Statutes, codes, and regulations
New Mexico Administrative Code
Title 13 - INSURANCEChapter 18 - CREDIT INSURANCE
Part 3 - CREDITOR-PLACED INSURANCE
Section 13.18.3.22 - FORM B CREDITOR'S EXPERIENCE REPORT

N.M. Admin. Code § 13.18.3.22

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Current through Register Vol. 35, No. 21, November 5, 2024
Section 13.18.3.22 - FORM B CREDITOR'S EXPERIENCE REPORT

CREDITOR'S EXPERIENCE REPORT

Name of Insurer: ______________________________________ Calendar Year: __________________

NEW MEXICO CREDITOR-PLACED INSURANCE

(1) Creditor Identification Number (2) Effective Date of Master Policy (3) Gross Written Premium (4) Refunds on Terminations (5) Written Premium Net of Terminations (3)-(4) (6) Cash Commissions Incurred (7) Cash Service Fees Incurred (8) Other Cash Compensation Incurred (9) Creditor's Percentage Compensation [(6)+(7)+(8)]/5
TOTALS

Instructions:

1. Fill in a row for each New Mexico creditor-placed insurance master policy.
2. In columns (6), (7) and (8), report all cash amounts incurred by the creditor for commissions, service fees and other compensation.

N.M. Admin. Code § 13.18.3.22

1/1/99; Recompiled 11/30/01