items 4b + 4c + 4d + 4e)                              $0 [Total WP reported by your company/group's annual statement]


   g. CEA Premium ONLY, DWP*
   h. Difference (4a - 4f - 4g)                                    $0

5. Explanation of Difference: Provide explanation below, if Item 4a. Total Business
   does not reconcile with the totals from your company's Annual Statement - Calif. State Page Exhibit
   for Lines 1, 4, 5.1 and 12. (Direct Written Premium)




    California Department of Insurance                                                                EQ-EXP 2004 Premium and Policy Count
    Rate Specialist Bureau                                                                                                     11/22/2010

				
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