SERFF Tracking Number: QBEC State: Oregon First Filing Company: QBE Insurance Corporation,... State Tracking Number: QBEC

Transcription

1 Filing at a Glance Companies: QBE Insurance Corporation, Praetorian Insurance Company, North Pointe Insurance Company ISO Market Segments - Hotels, SERFF Tr Num: QBEC State: Oregon Motels and Inns TOI: 05.0 CMP Liability and Non-Liability SERFF Status: Closed-Filed State Tr Num: QBEC Sub-TOI: Commercial Package Co Tr Num: OR-MU- State Status: Review completed HOTEL-F-RR Filing Type: Form/Rate/Rule Reviewer(s): David Dahl, FCAS, MAAA, Jan Vitus, CIC,MHP,HIA,CRM,CCP Authors: Virginia Putzu, Joshua Disposition Date: 03/07/2012 Altman Date Submitted: 02/23/2012 Disposition Status: Filed Effective Date Requested (New): 04/01/2012 Effective Date (New): 04/01/2012 Effective Date Requested (Renewal): 04/01/2012 Effective Date (Renewal): General Information Project Name: Status of Filing in Domicile: Pending Project Number: Domicile Status Comments: Reference Organization: ISO Reference Number: MS-2006-OHMFO, MS RHMRU, MS-2006-RHMLC Reference Title: Advisory Org. Circular: Filing Status Changed: 03/07/2012 State Status Changed: 03/07/2012 Deemer Date: Created By: Joshua Altman Submitted By: Joshua Altman Corresponding Filing Tracking Number: Filing Description: We are introducing a new filing for. Company and Contact Filing Contact Information Joshua Altman, Rate/Form Implementation Analyst joshua.altman@us.qbe.com

2 Wall Street Plaza [Phone] Pine Street New York, NY Filing Company Information QBE Insurance Corporation CoCode: State of Domicile: Pennsylvania 88 Pine Street - 16th Floor Group Code: 796 Company Type: New York, NY Group Name: QBE Insurance State ID Number: Group (212) ext. [Phone] FEIN Number: Praetorian Insurance Company CoCode: State of Domicile: Pennsylvania 88 Pine Street - 16th Floor Group Code: 796 Company Type: New York, NY Group Name: QBE Insurance State ID Number: Group (212) ext. [Phone] FEIN Number: North Pointe Insurance Company CoCode: State of Domicile: Pennsylvania 116 Pine Street Group Code: 796 Company Type: Property & Casualty Harrisburg, PA Group Name: QBE Insurance State ID Number: Group (800) ext. [Phone] FEIN Number: Filing Fees Fee Required? Retaliatory? Fee Explanation: Per Company: No No No COMPANY AMOUNT DATE PROCESSED TRANSACTION # Praetorian Insurance Company $0.00 QBE Insurance Corporation $0.00 North Pointe Insurance Company $0.00

3 State Specific Have you reviewed the General Instructions attached as a separate pdf at the bottom of the General Instructions page?: Yes Did you read the instructions regarding how to enter the form number and edition date in the Forms Schedule tab?: Yes Did you realize Oregon does not respond to Status Requests thru SERFF?: Yes Please confirm that you have read the Fraud Bulletin located at: Yes Have you attached under the Supporting Documentation tab any state specific Amendatory Endorsements that will be used to bring the submitted forms into compliance with our statutes?: N/A

4 Correspondence Summary Dispositions Status Created By Created On Date Submitted Filed David Dahl, FCAS, MAAA 03/07/ /07/2012

5 Disposition Disposition Date: 03/07/2012 Effective Date (New): 04/01/2012 Effective Date (Renewal): Status: Filed Comment: Rate data does NOT apply to filing. Overall Rate Information for Multiple Company Filings Overall Percentage Rate Indicated For This Filing 0.000% Overall Percentage Rate Impact For This Filing 0.000% Effect of Rate Filing-Written Premium Change For This Program $0 Effect of Rate Filing - Number of Policyholders Affected 0

6 Schedule Schedule Item Schedule Item Status Public Access Supporting Document Cover Letter or Explanatory Memorandum Reviewed-No Action Yes Supporting Document Third party filers letter of authorization Not Applicable to filing Yes Supporting Document 3894 Certification of Compliance Approved Yes Supporting Document 3618 Standards for Monoline and Package Property Information only Yes Supporting Document Highlighted/Redline form version if a replaced, amended or similar forms Not Applicable to filing Yes Rate ISO DIVISION TWELVE MARKET SEGMENTS HOTELS, MOTELS AND INNS COMPANIES EXCEPTION PAGE COUNTRYWIDE Reviewed-No Action Yes

7 Rate/Rule Schedule Schedule Item Exhibit Name: Rule # or Page Rate Action Previous State Filing Attachments Status: #: Number: Reviewed-No Action 03/07/2012 ISO DIVISION TWELVE MARKET SEGMENTS HOTELS, MOTELS AND INNS COMPANIES EXCEPTION PAGE COUNTRYWIDE MS-CW-HMI-1 New ISO Market Segments - Hotels Motels And Inns - Manual Page pdf

