COMBINED ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2016 OF THE CONDITION AND AFFAIRS OF THE

Transcription

1 PROPERTY AND CASUALTY COMPANIES - ASSOCIATION EDITION COMBINED ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER, 0 OF THE CONDITION AND AFFAIRS OF THE Zurich American Insurance Company Affiliates its affiliated property casualty insurers NAIC Group Code 0 NAIC Company Code 0 Mail Address Zurich Way, th Floor, Schaumburg, IL 0-0 (Street Number or P.O. Box) (City or Town, State Zip Code) Combined Statement Contact Colleen M Zitt, --0, colleen.zitt@zurichna.com (Name) (Area Code) (Telephone Number) ( Address) NAMES OF COMPANIES INCLUDED IN THIS STATEMENT Name of Company NAIC Company Code State of Domicile American Guarantee & Liability Insurance Company NY American Zurich Insurance Company 0 IL Colonial American Casualty Surety Company MD Empire Fire Marine Insurance Company NE Empire Indemnity Insurance Company OK Fidelity Deposit Company of Maryl 0 MD Steadfast Insurance Company DE Universal Underwriters Insurance Company IL Universal Underwriters of Texas Insurance Company 0 IL Zurich American Insurance Company NY Zurich American Insurance Company of Illinois IL a. Is this an original filing? Yes [ X ] No [ ] b. If no,. State the amendment number. Date filed. Number of pages attached NOTE: This annual statement contains combined data for the property casualty insurance companies listed above, compiled in accordance with the NAIC instructions for the completion of annual statements.

2 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES ASSETS Current Year Prior Year Assets Nonadmitted Assets Net Admitted Assets (Cols. - ) Net Admitted Assets. Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks. Mortgage loans on real estate (Schedule B):. First liens. Other than first liens. Real estate (Schedule A):. Properties occupied by the company (less $ encumbrances). Properties held for the production of income (less $ encumbrances). Properties held for sale (less $ encumbrances). Cash ($, Schedule E - Part ), cash equivalents ($, Schedule E - Part ) short-term investments ($, Schedule DA). Contract loans (including $ premium notes). Derivatives (Schedule DB). Other invested assets (Schedule BA). Receivable for securities 0. Securities lending reinvested collateral assets (Schedule DL). Aggregate write-ins for invested assets. Subtotals, cash invested assets (Lines to ). Title plants less $ charged off (for Title insurers only). Investment income due accrued. considerations:. Uncollected premiums agents' balances in the course of collection. Deferred premiums agents' balances installments booked but deferred not yet due (including $ earned but unbilled premiums). Accrued retrospective premiums ($ ). Reinsurance: contracts subject to redetermination ($ ). Amounts recoverable from reinsurers. Funds held by or deposited with reinsured companies. Other amounts receivable under reinsurance contracts. Amounts receivable relating to uninsured plans. Current federal foreign income tax recoverable interest thereon. Net deferred tax asset. Guaranty funds receivable or on deposit 0. Electronic data processing equipment software. Furniture equipment, including health care delivery assets ($ ). Net adjustment in assets liabilities due to foreign exchange rates. Receivables from parent, subsidiaries affiliates. Health care ($ ) other amounts receivable. Aggregate write-ins for other than invested assets. Total assets excluding Separate Accounts, Segregated Accounts Protected Cell Accounts (Lines to ). From Separate Accounts, Segregated Accounts Protected Cell Accounts. Total (Lines ) DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above). Totals (Lines 0 thru 0 plus )(Line above)

3 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES LIABILITIES, SURPLUS AND OTHER FUNDS Current Year Prior Year. es (Part A, Line, Column ). Reinsurance payable on paid losses loss adjustment expenses (Schedule F, Part, Column ). adjustment expenses (Part A, Line, Column ). Commissions payable, contingent commissions other similar charges. Other expenses (excluding taxes, licenses fees). Taxes, licenses fees (excluding federal foreign income taxes). Current federal foreign income taxes (including $ on realized capital gains (losses)). Net deferred tax liability. Borrowed money $ interest thereon $. Unearned premiums (Part A, Line, Column ) (after deducting unearned premiums for ceded reinsurance of $ including warranty reserves of $ accrued accident health experience rating refunds including $ for medical loss ratio rebate per the Public Health Service Act) 0. Advance premium. Dividends declared unpaid:. Stockholders. Policyholders. reinsurance premiums payable (net of ceding commissions). Funds held by company under reinsurance treaties (Schedule F, Part, Column ). Amounts withheld or retained by company for account of others. Remittances items not allocated. Provision for reinsurance (including $ certified) (Schedule F, Part ). Net adjustments in assets liabilities due to foreign exchange rates. Drafts outsting. Payable to parent, subsidiaries affiliates 0. Derivatives. Payable for securities. Payable for securities lending. Liability for amounts held under uninsured plans. Capital notes $ interest thereon $. Aggregate write-ins for liabilities. Total liabilities excluding protected cell liabilities (Lines through ). Protected cell liabilities. Total liabilities (Lines ). Aggregate write-ins for special surplus funds 0. Common capital stock. Preferred capital stock. Aggregate write-ins for other than special surplus funds. Surplus notes. Gross paid in contributed surplus. Unassigned funds (surplus). Less treasury stock, at cost:. shares common (value included in Line 0 $ ). shares preferred (value included in Line $ ). Surplus as regards policyholders (Lines to, less ) (Page, Line ). TOTALS (Page, Line, Col. ) DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above). Totals (Lines 0 thru 0 plus )(Line above). Totals (Lines 0 thru 0 plus )(Line above)

