Florida Office of Insurance Regulation Catastrophic Event Data Reporting and Analysis Data Collection Form Number: OIR-DO-1681, (rev.

Transcription

1 Contact Person (Last Name) Contact Person (First Name) Section A: Mobile Response Unit Contact Information Use as many lines as necessary. Street Address, Suite# City State Zip Code Telephone Cellular Phone Address Rule Page 1 of 12

2 Section B: Aggregate Information THIS IS REQUIRED INFORMATION that is to be provided on a statewide basis as it relates to the submitting individual carrier associated with this data submission. Please review your data template carefully prior to submission. All validation check indicators must read "TRUE" for a successful submission. If you need additional assistance, please contact the Office via at: DisasterReporting@fldfs.com As used in this section and as this template may be applied to Hurricane/Tropical Storm reporting, "EVENT" means a storm system that has been declared by the National Hurricane Center of the National Weather Service. The duration of the "reporting event" includes the time period, in Florida: a. Beginning at the time a storm watch or storm warning is issued for any part of Florida by the National Hurricane Center of the National Weather Service; VALIDATION CHECKS b. Continuing for the time period during which the storm conditions exist anywhere in Florida; and c. Ending 72 hours following the termination of the last storm watch or storm warning issued for any part of Florida by the National Hurricane Center of the National Weather Service. Required Data Field Complete? Response1 Response2 Response3 Dollar Amount of Estimated Gross Payable Loss from Event (Gross of Reinsurance) Please include all lines of business. This does include any [anticipated] claim expense or cost incurred by the direct insurer during the processing of the claim. (Loss Adjustment Expenses) (in whole dollars) FALSE Projected Net Retention Resulting from the Event Please include all lines of business. Since it is vital for the Office to understand the impact of a catastrophe on an individual insurer as early as possible, please, if necessary, estimate projected net retention based on your reinsurance chart. The Office realizes this number may change in future reports as actual claims are reported, paid and settled with the reinsurers. (in whole dollars) FALSE Dollar Amount of Estimated Gross Payable Loss from Event covered by Reinsurance or Other Loss-Transfer Agreements Auto-Calculation Validation Check - Excel References: (B6-B7)=B8 (in whole dollars) Name and Version of Model Used for Financial Projections (Maximum of 255 characters.) FALSE Rule Page 2 of 12

3 Row_ID Coverage_Type County_Code Number of Claims Received Indemnity Paid to Date (in whole dollars) Number of Open Claims Number of Closed Non- Payment Claims Number of Closed Average Days to Close Payment Made Claims Claims Number of Open Claims - Number of Open Claims - Number of Open Claims - Open Number of Open Claims - Open between 31 Days Open between 61 Days 30 Days or Less Open More than 90 Days and 60 days and 90 days Rule Page 3 of 12

4 unique identifier Row_ID Coverage_Type Primary Policy Coverage Type: see Coverage_Type tab see Coverage_Type tab County_Code Florida County/Area of Loss Occurrence Code (The physical location of the loss.): see County_Code tab see County_Code tab In Section C, "Claims and Payment by County of Occurrence," the submitter is to provide the following information for each county/area where claims were received for the reporting EVENT as described below: As this template may be applied to Hurricane/Tropical Storm reporting, "EVENT" means a storm system that has been declared by the National Hurricane Center of the National Weather Service. The duration of the "reporting event" includes the time period, in Florida: a. Beginning at the time a storm watch or storm warning is issued for any part of Florida by the National Hurricane Center of the National Weather Service; b. Continuing for the time period during which the storm conditions exist anywhere in Florida; and c. Ending 72 hours following the termination of the last storm watch or storm warning issued for any part of Florida by the National Hurricane Center of the National Weather Service. Other reporting "EVENTS" will be as defined by the Office in its implementing reporting order. Personal Residential: Dwelling - Fire Personal Residential: Dwelling - Allied Lines (Excluding Flood) Personal Residential - Farmowners Personal Residential - Owner Occupied Personal Residential - Condos Personal Residential - Mobile Homes Personal Residential - Tenants Commercial Residential: Dwelling - Fire (Condo Associations Only) Commercial Residential: Dwelling - Fire (Excluding Condo Associations) Commercial Non-Residential: Fire Commercial Residential: Dwelling - Allied Lines (Condo Associations Only; Exclude Flood) Commercial Residential: Dwelling - Allied Lines (Excluding Condo Associations and Flood)) Number of Claims Received