8 COMMERCIAL LINES MANUAL QBE INSURANCE CORPORATION PRAETORIAN INSURANCE COMPANY NORTH POINTE INSURANCE COMPANY ISO DIVISION TWELVE MARKET SEGMENTS HOTELS, MOTELS AND INNS COMPANIES EXCEPTION PAGE COUNTRYWIDE LOSS COST MULTIPLIER The loss cost multipliers (LCM) approved in your state as part of our Companies General Liability and Property filings will apply to Division Twelve Market Segments Hotels, Motels And Inns loss costs in ISO manual. OPTIONAL EQUIPMENT BREAKDOWN SECTION I GENERAL RULES ISO Market Segment Optional Equipment Breakdown forms, rules and rating procedures do not apply to QBEIC, PIC, & NPIC. Refer to QBEIC, PIC, & NPIC filed Equipment Breakdown forms, rules and rates under Division 5, Property. Includes copyrighted material of Insurance Services Office, Inc., with its permission Ed. 04/12 North Pointe Insurance Company MS-CW-HMI-1 Praetorian Insurance Company QBE Insurance Corporation

9 Supporting Document Schedules Satisfied - Item: Cover Letter or Explanatory Memorandum Comments: Attachment: ISO Market Segments - Hotels, Motels And Inns - Memorandum pdf Item Status: Status Date: Reviewed-No Action 03/07/2012 Bypassed - Item: Bypass Reason: Comments: Third party filers letter of authorization Not applicable. This is a direct company filing. Item Status: Status Date: Not Applicable to filing 03/07/2012 Item Status: Status Date: Satisfied - Item: 3894 Certification of Compliance Approved 03/07/2012 Comments: Attachment: OR form Cert of Compliance HMI pdf Item Status: Status Date: Satisfied - Item: 3618 Standards for Monoline and Information only 03/07/2012 Package Property Comments: QBE Insurance Corporation, Praetorian Insurance Company, & North Pointe Insurance Company acknowledges the 3618 Standards for Monoline and Package Property. Highlighted/Redline form version if Item Status: Not Applicable to filing Status Date:

10 Bypassed - Item: a replaced, amended or similar forms Bypass Reason: Not applicable - New Rating Rule. Comments: 03/07/2012

11 QBE Insurance Corporation Praetorian Insurance Company North Pointe Insurance Company ISO Initial Market Segments Hotels, Motels And Inns Filing Explanatory Memorandum QBE Insurance Corporation (QBEIC), Praetorian Insurance Company (PIC), & North Pointe Insurance Company (NPIC) are subscribers of Insurance Services Office, Inc. (ISO). In accordance with the regulatory provisions of your state, QBEIC, PIC, & NPIC are hereby adopting ISO Market Segments Hotels, Motels And Inns forms, loss costs, rules, rating plans that currently are in effect in your state. This is the initial filing for this Market Segment and therefore there is no rate impact. This is a new program filing. Also included for your review and approval, in this filing or a companion filing, is the enclosed companies state exception page. The companies exception page also refers to Division Five - Property for rates, rules, and forms for optional Equipment Breakdown coverage. The rates will be the combination of the ISO loss costs and the companies approved General Liability and Property loss cost multipliers and the state exception page. The rates in this filing are not excessive, inadequate, or unfairly discriminatory.

12 CERTIFICATE OF COMPLIANCE I, the undersigned authorized filer, hereby certify that the filing submitted complies with the applicable Oregon laws, Oregon Administrative Rules, Oregon Insurance Bulletins and applicable filing requirements and product standards set forth on the Insurance Division s website and that the filing is not false or misleading in any material respect. I further certify that I am authorized to sign and submit this certificate on behalf of the Company identified below (hereinafter Company). I, the undersigned authorized officer, a duly authorized officer of Company, certify that the undersigned authorized filer is authorized to certify on behalf of Company that this filing complies with the Oregon laws, Oregon Administrative Rules, Oregon Insurance Bulletins and applicable filing requirements and product standards set forth on the Insurance Division s website and that the filing is not false or misleading in any material respect. I understand that the Oregon Insurance Division will rely on this certificate and, should it be determined that this filing is materially false or misleading, appropriate corrective and disciplinary action including monetary penalties, as authorized by law, will be taken by the Oregon Insurance Division against the Company. Name of Company QBE Insurance Corporation, Praetorian Insurance Company, North Pointe Insurance Company. Company s filing number or the primary form number for the filing Signature of authorized filer Date 02/23/2012 Joshua Altman Print name of authorized filer 88 Pine Street Address of Company or authorized filer Rate & Form Implementation Analyst New York, NY Title City State ZIP joshua.altman@us.qbe.com Direct telephone number of authorized filer address of authorized filer Toll free or collect phone number Fax number of authorized filer (rev. 3/2002) F 473 UNIFORM INFORMATION SERVICES, INC. (Ed. 3/02)

13 Signature of authorized officer and title 02/23/2012 Date Janet Kiger Assistant Vice President 02/23/2012 Print name of authorized officer and title Date (rev. 3/2002) F 473 UNIFORM INFORMATION SERVICES, INC. (Ed. 3/02)