4 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES STATEMENT OF INCOME Current Year Prior Year UNDERWRITING INCOME. earned (Part, Line, Column ) DEDUCTIONS:. es incurred (Part, Line, Column ). adjustment expenses incurred (Part, Line, Column ). Other underwriting expenses incurred (Part, Line, Column ). Aggregate write-ins for underwriting deductions. Total underwriting deductions (Lines through ). Net income of protected cells. Net underwriting gain or (loss) (Line minus Line plus Line ) INVESTMENT INCOME. Net investment income earned (Exhibit of Net Investment Income, Line ) 0. Net realized capital gains or (losses) less capital gains tax of $ (Exhibit of Capital Gains (es) ). Net investment gain (loss) (Lines + 0) OTHER INCOME. Net gain (loss) from agents or premium balances charged off (amount recovered $ amount charged off $ ). Finance service charges not included in premiums. Aggregate write-ins for miscellaneous income. Total other income (Lines through ). Net income before dividends to policyholders, after capital gains tax before all other federal foreign income taxes (Lines + + ). Dividends to policyholders. Net income, after dividends to policyholders, after capital gains tax before all other federal foreign income taxes (Line minus Line ). Federal foreign income taxes incurred 0. Net income (Line minus Line )(to Line ) CAPITAL AND SURPLUS ACCOUNT. Surplus as regards policyholders, December prior year (Page, Line, Column ). Net income (from Line 0). Net transfers (to) from Protected Cell accounts. Change in net unrealized capital gains or (losses) less capital gains tax of $. Change in net unrealized foreign exchange capital gain (loss). Change in net deferred income tax. Change in nonadmitted assets (Exhibit of Nonadmitted Assets, Line, Col. ). Change in provision for reinsurance (Page, Line, Column minus Column ). Change in surplus notes 0. Surplus (contributed to) withdrawn from protected cells. Cumulative effect of changes in accounting principles. Capital changes:. Paid in. Transferred from surplus (Stock Dividend). Transferred to surplus. Surplus adjustments:. Paid in. Transferred to capital (Stock Dividend). Transferred from capital. Net remittances from or (to) Home Office. Dividends to stockholders. Change in treasury stock (Page, Lines.., Column minus Column ). Aggregate write-ins for gains losses in surplus. Change in surplus as regards policyholders for the year (Lines through ). Surplus as regards policyholders, December current year (Line plus Line ) (Page, Line ) DETAILS OF WRITE-INS 0. Totals (Lines 00 thru 00 plus 0)(Line above). Totals (Lines 0 thru 0 plus )(Line above). Totals (Lines 0 thru 0 plus )(Line above)

5 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES CASH FLOW Current Year Prior Year Cash from Operations. collected net of reinsurance. Net investment income. Miscellaneous income. Total (Lines through ). Benefit loss related payments. Net transfers to Separate Accounts, Segregated Accounts Protected Cell Accounts. Commissions, expenses paid aggregate write-ins for deductions. Dividends paid to policyholders. Federal foreign income taxes paid (recovered) net of $ tax on capital gains (losses) 0. Total (Lines through ). Net cash from operations (Line minus Line 0) Cash from Investments. Proceeds from investments sold, matured or repaid:. Bonds. Stocks. Mortgage loans. Real estate. Other invested assets. Net gains or (losses) on cash, cash equivalents short-term investments. Miscellaneous proceeds. Total investment proceeds (Lines. to.). Cost of investments acquired (long-term only):. Bonds. Stocks. Mortgage loans. Real estate. Other invested assets. Miscellaneous applications. Total investments acquired (Lines. to.). Net increase (decrease) in contract loans premium notes. Net cash from investments (Line. minus Line. minus Line ) Cash from Financing Miscellaneous Sources. Cash provided (applied):. Surplus notes, capital notes. Capital paid in surplus, less treasury stock. Borrowed funds. Net deposits on deposit-type contracts other insurance liabilities. Dividends to stockholders. Other cash provided (applied). Net cash from financing miscellaneous sources (Lines. to. minus Line. plus Line.) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS. Net change in cash, cash equivalents short-term investments (Line, plus Lines ). Cash, cash equivalents short-term investments:. Beginning of year. End of period (Line plus Line.) Note: Supplemental disclosures of cash flow information for non-cash transactions:

6 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES UNDERWRITING AND INVESTMENT EXHIBIT Line of Business PART - PREMIUMS EARNED Net Written per Column, Part B Unearned Dec. Prior Year - per Col., Last Year s Part Unearned Dec. Current Year - per Col. Part A Earned During Year (Cols. + - ). Fire. Allied lines. Farmowners multiple peril. Homeowners multiple peril. Commercial multiple peril. Mortgage guaranty. Ocean marine. Inl marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident health. Credit accident health (group individual). Other accident health. Workers' compensation. Other liability - occurrence. Other liability - claims-made. Excess workers' compensation. Products liability - occurrence. Products liability - claims-made.,. Private passenger auto liability.,. Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity. Surety. Burglary theft. Boiler machinery. Credit. International 0. Warranty. Reinsurance - nonproportional assumed property. Reinsurance - nonproportional assumed liability. Reinsurance - nonproportional assumed financial lines. Aggregate write-ins for other lines of business. TOTALS DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above)