include Commercial Non-Residential: Allied Lines (Excluding Flood) only those Florida claims received on Commercial Allied Lines: Time Element (Excluding Flood) a direct basis meeting the criteria Commercial Residential: CMP (Condo Associations Only) discussed in the data template instructions AND only those claims Commercial Residential: CMP (Excluding Condo Associations) associated with the CEDRA Reporting Commercial Non-Residential: CMP Categories indicated to the right. Ocean Marine Inland Marine Aircraft Boiler and Machinery Private Passenger Auto Physical Damage Commercial Auto Physical Damage Federal Flood - Personal Residential Federal Flood - Commercial Residential Federal Flood - Non-Residential Private Flood - Personal Residential Private Flood - Commercial Residential Private Flood - Non-Residential All Others Indemnity Paid to Date (in whole dollars) is the total indemnity paid by the direct insurer, exclusive of applicable deductions and reserves. This includes, but is not limited to, additional living expenses (ALE), business interruption (BI), structure coverage, and contents coverage associated with the Number of Claims Received defined above. This may not exceed the policy limit for all coverages contained in the policy against which the claim was made. This does include any claim expense or cost incurred by the direct insurer during the processing of the claim. Number of Open Claims is Number of Claims Received where settlement has not yet been reached, or, if settlement has been reached and payment is due, the claimant has not yet received payment of the full, agreed upon settlement amount. Number of Closed Non-Payment Claims is "Number of Claims Received" that have been denied or where no payment is to be made to the policyholder. This also includes claims determined to be below the policy deductible. These claims are mutually exclusive from, and are not to be included in, the "Number of Closed Payment Made Claims discussed below. Number of Closed Payment Made Claims is "Number of Claims Received" for which the claimant has received payment of the full, agreed upon settlement amount, and no additional payments are expected to be incurred by the insurer for this specific claim. These claims are mutually exclusive from, and are not to be included in, the Number of Closed Non-Payment Claims discussed above. Average Days to Close Claims Number of Open Claims - Open 30 Days or Less Number of Open Claims - Open between 31 Days and 60 days Number of Open Claims - Open between 61 Days and 90 days Number of Open Claims - Open More than 90 Days Commercial Residential: Dwelling - Fire (Condo Associations Only) Commercial Residential: Dwelling - Fire (Excluding Condo Associations) Commercial Non-Residential: Fire Commercial Residential: Dwelling - Allied Lines (Condo Associations Only; Exclude Flood) Commercial Residential: Dwelling - Allied Lines (Excluding Condo Associations and Flood)) Commercial Non-Residential: Allied Lines (Excluding Flood) Commercial Allied Lines: Time Element (Excluding Flood) Multiple Florida Counties This category Commercial Residential: CMP (Condo Associations Only) may only be utilized for claims Commercial Residential: CMP (Excluding Condo Associations) associated with the Commercial Commercial Non-Residential: CMP coverages indicated to the right AND Ocean Marine only after every effort has been made to Inland Marine assign each claim to the specific county in which the loss occurred. Additional Aircraft detail may be requested for each claim Boiler and Machinery reported in this category. Auto Physical Damage Federal Flood - Personal Residential Federal Flood - Commercial Residential Federal Flood - Non-Residential Private Flood - Personal Residential Private Flood - Commercial Residential Private Flood - Non-Residential All Others Rule Page 4 of 12

5 Coverage Type Code CEDRA Reporting Category (Coverage Type) Annual Financial Statement Line and Definition NAIC Uniform Product Coding Matrix Definition FL OIR Product Review Product Name 1001 Personal Residential: Dwelling - Fire Personal: Property insurance coverage sold for personal, family or household purposes. Line 01 Fire: Coverage protecting the insured against the loss to real or personal property from Property (Fire): Coverage protecting the insured against loss or damage to real or personal property from a damage caused by the peril of fire or lightning, including business interruption, loss of rents, etc. variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, etc. Property / Personal (Dwelling Fire) 1002 Personal Residential: Dwelling - Allied Lines (Excluding Flood) 1003 Personal Residential - Farmowners 1004 Personal Residential - Owner Occupied Line 02.1 Allied lines: Coverages which are generally written with property insurance, e.g., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; rain; and damage from aircraft and vehicle, etc. Line 03 Farmowners multiple peril: A package policy for farming and ranching risks, similar to a