OTHER INSURANCE REPORT
Name of Insurer: ______________________________________________ Calendar Year: ______________
INSURANCE OTHER THAN CREDITOR-PLACED INSURANCE
(1) Blanket Insurance Policies | (2) Other Credit Property Insurance Not Force-Placed | (3) Total Credit Property Insurance Not Force-Placed (1)+(2) | (4) All Other Insurance Purchased by a New Mexico Creditor |
A. Gross Written Premium | |||
B. Refunds on Terminations | |||
C. Net Written Premium (A)-(B) | |||
D. Beginning Premium Reserve | |||
E. Ending Premium reserve | |||
F. Net Earned Premium (C)+(D)-(E) | |||
G. Other Income Less Other Expenses | |||
H. Policyholder Dividends | |||
I. Incurred Losses | |||
J. LAE Incurred | |||
K. Commissions Incurred | |||
L. Service Fees Incurred | |||
M. Other Incurred Compensation | |||
N. Other Acquisition Expenses | |||
O. Other Underwriting Expenses | |||
P. Total Loss and Expense Sum (H) to (O) | |||
Q. Underwriting Profit (F)+(G)-(P) |
Instructions:
N.M. Admin. Code § 13.18.3.23