7 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES UNDERWRITING AND INVESTMENT EXHIBIT Line of Business PART A - RECAPITULATION OF ALL PREMIUMS Amount Unearned (Running One Year or Less from Date of Policy) (a) Amount Unearned (Running More Than One Year from Date of Policy) (a) Earned But Unbilled Premium Reserve for Rate Credits Retrospective Adjustments Based on Experience Total Reserve for Unearned Cols Fire. Allied lines. Farmowners multiple peril. Homeowners multiple peril. Commercial multiple peril. Mortgage guaranty. Ocean marine. Inl marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident health. Credit accident health (group individual). Other accident health. Workers' compensation. Other liability - occurrence. Other liability - claims-made. Excess workers' compensation. Products liability - occurrence. Products liability - claims-made.,. Private passenger auto liability.,. Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity. Surety. Burglary theft. Boiler machinery. Credit. International 0. Warranty. Reinsurance - nonproportional assumed property. Reinsurance - nonproportional assumed liability. Reinsurance - nonproportional assumed financial lines. Aggregate write-ins for other lines of business. TOTALS. Accrued retrospective premiums based on experience. Earned but unbilled premiums. Balance (Sum of Line through ) DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above) (a) State here basis of computation used in each case

8 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES UNDERWRITING AND INVESTMENT EXHIBIT PART B - PREMIUMS WRITTEN Line of Business Reinsurance Reinsurance Net Written Business (a) From Affiliates From Non-Affiliates To Affiliates To Non-Affiliates Cols Fire. Allied lines. Farmowners multiple peril. Homeowners multiple peril. Commercial multiple peril. Mortgage guaranty. Ocean marine. Inl marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident health. Credit accident health (group individual). Other accident health. Workers' compensation. Other liability - occurrence. Other liability - claims-made. Excess workers' compensation. Products liability - occurrence. Products liability - claims-made.,. Private passenger auto liability.,. Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity. Surety. Burglary theft. Boiler machinery. Credit. International 0. Warranty. Reinsurance - nonproportional assumed property XXX. Reinsurance - nonproportional assumed liability XXX. Reinsurance - nonproportional assumed financial lines XXX. Aggregate write-ins for other lines of business. TOTALS DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above) (a) Does the company's direct premiums written include premiums recorded on an installment basis? If yes:. The amount of such installment premiums $. Amount at which such installment premiums would have been reported had they been reported on an annualized basis $

9 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES UNDERWRITING AND INVESTMENT EXHIBIT PART - LOSSES PAID AND INCURRED es Paid Less Salvage Net es Current Year (Part A, Col. ) es Incurred Current Year (Cols. + - ) Percentage of es Incurred (Col., Part ) to Earned (Col., Part ) Reinsurance Reinsurance Net Payments Net es Line of Business Business Recovered (Cols. + - ) Prior Year. Fire. Allied lines. Farmowners multiple peril. Homeowners multiple peril. Commercial multiple peril. Mortgage guaranty. Ocean marine. Inl marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident health. Credit accident health (group individual). Other accident health. Workers' compensation. Other liability - occurrence. Other liability - claims-made. Excess workers' compensation. Products liability - occurrence. Products liability - claims-made.,. Private passenger auto liability.,. Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity. Surety. Burglary theft. Boiler machinery. Credit. International 0. Warranty. Reinsurance - nonproportional assumed property XXX. Reinsurance - nonproportional assumed liability XXX. Reinsurance - nonproportional assumed financial lines XXX. Aggregate write-ins for other lines of business. TOTALS DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above)

10 0 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES UNDERWRITING AND INVESTMENT EXHIBIT PART A - UNPAID LOSSES AND LOSS ADJUSTMENT EXPENSES Reported es Incurred But Not Reported Deduct Reinsurance Recoverable Net es Excl. Incurred But Not Reported (Cols. + - ) Net Adjustment Expenses Reinsurance Reinsurance Reinsurance Net es Line of Business (Cols ). Fire. Allied lines. Farmowners multiple peril. Homeowners multiple peril. Commercial multiple peril. Mortgage guaranty. Ocean marine. Inl marine 0. Financial guaranty. Medical professional liability - occurrence. Medical professional liability - claims-made. Earthquake. Group accident health (a). Credit accident health (group individual). Other accident health (a). Workers' compensation. Other liability - occurrence. Other liability - claims-made. Excess workers' compensation. Products liability - occurrence. Products liability - claims-made.,. Private passenger auto liability.,. Commercial auto liability. Auto physical damage. Aircraft (all perils). Fidelity. Surety. Burglary theft. Boiler machinery. Credit. International 0. Warranty. Reinsurance - nonproportional assumed property XXX XXX. Reinsurance - nonproportional assumed liability XXX XXX. Reinsurance - nonproportional assumed financial lines XXX XXX. Aggregate write-ins for other lines of business. TOTALS DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above) (a) Including $ for present value of life indemnity claims.

