ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO
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1 ANNUAL STATEMENT OF THE ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO of SAN JUAN in the state of Puerto Rico 2016 TO THE Insurance Department OF THE STATE OF Puerto Rico For the Year Ended DECEMBER 31, 2016 PROPERTY AND CASUALTY 2016
2 PROPERTY AND CASUALTY COMPANIES - ASSOCIATION EDITION ANNUAL STATEMENT For the Year Ended DECEMBER 31, 2016 OF THE CONDITION AND AFFAIRS OF THE Document Code: 201 ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO NAIC Group Code 0000, 0000 NAIC Company Code Employer s ID Number (Current Period) (Prior Period) Organized under the Laws of Puerto Rico, State of Domicile or Port of Entry PR Country of Domicile United States of America Incorporated/Organized 12/27/1995 Commenced Business 01/01/1998 Statutory Home Office Prof Of. Park V, 997 S. Roberto St., Suite 601, SAN JUAN, PR, (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office Prof. Office Park 997 San Roberto Stl, Suite 601 (Street and Number) SAN JUAN, PR, (787) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address PO BOX 11457, San Juan, PR, (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records Prof. Office Park 997 San Roberto St., Suite 601 (Street and Number) SAN JUAN, PR, (787) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Website Address Statutory Statement Contact Ms. Michelle Giraldi (787) (Name) (Area Code)(Telephone Number)(Extension) giraldim@ascpr.biz (787) ( Address) (Fax Number) OFFICERS Name Luz N. Carrero Juan A. Terrassa Title Executive Director President of the Board Raymond Fournier, Secretary of the Board OTHERS DIRECTORS OR TRUSTEES Lcdo. Roberto Castro, Sub-Secretary of the Board Juan A. Terrassa-Rep. of the Public Interest Marisol Flores-Rep. of the Public Interest # Adrian E. Ortiz-Rep. of the Public Interest # Raymond Fournier - Guardian Ins. Co Lic. Roberto Castro - Coperativa Seguros Mœltiples Joaquin Castrillo - MAPFRE Luis Pimentel - Multinational Insurance State of Puerto Rico County of San Juan ss The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of the said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. (Signature) (Signature) (Signature) Luz N. Carrero - Muæiz Lcdo. Roberto Castro Juan A. Terrassa (Printed Name) (Printed Name) (Printed Name) Executive Director Sub-Secretary of the Board of Directors President of the Board of Directors (Title) (Title) (Title) Subscribed and sworn to before me this a. Is this an original filing? Yes[X] No[ ] day of, 2017 b. If no, 1. State the amendment number 2. Date filed 3. Number of pages attached (Notary Public Signature)
3 2 ANNUAL STATEMENT FOR THE YEAR OF THE 2016 ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO ASSETS Current Year Prior Year Net Admitted Nonadmitted Assets Net Admitted Assets Assets (Cols.1-2) Assets 1. Bonds (Schedule D) ,850, ,850, ,946, Stocks (Schedule D): 2.1 Preferred stocks Common Stocks ,360, ,360, ,525, Mortgage loans on real estate (Schedule B): 3.1 First liens Other than first liens Real estate (Schedule A): 4.1 Properties occupied by the company (less $...0 encumbrances) Properties held for the production of income (less $...0 encumbrances) Properties held for sale (less $...0 encumbrances) Cash ($...4,205,528, Schedule E Part 1), cash equivalents ($...0, Schedule E Part 2) and short-term investments ($...154,696, Schedule DA) ,360, ,360, ,615, Contract loans (including $...0 premium notes) Derivatives (Schedule DB) Other invested assets (Schedule BA) Receivables for securities ,910, Securities Lending Reinvested Collateral Assets (Schedule DL) Aggregate write-ins for invested assets Subtotals, cash and invested assets (Lines 1 to 11) ,571, ,571, ,998, Title plants less $...0 charged off (for Title insurers only) Investment income due and accrued ,006, ,006, ,709, Premiums and considerations: 15.1 Uncollected premiums and agents balances in the course of collection Deferred premiums, agents balances and installments booked but deferred and not yet due (Including $...0 earned but unbilled premiums) Accrued retrospective premiums ($...0) and contracts subject to redetermination ($...0) Reinsurance: 16.1 Amounts recoverable from reinsurers Funds