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. Code R. § 13.18.3.23