11 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES UNDERWRITING AND INVESTMENT EXHIBIT. Claim adjustment services: PART - EXPENSES Adjustment Expenses Other Underwriting Expenses Investment Expenses.. Reinsurance assumed. Reinsurance ceded. Net claim adjustment service ( ). Commission brokerage:. excluding contingent. Reinsurance assumed, excluding contingent. Reinsurance ceded, excluding contingent. Contingent - direct. Contingent - reinsurance assumed. Contingent - reinsurance ceded. Policy membership fees. Net commission brokerage ( ). Allowances to managers agents. Advertising. Boards, bureaus associations. Surveys underwriting reports. Audit of assureds records. Salary related items:. Salaries. Payroll taxes. Employee relations welfare 0. Insurance. ors fees. Travel travel items. Rent rent items. Equipment. Cost or depreciation of EDP equipment software. Printing stationery. Postage, telephone telegraph, exchange express. Legal auditing. Totals (Lines to ) 0. Taxes, licenses fees: 0. State local insurance taxes deducting guaranty association credits of $ 0. Insurance department licenses fees 0. Gross guaranty association assessments 0. All other (excluding federal foreign income real estate) 0. Total taxes, licenses fees ( ). Real estate expenses. Real estate taxes. Reimbursements by uninsured plans. Aggregate write-ins for miscellaneous expenses. Total expenses incurred (a). Less unpaid expenses - current year. Add unpaid expenses - prior year. Amounts receivable relating to uninsured plans, prior year. Amounts receivable relating to uninsured plans, current year 0. TOTAL EXPENSES PAID (Lines ) DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above) (a) Includes management fees of $ to affiliates $ to non-affiliates. Total

12 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES EXHIBIT OF NET INVESTMENT INCOME Collected During Year Earned During Year. U.S. Government bonds (a). Bonds exempt from U.S. tax (a). Other bonds (unaffiliated) (a). Bonds of affiliates (a). Preferred stocks (unaffiliated) (b). Preferred stocks of affiliates (b). Common stocks (unaffiliated). Common stocks of affiliates. Mortgage loans (c). Real estate (d) Contract loans Cash, cash equivalents short-term investments (e) Derivative instruments (f). Other invested assets. Aggregate write-ins for investment income 0. Total gross investment income. Investment expenses (g). Investment taxes, licenses fees, excluding federal income taxes (g). Interest expense (h). Depreciation on real estate other invested assets (i). Aggregate write-ins for deductions from investment income. Total deductions (Lines through ). Net investment income (Line 0 minus Line ) DETAILS OF WRITE-INS 0. Totals (Lines 00 thru 00 plus 0) (Line, above). Totals (Lines 0 thru 0 plus ) (Line, above) (a) Includes $ accrual of discount less $ amortization of premium less $ paid for accrued interest on purchases. (b) Includes $ accrual of discount less $ amortization of premium less $ paid for accrued dividends on purchases. (c) Includes $ accrual of discount less $ amortization of premium less $ paid for accrued interest on purchases. (d) Includes $ for company s occupancy of its own buildings; excludes $ interest on encumbrances. (e) Includes $ accrual of discount less $ amortization of premium less $ paid for accrued interest on purchases. (f) Includes $ accrual of discount less $ amortization of premium. (g) Includes $. investment expenses $ investment taxes, licenses fees, excluding federal income taxes, attributable to segregated Separate Accounts. (h) Includes $ interest on surplus notes $ interest on capital notes. (i) Includes $ depreciation on real estate $ depreciation on other invested assets. EXHIBIT OF CAPITAL GAINS (LOSSES) Total Realized Capital Gain () (Columns + ) Change in Unrealized Capital Gain () Change in Unrealized Foreign Exchange Capital Gain () Realized Gain () On Sales or Maturity Other Realized Adjustments. U.S. Government bonds. Bonds exempt from U.S. tax. Other bonds (unaffiliated). Bonds of affiliates. Preferred stocks (unaffiliated). Preferred stocks of affiliates. Common stocks (unaffiliated). Common stocks of affiliates. Mortgage loans. Real estate. Contract loans. Cash, cash equivalents short-term investments. Derivative instruments. Other invested assets. Aggregate write-ins for capital gains (losses) 0. Total capital gains (losses) DETAILS OF WRITE-INS 0. Totals (Lines 00 thru 00 plus 0) (Line, above)

13 0 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Reinsurance as of December, Current Year (000 Omitted) Reinsurance On 0 Amount of Assets Pledged or NAIC Funds Held By or Compensating Company Paid es Contingent Deposited With Balances to Domiciliary Adjustment Known Case Commissions Unearned Reinsured Letters of Credit Secure Letters of Code Name of Reinsured Jurisdiction Premium Expenses es LAE Cols. + Payable Receivable Premium Companies Posted Credit Amount of Assets Pledged or Collateral Held in Trust ID Number 0 Affiliates - U.S. Intercompany Pooling 0 Affiliates - U.S. Non-Pool - Captive 0 Affiliates - U.S. Non-Pool - Other 0 Total - U.S. Non-Pool 0 Affiliates - Other (Non-U.S.) - Captive 0 Affiliates - Other (Non-U.S.) - Other 0 Total - Other (Non-U.S.) 0 Total - Affiliates 0 Other U.S. Unaffiliated Insurers Reinsurance for which the total of Column is less than $00,000 0 Total Other U.S. Unaffiliated Insurers 0 Pools Associations - Reinsurance for which the total of Column is less than $00,000 - Matory Pools 0 Total Pools, Associations or Other Similar Facilities - Matory Pools Pools Associations - Reinsurance for which the total of Column is less than $00,000 - Voluntary Pools Total Pools, Associations or Other Similar Facilities - Voluntary Pools Total - Pools Associations Other Non-U.S. Insurers - Reinsurance for which the total of Column is less than $00,000 Total Other Non-U.S. Insurers Totals

