N.M. Admin. Code § 13.18.2.32

Current through Register Vol. 35, No. 24, December 23, 2024

Section 13.18.2.32 - FORM CI-DRF: PART B - CASE EXPERIENCE

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1. Actual Earned Premiums

a. Net Written Premiums* _____ _____ _____ _____

b. Premium Reserve Beginning of Period _____ _____ _____ _____

c. Premium Reserve End of Period _____ _____ _____ _____

d. Earned Premiums (a+b-c) _____ _____ _____ _____

2. Earned Premiums at Presumptive Rates _____ _____ _____ _____

3. Incurred Claims

a. Claims Paid _____ _____ _____ _____

b. Unreported Claims, Beginning of Period _____ _____ _____ _____

c. Unreported Claims, End of Period _____ _____ _____ _____

d. Claim Reserve, Beginning of Period _____ _____ _____ _____

e. Claim Reserve, End of Period _____ _____ _____ _____

f. Incurred Claims, (a+b+c-d-e) _____ _____ _____ _____

4. Actual Loss Ratio for Case at Presumptive

Rates: 3(f) [divided by] 2 _____ _____ _____ _____

5. Average Number of Life Years _____ _____ _____ _____

6. Incurred Claim Count** _____ _____ _____ _____

*Net written premiums are to be determined as Gross Premium written (before deductions for dividends and experience rating credits) less refunds on terminations.

**Entries on 5. and 6. should be based on the Credibility Table elected by the insurer.

N.M. Admin. Code § 13.18.2.32

7/1/97; 13.18.2.32 NMAC - Rn, 13 NMAC 18.2.32, 12/31/07