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Company NamesInsert more rows if neededCommercial Property Personal AutoCommercial AutoBusiness InterruptionAll Other LinesTotalsResidential Property% Closedt"All Other" shall exclude Workers Compensation, other than property damage claims, and non-Property/Casualty claims. I* Data will only be released in aggregate form on an overall state level.G* E-mail the report to xxxx@xxxx. Please do not submit printed copies. $Residential Property Claims Reported/Residential Property Claims Closed With Payment2Residential Property Claims Closed Without Payment Residential Property Paid Loss( Residential Property Case Incurred Loss#Commercial Property Claims Reported/Commercial Property Claims Closed With Payment2Commercial Property Claims Closed Without Payment Commercial Property Paid Loss( Commercial Property Case Incurred Loss(Personal Auto Claims Closed With Payment,Personal Auto Claims Closed Without PaymentPersonal Auto Paid Loss Personal Auto Case Incurred LossCommercial Auto Claims Reported*Commercial Auto Claims Closed With Payment-Commercial Auto Claims Closed Without Payment Commercial Auto Paid Loss# Commercial Auto Case Incurred Loss%Business Interruption Claims Reported0Business Interruption Claims Closed With Payment3Business Interruption Claims Closed Without Payment Business Interruption Paid Loss) Business Interruption Case Incurred LossAll Other Claims Reported$All Other Claims Closed With Payment'All Other Claims Closed Without PaymentPersonal Auto Claims ReportedCity 1City 2City 3City 4City 5City 6�NOTE: This entire tab is protected. All information is pulled in based upon the information provided in either the Instructions tab or the Data by Zip Code tabZip Code�Each individual state can provide the zip codes in their state. These zipcodes can be put into the spreadsheet and protected. The company can then enter information by zip code. Prepopulation of zip codes makes it easier to get correct information as some companies do not provide zip codes. There can also be a listing for unknown. Note that rows 1 & 2 are also locked. The numbers fill in automatically using the sum of the columns.Unknown[Please continue to report data even if there are no changes from the prior reporting periodT* Numbers that are zeroes should be reported using a zero - do not leave cells blankV* Data should be inception-to-date as of the evaluation date (this is cumulative data) 1st Report due 2nd Report due 3rd Report due4th Report due5th Report due6th Report due7th Report due.Make sure the data reported is cumulative data}* Data should be entered as a number - this has been incorporated into the form - please do not change the form in any wayAll Other Claims Paid Loss#All Other Claims Case Incurred Loss�Please use the space provided below to explain any potential differences in the information you have provided, such as, an unusual decrease in the data reported or any unusually large swings in the data previously reported. XX/XX/XXXX0Workers' Compensation Claims Reported (Optional);Workers' Compensation Claims Closed With Payment (Optional)>Workers' Compensation Claims Closed Without Payment (Optional)+Workers' Compensation Paid Loss (Optional)3Workers' Compensation Case Incurred Loss (Optional)WEach state should place their own confidentiality statement in the space provided belowData Call for [Event]\"Claims Reported" means all claims reported regardless of whether a payment was made or not. �"Claims Closed with Payment" means all claims closed where a loss payment was made regardless of the date of loss or when the claim was received. Exclude claims closed where loss adjustment expense was incurred but no payment to the insured was made. �"Claims Closed without Payment" means all claims closed where no loss payment was made regardless of the date of loss or when the claims was received. Include claims closed where loss adjustment expense was incurred but no payment to the insured was made. w"Case Incurred Loss" means indemnity case reserves plus payments to date. Estimates of IBNR should not be included. �"Residential Property" is defined as any type of personal insurance protecting against loss to owner-occupied property as defined in the standard fire policy and extended coverage thereon, a dwelling policy, a homeowners, tenants and condominium unit-owners multiple peril policy, a mobile homeowners insurance policy, insurance against the perils of vandalism, malicious mischief, burglary or theft, personal liability insurance or any combination of these policy coverages. ["Commercial Property" is defined as all property not categorized as "Residential Property." #"Personal Auto" is defined as liability and physical damage insurance that covers a vehicle driven for personal use. This coverage includes automobiles, motorcycles and recreational vehicles. Experience for these vehicles is reported on lines 19.1, 19.2 and 21.1 of the P&C annual statement. �"Commercial Auto" is defined as liability and physical damage insurance that covers vehicles used for commercial purposes. Experience for these vehicles is reported on lines 19.3, 19.4 and 21.2 of the P&C annual statement. �"Business Interruption" is defined as insurance that covers the loss of income, continuing fixed expenses or extra expenses a business suffers after a disaster while its facility is either closed because of the disaster or in the process of being rebuilt after it. Losses under business interruption coverage should be reported under "Business Interruption" and not under "Commercial Property." �"Workers Compensation" is defined as insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee's right to sue his or her employer for the tort of negligence. "Workers Compensation" includes associated employers liability coverage. Experience for this type of coverage is reported on line 16 of the P&C annual statement. €"All Other Lines" is defined as any line of business or coverage that is not included in any of the above line/coverage definitions for which claims attributable to the disaster subject to this data call were reported. "All Other Lines" does NOT include mortgage/financial guaranty, title, fidelity, surety, medical malpractice, or professional liability insurance lines of business. � � State of [STATE NAME]R"Private Flood" is defined as specific insurance coverage against property loss from flooding under any policy or endorsement, issued by any entity other than the NFIP. Flood coverage provided as an additional peril without endorsement under a residential or commercial property policy may be included with the associated property policy. � � Industry Comments: Workers' Compensation (Optional)Private Flood (Optional)(Private Flood Claims Reported (Optional)3Private Flood Claims Closed With Payment (Optional)6Private Flood Claims Closed Without Payment (Optional)"Private Flood Paid Loss (Optional)+Private Flood Case Incurred Loss (Optional)Claims as of: -The respective Department of Insurance will determine updated reporting timeframes and list that information here. Additionally a Department of insurance generally requires insurers to continue to report updated data until the respective Department of Insurance advises the insurer to cease reporting.m* Reporting does not apply to Reinsurance claims. Reporting applies solely to Property & Casualty Insurers."Paid Loss" means<�q indemnity payments but excludes adjustment expense. Payments should be net of actual salvage and subrogation recoveries. For applicable lines, include losses associated with the loss of use, additional living expense, fair rental value, etc. k"% Closed" is calculated as (Claims Closed with Payment + Claims Closed without Payment)/(Claims Reported). �* The Zip Code data fields are locked down. 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