14 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Premium Portfolio Reinsurance Effected or (Canceled) during Current Year NAIC Company Date of NONE ID Number Code Name of Company Contract 0 Total Reinsurance By Portfolio 0 Total Reinsurance By Portfolio Original Premium Reinsurance Premium

15 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Reinsurance as of December, Current Year (000 Omitted) Reinsurance Recoverable On Reinsurance Payable 0 Net Amount Recoverable NAIC Other From Company Reinsurance Known Case Known Case Contingent Columns Amounts Reinsurers Domiciliary Special Paid LAE IBNR IBNR LAE Unearned Commis- thru Balances Due to Cols. - Code Name of Reinsurer Jurisdiction Code es Paid LAE Reserves Reserves Reserves Reserves sions Totals Payable Reinsurers [ + ] ID Number 0 Total Authorized - Affiliates - U.S. Intercompany Pool 0 Total Authorized - Affiliates - U.S. Non-Pool - Captive 0 Total Authorized - Affiliates - U.S. Non-Pool - Other 0 Total Authorized - Affiliates - U.S. Non-Pool 0 Total Authorized - Affiliates - Other (Non-U.S.) - Captive 0 Total Authorized - Affiliates - Other (Non-U.S.) - Other 0 Total Authorized - Affiliates - Other (Non-U.S.) 0 Total Authorized - Affiliates 0 Total Authorized - Other U.S. Unaffiliated Insurers (Under $00,000) 0 Total Authorized - Other U.S. Unaffiliated Insurers 0 Total Authorized - Pools - Matory Pools Total Authorized - Pools - Voluntary Pools Total Authorized - Other Non-U.S. Insurers (Under $00,000) Total Authorized - Other Non-U.S. Insurers Total Authorized Total Unauthorized - Affiliates - U.S. Intercompany Pooling Total Unauthorized - Affiliates - U.S. Non-Pool - Captive Total Unauthorized - Affiliates - U.S. Non-Pool - Other Total Unauthorized - Affiliates - U.S. Non-Pool Total Unauthorized - Affiliates - Other (Non-U.S.) - Captive Total Unauthorized - Affiliates - Other (Non-U.S.) - Other 0 Total Unauthorized - Affiliates - Other (Non-U.S.) Total Unauthorized - Affiliates Total Unauthorized - Other U.S. Unaffiliated Insurers (Under $00,000) Total Unauthorized - Other U.S. Unaffiliated Insurers Total Unauthorized - Pools - Matory Pools Total Unauthorized - Pools - Voluntary Pools Total Unauthorized - Other Non-U.S. Insurers (Under $00,000) Total Unauthorized - Other Non-U.S. Insurers Total Unauthorized Total Certified - Affiliates - U.S. Intercompany Pooling Total Certified - Affiliates - U.S. Non-Pool - Captive Total Certified - Affiliates - U.S. Non-Pool - Other 0 Total Certified - Affiliates - U.S. Non-Pool Total Certified - Affiliates - Other (Non-U.S.) - Captive Total Certified - Affiliates - Other (Non-U.S.) - Other Total Certified - Affiliates - Other (Non-U.S.) Total Certified - Affiliates Total Certified - Other U.S. Unaffiliated Insurers (Under $00,000) Total Certified - Other U.S. Unaffiliated Insurers Total Certified - Pools - Matory Pools Total Certified - Pools - Voluntary Pools Total Certified - Other Non-U.S. Insurers (Under $00,000) Total Certified - Other Non-U.S. Insurers Total Certified 0 Total Authorized, Unauthorized Certified Total Protected Cells Totals NOTE: Report the five largest provisional commission rates included in the cedant's reinsurance treaties. The commission rate to be reported is by contract with ceded premium in excess of $0,000: B. Report the five largest reinsurance recoverables reported in Column, due from any one reinsurer (based on the total recoverables, Line, Column ), the amount of ceded premium, indicate whether the recoverables are due from an affiliated insurer. Name of Reinsurer Commission Rate Premium Name of Reinsurer Total Recoverables Affiliated Funds Held By Company Under Reinsurance Treaties