homeowners policy that has been adopted for farms and ranches and includes both property and liability coverages for personal and business losses. Coverages include farm dwellings and their contents, barns, stables, other farm structures and farm inland marine, such as mobile equipment and livestock. Personal: Property insurance coverage sold for personal, family or household purposes. Property (Allied Lines): Coverage protecting the insured against loss or damage to real or personal property from Property / Personal (Dwelling Fire) a variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, glass Allied Lines/ Wind Only breakage, tornado, windstorm, hail, water damage, explosion, riot, civil commotion, rain, or damage from aircraft or vehicles. Farmowners Multi-Peril: Farmowners insurance sold for personal, family or household purposes. This package policy is similar to a homeowners policy, in that it has been developed for farms and ranches and includes both property and liability coverage for personal and business losses. Coverage includes farm dwellings and their contents, barns, stables, other farm structures and farm inland marine, such as mobile equipment and livestock. Farmowners Multi-Peril Line 04 Homeowners multiple peril: A package policy combining broad property coverage for Homeowners Multi-Peril: A package policy combining real and personal property coverage with personal liability the personal property and/or structure with broad personal liability coverage. Coverage coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and Homeowners Multi-Peril applicable to the dwelling, appurtenant structures, unscheduled personal property and additional additional living expense are typical. Includes mobile homes at a fixed location. living expenses are typical. Includes mobile homes at a fixed location. Owner Occupied: Homeowners insurance sold to owners occupying the described property Personal Residential - Condos Line 04 Homeowners multiple peril: A package policy combining broad property coverage for Homeowners Multi-Peril: A package policy combining real and personal property coverage with personal liability the personal property and/or structure with broad personal liability coverage. Coverage coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and Homeowners Multi-Peril applicable to the dwelling, appurtenant structures, unscheduled personal property and additional additional living expense are typical. Includes mobile homes at a fixed location. living expenses are typical. Includes mobile homes at a fixed location. Condos: Homeowners insurance sold to condominium owners occupying the described property Personal Residential - Mobile Homes Line 04 Homeowners multiple peril: A package policy combining broad property coverage for the personal property and/or structure with broad personal liability coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and additional living expenses are typical. Includes mobile homes at a fixed location. Homeowners Multi-Peril: A package policy combining real and personal property coverage with personal liability coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and additional living expense are typical. Includes mobile homes at a fixed location. Mobile Homes: Homeowners insurance sold to owners occupying the described mobile home. Mobile Home Multi-Peril Mobile Home Physical Damage 1007 Personal Residential - Tenants Line 04 Homeowners multiple peril: A package policy combining broad property coverage for Homeowners Multi-Peril: A package policy combining real and personal property coverage with personal liability the personal property and/or structure with broad personal liability coverage. Coverage coverage. Coverage applicable to the dwelling, appurtenant structures, unscheduled personal property and Homeowners Multi-Peril applicable to the dwelling, appurtenant structures, unscheduled personal property and additional additional living expense are typical. Includes mobile homes at a fixed location. living expenses are typical. Includes mobile homes at a fixed location. Tenants: Homeowners insurance sold to tenants occupying the described property Commercial Residential: Dwelling - Fire (Condo Associations Only) Line 01 Fire: Coverage protecting the insured against the loss to real or personal property from Property (Fire): Coverage protecting the insured against loss or damage to real or personal property from a damage caused by the peril of fire or lightning, including business interruption, loss of rents, etc. variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, etc. Property / Commercial Residential - Condo Assn Only 1009 Commercial Residential: Dwelling - Fire (Excluding Condo Associations) Line 01 Fire: Coverage protecting the insured against the loss to real or personal property from Property (Fire): Coverage protecting the insured against loss or damage to real or personal property from a damage caused by the peril of fire or lightning, including business interruption, loss