held by or deposited with reinsured companies Other amounts receivable under reinsurance contracts Amounts receivable relating to uninsured plans Current federal and foreign income tax recoverable and interest thereon ,585, Net deferred tax asset ,896, ,083, , ,196, Guaranty funds receivable or on deposit Electronic data processing equipment and software , , , , Furniture and equipment, including health care delivery assets ($...0) , , Net adjustment in assets and liabilities due to foreign exchange rates Receivables from parent, subsidiaries and affiliates Health care ($...0) and other amounts receivable Aggregate write-ins for other than invested assets ,101, ,213, ,888, ,522, TOTAL Assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) ,606, ,887, ,719, ,585, From Separate Accounts, Segregated Accounts and Protected Cell Accounts TOTAL (Lines 26 and 27) ,606, ,887, ,719, ,585,705 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 11 from overflow page TOTALS (Lines 1101 through 1103 plus 1198) (Line 11 above) Other Assets ,952, , ,010, ,500, Remittance Account Receivable and Other A/R ,149, , ,878, ,022, Summary of remaining write-ins for Line 25 from overflow page TOTALS (Lines 2501 through 2503 plus 2598) (Line 25 above) ,101, ,213, ,888, ,522,075
4 3 ANNUAL STATEMENT FOR THE YEAR OF THE 2016 ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO LIABILITIES, SURPLUS AND OTHER FUNDS 1 2 Current Year Prior Year 1. Losses (Part 2A, Line 35, Column 8) ,800, ,507, Reinsurance payable on paid losses and loss adjustment expenses (Schedule F, Part 1, Column 6) Loss adjustment expenses (Part 2A, Line 35, Column 9) ,500, ,000, Commissions payable, contingent commissions and other similar charges Other expenses (excluding taxes, licenses and fees) ,737, ,271, Taxes, licenses and fees (excluding federal and foreign income taxes) Current federal and foreign income taxes (including $...0 on realized capital gains (losses)) Net deferred tax liability Borrowed money $...0 and interest thereon $ Unearned premiums (Part 1A, Line 38, Column 5) (after deducting unearned premiums for ceded reinsurance of $...0 and including warranty reserves of $...0 and accrued accident and health experience rating refunds including $...0 for medical loss ratio rebate per the Public Health Service Act) ,388, ,365, Advance premiums Dividends declared and unpaid: 11.1 Stockholders Policyholders Ceded reinsurance premiums payable (net of ceding commissions) Funds held by company under reinsurance treaties (Schedule F, Part 3, Column 19) Amounts withheld or retained by company for account of others ,550, ,136, Remittances and items not allocated Provision for reinsurance (including ($...0 certified)) (Schedule F, Part 8) Net adjustments in assets and liabilities due to foreign exchange rates Drafts outstanding Payable to parent, subsidiaries and affiliates Derivatives Payable for securities , Payable for securities lending Liability for amounts held under uninsured plans Capital notes $...0 and interest thereon $ Aggregate write-ins for liabilities ,279, ,018, TOTAL Liabilities excluding protected cell liabilities (Lines 1 through 25) ,591, ,299, Protected cell liabilities TOTAL Liabilities (Lines 26 and 27) ,591, ,299, Aggregate write-ins for special surplus funds ,407, ,628, Common capital stock Preferred capital stock Aggregate write-ins for other than special surplus funds Surplus notes Gross paid in and contributed surplus Unassigned funds (surplus) ,720, ,657, Less treasury stock, at cost: shares common (value included in Line 30 $...0) shares preferred (value included in Line 31 $...0) Surplus as regards policyholders (Lines 29 to 35, minus 36) (Page 4, Line 39) ,128, ,286, TOTALS (Page 2, Line 28, Column 3) ,719, ,585,705 DETAILS OF WRITE-INS Uncollected Checks ,418, ,534, Premium Pending Distribution to Others ,269, ,330, Other Payables , ,000, Summary of remaining write-ins for Line 25 from overflow page , ,153, TOTALS (Lines 2501 through 2503 plus 2598) (Line 25 above) ,279, ,018, Rule LXX Reserve ,407, ,628, Summary of remaining write-ins for Line 29 from overflow page TOTALS (Lines 2901 through 2903 plus 2998) (Line 29 above) ,407, ,628, Summary of remaining write-ins for Line 32 from overflow page TOTALS (Lines 3201 through 3203 plus 3298) (Line 32 above)