16 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Aging of Reinsurance as of December, Current Year (000 Omitted) Reinsurance Recoverable on Paid es Paid Adjustment Expenses NAIC Overdue Percentage More Company 0 Percentage Than 0 Days ID Number Code Name of Reinsurer Domiciliary Jurisdiction Current to Days 0 to 0 Days to 0 Days Over 0 Days Total Overdue Cols Total Due Cols. + 0 Overdue Col. 0/Col. Overdue Col. /Col. 0 Total Authorized - Affiliates - U.S. Intercompany Pool 0 Total Authorized - Affiliates - U.S. Non-Pool - Captive 0 Total Authorized - Affiliates - U.S. Non-Pool - Other 0 Total Authorized - Affiliates - U.S. Non-Pool 0 Total Authorized - Affiliates - Other (Non-U.S.) - Captive 0 Total Authorized - Affiliates - Other (Non-U.S.) - Other 0 Total Authorized - Affiliates - Other (Non-U.S.) 0 Total Authorized - Affiliates 0 Total Authorized - Other U.S. Unaffiliated Insurers 0 Total Authorized - Pools - Matory Pools Total Authorized - Pools - Voluntary Pools Total Authorized - Other Non-U.S. Insurers Total Authorized Total Unauthorized - Affiliates - U.S. Intercompany Pooling Total Unauthorized - Affiliates - U.S. Non-Pool - Captive Total Unauthorized - Affiliates - U.S. Non-Pool - Other Total Unauthorized - Affiliates - U.S. Non-Pool Total Unauthorized - Affiliates - Other (Non-U.S.) - Captive Total Unauthorized - Affiliates - Other (Non-U.S.) - Other 0 Total Unauthorized - Affiliates - Other (Non-U.S.) Total Unauthorized - Affiliates Total Unauthorized - Other U.S. Unaffiliated Insurers Total Unauthorized - Pools - Matory Pools Total Unauthorized - Pools - Voluntary Pools Total Unauthorized - Other Non-U.S. Insurers Total Unauthorized Total Certified - Affiliates - U.S. Intercompany Pooling Total Certified - Affiliates - U.S. Non-Pool - Captive Total Certified - Affiliates - U.S. Non-Pool - Other 0 Total Certified - Affiliates - U.S. Non-Pool Total Certified - Affiliates - Other (Non-U.S.) - Captive Total Certified - Affiliates - Other (Non-U.S.) - Other Total Certified - Affiliates - Other (Non-U.S.) Total Certified - Affiliates Total Certified - Other U.S. Unaffiliated Insurers Total Certified - Pools - Matory Pools Total Certified - Pools - Voluntary Pools Total Certified - Other Non-U.S. Insurers Total Certified 0 Total Authorized Unauthorized Total Protected Cells Totals

17 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Provision for Unauthorized Reinsurance as of December, Current Year (000 OMITTED) 0 NAIC Company Code Domiciliary Jurisdiction Reinsurance Recoverable all Items Schedule F Part, Col. Funds Held By Company Under Reinsurance Treaties Issuing or Confirming Bank Reference Number (a) Balances Payable Miscellaneous Balances Payable Trust Funds Other Allowed Offset Items Total Collateral Offsets Allowed (Cols but not in Excess of Col. ) Provision for Unauthorized Reinsurance (Col. Minus Col. ) Recoverable Paid es & LAE Expenses Over 0 Days past Due not in Dispute 0% of Amount in Col. 0% of Amount in Dispute Included in Column Total Provision for Reinsurance to Unauthorized Provision for Reinsurers Overdue (Col. plus Reinsurance Col. but not (Col plus in Excess of Col. ) Col. ) ID Number Name of Reinsurer Special Code Letters of Credit 0 Total Affiliates - U.S. Intercompany Pooling XXX 0 Affiliates - U.S. Non-Pool - Captive XXX 0 Affiliates - U.S. Non-Pool - Other XXX 0 Total - U.S. Non-Pool XXX 0 Affiliates - Other (Non-U.S.) - Captive XXX 0 Affiliates - Other (Non-U.S.) - Other XXX 0 Total - Other (Non-U.S.) XXX 0 Total Affiliates XXX 0 Total Other U.S. Unaffiliated Insurers XXX 0 Total Pools Associations - Matory XXX Total Pools Associations - Voluntary XXX Total Other Non-U.S. Insurers XXX Total Affiliates Others XXX Total Protected Cells XXX Totals XXX. Amounts in dispute totaling $ are included in Column.. Amounts in dispute totaling $ are excluded from Column. (a) Code American Bankers Association (ABA) Routing Number Bank Name

18 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART - SECTION Provision for Reinsurance to Certified Reinsurers as of December, Current Year (000 Omitted) 0 Collateral Provided 0 NAIC Company Code Domiciliary Jurisdiction Certified Reinsurer Rating ( through ) Effective Date of Certified Reinsurer Rating Percent Collateral Required for Full Credit (0% - 00%) Net Amount Recoverable from Reinsurers (Sch. F Part Catastrophe Recoverables Qualifying for Collateral Deferral Net Recoverables Subject to Collateral Requirements for Full Credit (Col - Col ) Dollar Amount of Collateral Required (Col 0 x Col ) Percent Percent of Credit Collateral Allowed on Provided Net Recoverables for Net Recoverables Subject to Collateral Subject to Requirements Funds Held Issuing or Total Collateral By Company Confirming Collateral Requirements (Col / Col Under Bank Other Provided, not to Reinsurance Letters of Reference Allowable (Col. + (Col. / by Exceed Treaties Credit Number (a) Collateral + + ) Col. 0) 00%) Multiple Beneficiary Trust Amount of Credit Allowed for Net Recoverables (Col. + (Col. 0 x Col. )) ID Number Name of Reinsurer Col. ) 0 Total Affiliates - U.S. Intercompany Pooling XXX XXX XXX 0 - Affiliates - U.S. Non-Pool - Captive XXX XXX XXX 0 - Affiliates - U.S. Non-Pool - Other XXX XXX XXX 0 - Total - U.S. Non-Pool XXX XXX XXX 0 - Affiliates - Other (Non-U.S.) - Captive XXX XXX XXX 0 - Affiliates - Other (Non-U.S.) - Other XXX XXX XXX 0 - Total - Other (Non-U.S.) XXX XXX XXX 0 - Total - Affiliates XXX XXX XXX 0 Total Other U.S. Unaffiliated Insurers XXX XXX XXX 0 Total Pools Associations - Matory XXX XXX XXX Total Pools Associations - Voluntary XXX XXX XXX Total Other Non-U.S. Insurers XXX XXX XXX Total Affiliates Others XXX XXX XXX Total Protected Cells XXX XXX XXX - Total XXX XXX XXX Provision for Reinsurance with Certified Reinsurers Due to Collateral Deficiency (Col. - Col. 0) (a) Code American Bankers Association (ABA) Routing Number Bank Name