of rents, etc. variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, etc. Property / Commercial Residential (Excluding Condo Assn) 1010 Commercial Non-Residential: Fire Line 01 Fire: Coverage protecting the insured against the loss to real or personal property from Property (Fire): Coverage protecting the insured against loss or damage to real or personal property from a damage caused by the peril of fire or lightning, including business interruption, loss of rents, etc. variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, etc. Property / Commercial Non-Residential Commercial Residential: Dwelling - Allied Lines (Condo Associations Only) (Excluding Flood) Commercial Residential: Dwelling - Allied Lines (Excluding Condo Associations) (Excluding Flood) Line 02.1 Allied lines Coverages which are generally written with property insurance, e.g., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; rain; and damage from aircraft and vehicle, etc. Line 02.1 Allied lines Coverages which are generally written with property insurance, e.g., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; rain; and damage from aircraft and vehicle, etc. Property (Allied Lines): Coverage protecting the insured against loss or damage to real or personal property from Property / Commercial Residential - Condo Assn Only a variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, glass Allied Lines/ Wind Only breakage, tornado, windstorm, hail, water damage, explosion, riot, civil commotion, rain, or damage from aircraft or vehicles. Property (Allied Lines): Coverage protecting the insured against loss or damage to real or personal property from Property / Commercial Residential (Excluding Condo Assn) a variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, glass Allied Lines/ Wind Only breakage, tornado, windstorm, hail, water damage, explosion, riot, civil commotion, rain, or damage from aircraft or vehicles Commercial Non-Residential: Allied Lines (Exluding Flood) Line 02.1 Allied lines Coverages which are generally written with property insurance, e.g., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; rain; and damage from aircraft and vehicle, etc. Property (Allied Lines): Coverage protecting the insured against loss or damage to real or personal property from Property / Commercial Non-Residential a variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, glass Allied Lines/ Wind Only breakage, tornado, windstorm, hail, water damage, explosion, riot, civil commotion, rain, or damage from aircraft or vehicles. Rule Page 5 of 12

6 1014 Commercial Allied Lines: Time Element (Excluding Flood) Line 02.1 Allied lines Coverages which are generally written with property insurance, e.g., glass, tornado, windstorm and hail; sprinkler and water damage; explosion, riot, and civil commotion; growing crops; rain; and damage from aircraft and vehicle, etc. Property (Allied Lines): Coverage protecting the insured against loss or damage to real or personal property from a variety of perils, including, but not limited to, fire, lightening, business interruption, loss of rents, glass Allied Lines / Time Element - Business Interruption breakage, tornado, windstorm, hail, water damage, explosion, riot, civil commotion, rain, or damage from aircraft or vehicles Commercial Residential: CMP (Condo Associations Only) Commercial Multiple Peril: The policy packages two or more insurance coverages protecting an enterprise from various property and liability risk exposures. Frequently includes fire, allied lines, various other coverages (e.g., difference in conditions) and liability coverage. Such coverages would be included in other annual statement lines, if written individually. Include under this type of insurance multi-peril policies (other than farmowners, homeowners and automobile policies) that include coverage for liability other than auto. Line 05.1 Commercial multiple peril (non-liablity portion): A contract for a commercial Non-Liability Portion: Absence of a responsibility to fulfill a contract or obligation. enterprise, which packages two or more insurance coverages protecting an enterprise from Builders Risk Policies: Typically written on a reporting or completed value form, this coverage insures against various property and liability, risk exposures. Frequently includes fire, allied lines, various other loss to buildings in the course of construction. The coverage also includes machinery and equipment used in the CMP / Indivisible Pkg / Residential - Condo Assn coverages (e.g., difference in conditions) and liability coverage (such coverages would be course of construction and to materials incidental to construction. CMP / Divisible Pkg / Residential - Condo Assn included in other annual statement lines, if written individually). Include multi-peril policies Businessowners: The Businessowners (BOP) provides a broad package of property and liability coverages for (other than farmowners, homeowners and automobile policies) that include coverage fro