5 4 ANNUAL STATEMENT FOR THE YEAR OF THE 2016 ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO STATEMENT OF INCOME 1 2 Current Prior Year Year UNDERWRITING INCOME 1. Premiums earned (Part 1, Line 35, Column 4) ,405, ,152,901 DEDUCTIONS 2. Losses incurred (Part 2, Line 35, Column 7) ,889, ,537, Loss adjustment expenses incurred (Part 3, Line 25, Column 1) ,690, ,531, Other underwriting expenses incurred (Part 3, Line 25, Column 2) ,870, ,582, Aggregate write-ins for underwriting deductions TOTAL Underwriting Deductions (Lines 2 through 5) ,450, ,651, Net income of protected cells Net underwriting gain or (loss) (Line 1 minus Line 6 plus Line 7) ,955, ,501,112 INVESTMENT INCOME 9. Net investment income earned (Exhibit of Net Investment Income, Line 17) ,653, ,040, Net realized capital gains (losses) less capital gains tax of $...0 (Exhibit of Capital Gains (Losses)) ,490, (15,927,170) 11. Net investment gain or (loss) (Lines ) ,144, (8,886,666) OTHER INCOME 12. Net gain or (loss) from agents or premium balances charged off (amount recovered $...0 amount charged off $...0) Finance and service charges not included in premiums Aggregate write-ins for miscellaneous income , (627,897) 15. TOTAL Other Income (Lines 12 through 14) , (627,897) 16. Net income before dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Lines ) ,283, ,986, Dividends to policyholders Net income, after dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Line 16 minus Line 17) ,283, ,986, Federal and foreign income taxes incurred ,700, ,897, Net income (Line 18 minus Line 19) (to Line 22) ,583, (2,911,383) CAPITAL AND SURPLUS ACCOUNT 21. Surplus as regards policyholders, December 31 prior year (Page 4, Line 39, Column 2) ,286, ,099, Net income (from Line 20) ,583, (2,911,383) 23. Net transfers (to) from Protected Cell accounts Change in net unrealized capital gains or (losses) less capital gains tax of $ ,508, ,949, Change in net unrealized foreign exchange capital gain (loss) Change in net deferred income tax (2,233,647) ,058, Change in nonadmitted assets (Exhibit of Nonadmitted Assets Line 28, Column 3) ,308, (2,713,441) 28. Change in provision for reinsurance (Page 3, Line 16, Column 2 minus Column 1) Change in surplus notes Surplus (contributed to) withdrawn from protected cells Cumulative effect of changes in accounting principles Capital changes: 32.1 Paid in Transferred from surplus (Stock Dividend) Transferred to surplus Surplus adjustments: 33.1 Paid in Transferred to capital (Stock Dividend) Transferred from capital Net remittances from or (to) Home Office Dividends to stockholders (6,324,762) (28,196,288) 36. Change in treasury stock (Page 3, Line 36.1 and 36.2, Column 2 minus Column 1) Aggregate write-ins for gains and losses in surplus Change in surplus as regards policyholders for the year (Lines 22 through 37) ,841, (26,813,625) 39. Surplus as regards policyholders, December 31 current year (Line 21 plus Line 38) (Page 3, Line 37) ,128, ,286,244 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 5 from overflow page TOTALS (Lines 0501 through 0503 plus 0598) (Line 5 above) Net Gain on Sale of Equipment (52,336) , Other losses (1,153,529) Other Income , , Summary of remaining write-ins for Line 14 from overflow page (637,450) TOTALS (Lines 1401 through 1403 plus 1498) (Line 14 above) , (627,897) Summary of remaining write-ins for Line 37 from overflow page TOTALS (Lines 3701 through 3703 plus 3798) (Lines 37 above)
6 Cash from Operations CASH FLOW 1 2 Current Year Prior Year 1. Premiums collected net of reinsurance ,428, ,335, Net investment income ,586, ,793, Miscellaneous income , (627,897) 4. TOTAL (Lines 1 through 3) ,198, ,500, Benefit and loss related payments ,596, ,579, Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts Commissions, expenses paid and aggregate write-ins for deductions ,568, ,019, Dividends paid to policyholders Federal and foreign income taxes paid (recovered) net of $...0 tax on capital gains (losses) ,115, ,802, TOTAL (Lines 5 through 9) ,280, ,401, Net cash from operations (Line 4 minus Line 10) (14,081,374) (20,900,405) 12. Proceeds from investments sold, matured or repaid: Cash from Investments 12.1 Bonds ,277, ,100, Stocks ,705, ,504, Mortgage loans Real estate Other invested assets Net gains or (losses) on cash, cash equivalents and short-term investments Miscellaneous proceeds ,953, (2) 12.8 TOTAL Investment proceeds (Lines 12.1 to 12.7) ,937, ,604, Cost of investments acquired (long-term only): 13.1 Bonds ,239, ,818, Stocks ,740, ,851, Mortgage loans Real estate Other invested assets Miscellaneous applications , ,910, TOTAL Investments acquired (Lines 13.1 to 13.6) ,687, ,581, Net increase (decrease) in contract loans and premium notes Net cash from investments (Line 12.8 minus Line 13.7 minus Line 14) ,250, ,023, Cash provided (applied): Cash from Financing and Miscellaneous Sources 16.1 Surplus notes, capital notes Capital and paid in surplus, less treasury stock Borrowed funds Net deposits on deposit-type contracts and other insurance liabilities Dividends to stockholders ,324, ,196, Other cash provided (applied) (31,099,207) ,992, Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) (37,423,969) (25,203,546) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) (255,206) (12,080,343) 19. Cash, cash equivalents and short-term investments: 19.1 Beginning of year ,615, ,695, End of year (Line 18 plus Line 19.1) ,360, ,615,430 Note: Supplemental Disclosures of Cash Flow Information for Non-Cash Transactions:
7 6 ANNUAL STATEMENT FOR THE YEAR OF THE 2016 ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO UNDERWRITING AND INVESTMENT EXHIBIT PART 1 - PREMIUMS EARNED Net Unearned Unearned Premiums Premiums Premiums Premiums Earned Written Per Dec. 31 Prior Year - Dec. 31 During Year Column 6, per Column 3, Current Year - per (Columns Line of Business Part 1B Last Year s Part 1 Column 5, Part 1A ) 1. Fire Allied lines Farmowners multiple peril Homeowners multiple peril Commercial multiple peril Mortgage guaranty Ocean marine Inland marine Financial guaranty Medical professional liability - occurrence Medical professional liability - claims-made Earthquake Group accident and health Credit accident and health (group and individual) Other accident and 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 and theft Boiler and machinery Credit International Warranty Reinsurance-Nonproportional Assumed Property Reinsurance-Nonproportional Assumed Liability Reinsurance-Nonproportional Assumed Financial Lines Aggregate write-ins for other lines of business ,428, ,365, ,388, ,405, TOTALS ,428, ,365, ,388, ,405,979 DETAILS OF WRITE-INS Compulsory Vehicle Liabilty ,428, ,365, ,388, ,405, Summary of remaining write-ins for Line 34 from overflow page TOTALS (Lines 3401 through 3403 plus 3498) (Line 34 above) ,428, ,365, ,388, ,405,979
8 7 ANNUAL STATEMENT FOR THE YEAR OF THE 2016 ASOCIACION DE SUSCRIPCION CONJUNTA DEL SEGURO DE RESPONSABILIDAD OBLIGATORIO UNDERWRITING AND INVESTMENT EXHIBIT PART 1A - RECAPITULATION OF ALL PREMIUMS Amount Unearned Amount Unearned Reserve for Total (Running One (Running More Rate Credits Reserve Year or Less Than One Year Earned and Retrospective For Unearned From Date From Date But Adjustments Premiums of Policy) of Policy) Unbilled Based on Columns Line of Business (a) (a) Premium Experience Fire Allied lines Farmowners multiple peril Homeowners multiple peril Commercial multiple peril Mortgage guaranty Ocean marine Inland marine Financial guaranty Medical professional liability - occurrence Medical professional liability - claims-made Earthquake Group accident and health Credit accident and health (group and individual) Other accident and 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 and theft Boiler and machinery Credit International Warranty Reinsurance-Nonproportional Assumed Property Reinsurance-Nonproportional Assumed Liability Reinsurance-Nonproportional Assumed Financial Lines Aggregate write-ins for other lines of business ,388, ,388, TOTALS ,388, ,388, Accrued retrospective premiums based on experience Earned but unbilled premiums Balance (Sum of Lines 35 through 37) ,388,075 DETAILS OF WRITE-INS Compulsory Vehicle Liability ,388, ,388, Summary of remaining write-ins for Line 34 from overflow page TOTALS (Lines 3401 through 3403 plus 3498) (Line 34 above) ,388, ,388,075 (a) State here basis of computation used in each case: Monthly
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