19 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART - SECTION Provision for Overdue Reinsurance to Certified Reinsurers as of December, Current Year (000 OMITTED) 0 Complete if Column is 0% or Greater: NAIC Company Code Reinsurance Recoverable on Paid LAE More Than 0 Days Overdue (a) Total Reinsurance Recoverable on Paid es LAE (b) Amounts Received Prior 0 Days Percent More Than 0 Days Overdue 0% of Amounts in Col. 0% of Amounts in Dispute Excluded from Col. Amount of Credit Allowed for Net Recoverables (Sch. F Part Section Col. 0) Total Collateral Provided (Sch. F Part Section Col. ) not to Exceed Col Net Unsecured Recoverable for which Credit is allowed (Col. - Col. ) Provision for Overdue Reinsurance to Certified Reinsurers (Greater of Col. + Col. 0 or Col. ) not to Exceed Col. ID Number Name of Reinsurer Domiciliary Jurisdiction 0% of Amount in Col. 0 Total Affiliates - U.S. Intercompany Pooling XXX 0 Affiliates - U.S. Non-Pool - Captive XXX 0 Affiliates - U.S. Non-Pool - Other XXX 0 Total - U.S. Non-Pool XXX 0 Affiliates - Other (Non-U.S.) - Captive XXX 0 Affiliates - Other (Non-U.S.) - Other XXX 0 Total - Other (Non-U.S.) XXX 0 Total Affiliates XXX 0 Total Other U.S. Unaffiliated Insurers XXX 0 Total Pools Associations - Matory XXX Total Pools Associations - Voluntary XXX Total Other Non-U.S. Insurers XXX Total Affiliates Others XXX Total Protected Cells XXX Totals XXX (a) From Schedule F - Part Columns +, total certified, less $ (b) From Schedule F - Part Columns +, total certified, less $ in dispute. in dispute.

20 Federal ID Number NAIC Company Code COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Name of Reinsurer Provision for Overdue Authorized Reinsurance as of December, Current Year Reinsurance Recoverable on Paid es Total Reinsurance LAE More Than Recoverable on Paid 0 Days Overdue es LAE Amounts Received (a) (b) Prior 0 Days Col. divided by (Cols. + ) Amounts in Col. for Companies Reporting less than 0% in Col. Amounts in Dispute Excluded from Col. for Companies Reporting less than 0% in Col. 0 0% of Amount in Col. Amount Reported in Col. x 0% + Col. 0 Totals XXX (a) From Schedule F - Part Columns +, total authorized, less $ in dispute. (b) From Schedule F - Part Columns +, total authorized, less $ in dispute.

21 Federal ID Number NAIC Company Code COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE F - PART Name of Reinsurer Provision for Overdue Reinsurance as of December, Current Year Funds Held By Reinsurance Company Under Recoverable Reinsurance Balances All Items Treaties Letters of Credit Payable Other Miscellaneous Balances Other Allowed Offset Items 0 Sum of Cols. through but not in excess of Col. Col. minus Col. 0 Greater of Col. or Schedule F - Part Cols. + Totals. Total. Line x.0. Schedule F - Part Col.. Provision for Overdue Authorized Reinsurance (Lines + ). Provision for Reinsurance to Unauthorized Reinsurers (Schedule F - Part Col. x000). Provision for Reinsurance to Certified Reinsurers (Schedule F- Part, Section, Col. x 000). Provision for Overdue Reinsurance to Certified Reinsurers (Schedule F - Part, Section, Col x 000). Provision for Reinsurance (sum Lines ) (Enter this amount on Page, Line )

22 Total Amount COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES % SCHEDULE H - ACCIDENT AND HEALTH EXHIBIT Group Accident Health Amount % Credit Accident Health (Group Individual) Collectively Renewable Non-Cancelable Guaranteed Renewable 0 Amount % Amount % Amount % Amount % PART. - ANALYSIS OF UNDERWRITING OPERATIONS Other Individual Contracts Non-Renewable for Stated Reasons Only Other Accident Only All Other Amount % Amount % Amount %. written XXX XXX XXX XXX XXX XXX XXX XXX XXX. earned XXX XXX XXX XXX XXX XXX XXX XXX XXX. Incurred claims. Cost containment expenses. Incurred claims cost containment expenses (Lines ). Increase in contract reserves. Commissions (a). Other general insurance expenses. Taxes, licenses fees 0. Total other expenses incurred. Aggregate write-ins for deductions 0. Gain from underwriting before dividends or refunds. Dividends or refunds. Gain from underwriting after dividends or refunds DETAILS OF WRITE-INS. Totals (Lines 0 thru 0 plus )(Line above) (a) Includes $ reported as "Contract, membership other fees retained by agents.