liability small and medium sized apartment buildings, offices, and retail stores. other than auto. Commercial Package Policy: The Commercial Package Policy (CPP) provides a broad package of property and liabi Manufacturers Output Policies: Provides broad form all risks coverage of personal property of an insured manufac E-Commerce: Coverage for all aspects of E-Commerce Business. Commercial Farm and Ranch: A commercial package policy for farming and ranching risks that includes both prop Other CMP Policies: All other commercial multiple peril (CMP) insurance products Commercial Residential: CMP (Excluding Condo Associations) Line 05.1 Commercial multiple peril (non-liablity portion): A contract for a commercial enterprise, which packages two or more insurance coverages protecting an enterprise from various property and liability, risk exposures. Frequently includes fire, allied lines, various other coverages (e.g., difference in conditions) and liability coverage (such coverages would be included in other annual statement lines, if written individually). Include multi-peril policies (other than farmowners, homeowners and automobile policies) that include coverage fro liability other than auto. Commercial Multiple Peril: The policy packages two or more insurance coverages protecting an enterprise from various property and liability risk exposures. Frequently includes fire, allied lines, various other coverages (e.g., difference in conditions) and liability coverage. Such coverages would be included in other annual statement lines, if written individually. Include under this type of insurance multi-peril policies (other than farmowners, homeowners and automobile policies) that include coverage for liability other than auto. Non-Liability Portion: Absence of a responsibility to fulfill a contract or obligation. Builders Risk Policies: Typically written on a reporting or completed value form, this coverage insures against loss to buildings in the course of construction. The coverage also includes machinery and equipment used in the CMP / Indivisible Pkg / Residential (Excludes Condo Assns) course of construction and to materials incidental to construction. CMP / Divisible Pkg / Residential (Excludes Condo Assns) Businessowners: The Businessowners (BOP) provides a broad package of property and liability coverages for small and medium sized apartment buildings, offices, and retail stores. Commercial Package Policy: The Commercial Package Policy (CPP) provides a broad package of property and liabi Manufacturers Output Policies: Provides broad form all risks coverage of personal property of an insured manufac E-Commerce: Coverage for all aspects of E-Commerce Business. Commercial Farm and Ranch: A commercial package policy for farming and ranching risks that includes both prop Other CMP Policies: All other commercial multiple peril (CMP) insurance products. Rule Page 6 of 12

7 1017 Commercial Non-Residential: CMP Commercial Multiple Peril: The policy packages two or more insurance coverages protecting an enterprise from various property and liability risk exposures. Frequently includes fire, allied lines, various other coverages (e.g., difference in conditions) and liability coverage. Such coverages would be included in other annual statement lines, if written individually. Include under this type of insurance multi-peril policies (other than farmowners, homeowners and automobile policies) that include coverage for liability other than auto. Line 05.1 Commercial multiple peril (non-liablity portion): A contract for a commercial Non-Liability Portion: Absence of a responsibility to fulfill a contract or obligation. enterprise, which packages two or more insurance coverages protecting an enterprise from Builders Risk Policies: Typically written on a reporting or completed value form, this coverage insures against various property and liability, risk exposures. Frequently includes fire, allied lines, various other loss to buildings in the course of construction. The coverage also includes machinery and equipment used in the CMP / Indivisible Pkg / Non-Residential coverages (e.g., difference in conditions) and liability coverage (such coverages would be course of construction and to materials incidental to construction. CMP / Divisible Pkg / Non-Residential included in other annual statement lines, if written individually). Include multi-peril policies Businessowners: The Businessowners (BOP) provides a broad package of property and liability coverages for (other than farmowners, homeowners and automobile policies) that include coverage fro liability small and medium sized apartment buildings, offices, and retail stores. other than auto. Commercial Package Policy: The Commercial Package Policy (CPP) provides a broad package of property and liabi Manufacturers Output Policies: Provides broad form all risks coverage of personal property of an insured manufac E-Commerce: Coverage for all aspects of E-Commerce Business. Commercial Farm and Ranch: A commercial