23 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE H - ACCIDENT AND HEALTH EXHIBIT (Continued) Other Individual Contracts Credit Accident Health Non-Renewable Total Group Accident Health (Group Individual) Collectively Renewable Non-Cancelable Guaranteed Renewable for Stated Reasons Only PART. - RESERVES AND LIABILITIES A. Premium Reserves:. Unearned premiums. Advance premiums. Reserve for rate credits. Total premium reserves, current year. Total premium reserves, prior year. Increase in total premium reserves B. Contract Reserves:. Additional reserves (a). Reserve for future contingent benefits (deferred maternity other similar benefits). Total contract reserves, current year. Total contract reserves, prior year.. Increase in contract reserves C. Claim Reserves Liabilities:. Total current year. Total prior year. Increase Other Accident Only All Other PART. - TEST OF PRIOR YEAR'S CLAIM RESERVES AND LIABILITIES. Claims paid during the year:. On claims incurred prior to current year. On claims incurred during current year. Claim reserves liabilities, December, current year:. On claims incurred prior to current year. On claims incurred during current year. Test:. Line... Claim reserves liabilities, December, prior year. Line. minus Line. PART. - REINSURANCE A. Reinsurance :. written. earned. Incurred claims. Commissions B. Reinsurance :. written. earned. Incurred claims. Commissions (a) Includes $ premium deficiency reserve.

24 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - ANALYSIS OF LOSSES AND LOSS EXPENSES SCHEDULE P - PART - SUMMARY ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX. 00 XXX. 00 XXX. 00 XXX. 00 XXX. 0 XXX. 0 XXX. 0 XXX. 0 XXX 0. 0 XXX. 0 XXX. Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Other Case Basis Bulk + IBNR Case Basis Bulk + IBNR 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior XXX. 00 XXX. 00 XXX. 00 XXX. 00 XXX. 0 XXX. 0 XXX. 0 XXX. 0 XXX 0. 0 XXX. 0 XXX. Totals XXX Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX Note: Parts are gross of all discounting, including tabular discounting. Part is gross of only nontabular discounting, which is reported in Columns of Part. The tabular discount, if any, is reported in the Notes to Financial Statements which will reconcile Part with Parts.

25 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART - SUMMARY INCURRED NET LOSSES AND DEFENSE AND COST CONTAINMENT EXPENSES REPORTED AT YEAR END ($000 OMITTED) DEVELOPMENT One Year Which es Two Year. Prior XXX. 00 XXX XXX. 00 XXX XXX XXX. 0 XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX 0. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX. Totals Which es Were Incurred SCHEDULE P - PART - SUMMARY CUMULATIVE PAID NET LOSSES AND DEFENSE AND COST CONTAINMENT EXPENSES REPORTED AT YEAR END ($000 OMITTED) Number of Claims Closed With Payment Number of Claims Closed Without Payment. Prior 000 XXX XXX. 00 XXX XXX. 00 XXX XXX XXX. 00 XXX XXX XXX XXX. 00 XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX 0. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Which es Were Incurred SCHEDULE P - PART - SUMMARY BULK AND IBNR RESERVES ON NET LOSSES AND DEFENSE AND COST CONTAINMENT EXPENSES REPORTED AT YEAR END ($000 OMITTED) Prior XXX. 00 XXX XXX. 00 XXX XXX XXX. 0 XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX 0. 0 XXX XXX XXX XXX XXX XXX XXX XXX. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX

26 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART A - HOMEOWNERS/FARMOWNERS ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX

27 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART B - PRIVATE PASSENGER AUTO LIABILITY/MEDICAL ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX

28 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART C - COMMERCIAL AUTO/TRUCK LIABILITY/MEDICAL ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX

29 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART D - WORKERS' COMPENSATION (EXCLUDING EXCESS WORKERS COMPENSATION) ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX

30 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART E - COMMERCIAL MULTIPLE PERIL ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX

31 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART F - SECTION - MEDICAL PROFESSIONAL LIABILITY - OCCURRENCE ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX 0

32 COMBINED STATEMENT FOR THE YEAR 0 OF THE ZURICH AMERICAN INSURANCE COMPANY AND AFFILIATES SCHEDULE P - PART F - SECTION - MEDICAL PROFESSIONAL LIABILITY - CLAIMS-MADE ($000 OMITTED) Which Were Earned es Were Incurred Earned Expense Payments Defense Cost Adjusting Other 0 Payments Containment Payments Payments Number of Total Net Claims Salvage Paid Cols Reported Subrogation ( Net ( - ) Received + - ). Prior XXX XXX XXX XXX Totals XXX XXX XXX XXX es Defense Cost Containment Adjusting Case Basis Bulk + IBNR Case Basis Bulk + IBNR Other 0 Salvage Subrogation Anticipated Total Net es Expenses Number of Claims Outsting. Prior Totals Total es Expenses Incurred Net Expense Percentage (Incurred / Earned) 0 Net Nontabular Discount Expense Net Balance Sheet Reserves After Discount Inter- Company Pooling Participation Percentage es Expenses. Prior XXX XXX XXX XXX XXX XXX XXX Totals XXX XXX XXX XXX XXX XXX XXX