package policy for farming and ranching risks that includes both prop Other CMP Policies: All other commercial multiple peril (CMP) insurance products Ocean Marine Line 08 Ocean Marine: Coverage for ocean and inland water transportation exposures; goods or Ocean Marine: Coverage for ocean and inland water transportation exposures; goods or cargoes; ships or hulls; cargoes; ships or hulls; earnings; and liability. earnings; and liability. Not applicable 1019 Inland Marine Inland Marine: Coverage for property that may be in transit, held by a bailee, at a fixed location, or movable goods that are often at different locations (e.g., off-road constructions equipment), or scheduled property (e.g., Homeowners Personal Property Floater) including items such as live animals, property with antique or collector s value, etc. These lines also include instrumentalities of transportation and communication, such as bridges, tunnels, piers, wharves, docks, pipelines, power and phone lines, and radio and television towers. Line 09 - Inland Marine: Coverage for property that may be in transit, held by a bailee, at a Animal Mortality: Coverage that provides a death benefit to the owner of a policy in the event of the death of Inland Marine / Portion of a CPP Policy fixed location, a movable good that is often at different locations (e.g., Homeowners Personal the insured livestock. Inland Marine / Personal Boatowners Property Floater) including items such as live animals, property with antique or collector's value, Difference in Conditions (DIC): DIC is a special form of open-peril coverage written in conjunction with basic Inland Marine / Personal Property Floater (Sch D Prop) etc. This line also includes instrumentalities of transportation and communication, such as fire coverage and designed to provide protection against losses not reimbursed under the standard fire forms. Inland Marine / All Other Personal Inland Marine bridges, tunnels, piers, wharves, docks, pipelines, power and phone lines, and radio and EDP Policies: Coverage to protect against losses arising out of damage to or destruction of electronic data Livestock & Live Animals (Pet Insurance Animal Mortality) television towers. processing equipment and its software. Pet Insurance Plans: Veterinary care plan insurance policy providing care for a pet animal (e.g., dog or cat) of th Other Commercial Inland Marine: All other inland marine coverage that is sold to commercial ventures. Other Personal Inland Marine: All other inland marine coverage that is sold for personal, family or household pur 1020 Aircraft Line 22 Aircraft (all perils): Coverage for aircraft (hull) and their contacts; aircraft owner's and Aircraft: Coverage for aircraft (hull) and their contents; aircraft owners and aircraft manufacturers liability to Not applicable aircraft manufacturers liability to passengers, airports and other third parties. passengers, airports and other third parties Boiler and Machinery Line 27 - Boiler and Machinery: Coverage for the failure of boilers, machinery and eletrical Boiler and Machinery: Coverage for the failure of boilers, machinery and other electrical equipment. Benefits equipment. Benefits include:(i) property of the insured, which has been directly damaged by the include (i) property of the insured, which has been directly damaged by the accident; (ii) costs of temporary accident;(ii) costs of temporary repairs and expediting expenses; and (iii) liabilty for damage to repairs and expediting expenses; and (iii) liability for damage to the property of others. Coverage also includes the property of others. inspection of the equipment. Boiler & Machinery 1022 Private Passenger Auto Physical Damage Line 21.1 Auto Physical Damage: Any motor vehicle insurance coverage (including collision, vandalism, fire and theft) that insures against material damage to the insured's vehicle. Personal Auto: Privately owned motor vehicles and trailers for roads not owned or used for commercial purposes. Private Passenger Auto (PPA): PPA filings that include singularly or in any combination coverage such as the PPA / Private Passenger Types (Autos Only) following: Auto Liability, Personal Injury Protection (PIP), Medical Payments (MP), Uninsured/Underinsured PPA / Private Passenger Types (Autos+MC/MH/Antique) (UM/UIM); Specified Causes of Loss, Comprehensive, and Collision. PPA / Motorcycles Only Motorcycle: Motorcycle filings that include singularly or in any combination coverage such as in the following: PPA / Recreational Vehicles or Motor Homes Only Motorcycle Liability, PIP, MP, UM/UIM, Specified Causes of Loss, Comprehensive, and Collision. PPA / Antique / Classic Only Recreational Vehicle (RV): RV filings (including filings for Golf Carts) which include singularly or in any PPA Physical Damage Only combination coverage such as the following: Auto Liability, PIP, MP, Uninsured Motorist and/or Underinsured Mobile Home Physical Damage Motorists (UM/UIM); Specified Causes of loss, Comprehensive, and Collision. Mobile Homes under Transport: Mobile Homes while under transport for personal or commercial use. Rule Page 7 of 12

8 1023 Commercial Auto Physical Damage 1024 Federal Flood - Personal Residential 1025 Federal Flood - Commercial Residential 1026 Federal Flood - Non-Residential 1027 Private Flood - Personal Residential 1028 Private Flood - Commercial Residential 1029 Private Flood - Non-Residential Line Auto Physical Damage: Any motor vehicle insurance coverage (including collision, vandalism, fire and theft) that insures against material damage to the insured's vehicle. Commercial is defined as all motor vehicle polices that include vehicles that are used in connection with business, commercial establishments, activity, employment, or activities carried on for gain or profit.. Line Flood: Coverage protecting the insured against loss or damage to real or personal property from flood.(note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.) Line Flood: Coverage protecting the insured against loss or damage to real or personal property from flood.(note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.) Line Flood: Coverage protecting the insured against loss or damage to real or personal property from flood.(note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.) Line Flood: Coverage protecting the insured against loss or damage to real or personal property from flood.(note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.) Line Flood: Coverage protecting the insured against loss or damage to real or personal property from flood.(note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.) Line Flood: Coverage protecting the insured against loss or damage to real or personal property from flood.(note: If coverage for flood is offered as an additional peril on a property insurance policy, file it under the applicable property insurance filing code.) Commercial Auto: Coverage for motor vehicles owned by a business engaged in commerce that protects the insured against financial loss because of legal liability for motor vehicle related injuries, or damage to the property of others caused by accidents arising out of the ownership, maintenance, use, or care-custody & control of a motor vehicle. Business Auto: Coverage for motor vehicles, other than those in the garage business, engaged in commerce. Business Auto filings include singularly or in any combination coverage such as the following: Auto Liability, PIP, MP, Uninsured Motorist and/or Underinsured Motorists (UM/UIM); Specified Causes of Loss, Comprehensive, and Collision Garage: Garage auto filings pertaining to auto dealers and to auto non-dealers (auto repair shops, auto service stations, parking garages, and similar risks). Garage filings include singularly or in any combination coverage such as the following: Garage Liability, Garagekeepers Legal Liability, PIP, MP, UM/UIM; Specified Causes of Loss, Comprehensive, and Collision. Truckers: Coverage for persons or organizations engaged in the business of transporting property by auto for hire, Mobile Homes under Transport: Mobile Homes while under transport for personal or commercial use Personal Flood: Coverage protecting the insured against loss or damage to real or personal property from flood. Separate flood insurance policy sold for personal, family or household purposes. Commercial Flood: Coverage protecting the insured against loss or damage to real or personal property from flood. Separate flood insurance policy sold to commercial ventures. Commercial Flood: Coverage protecting the insured against loss or damage to real or personal property from flood. Separate flood insurance policy sold to commercial ventures. Personal Flood: Coverage protecting the insured against loss or damage to real or personal property from flood. Separate flood insurance policy sold for personal, family or household purposes. Commercial Flood: Coverage protecting the insured against loss or damage to real or personal property from flood. Separate flood insurance policy sold to commercial ventures. Commercial Flood: Coverage protecting the insured against loss or damage to real or personal property from flood. Separate flood insurance policy sold to commercial ventures. Commercial Auto / Trucking/Hauling Commercial Auto / Garages Commercial Auto / Public Autos Commercial Auto / Business Auto Commercial Auto / Other Commercial Auto Commercial Auto Physical Damage Only Mobile Home Physical Damage Federal Flood - Personal Federal Flood - Commercial Federal Flood - Commercial Other Flood - Personal Other Flood - Commercial Other Flood - Commercial 1030 All Other Lines of Business All other lines of business not listed above All other lines of business not listed above All other lines of business not listed above Rule Page 8 of 12

9 COUNTY_NAME COUNTY_CODE Multiple Florida Counties (Commerical Policies Only) 68 Alachua 11 Baker 52 Bay 23 Bradford 45 Brevard 19 Broward 10 Calhoun 58 Charlotte 53 Citrus 47 Clay 48 Collier 64 Columbia 29 Dade 01 Desoto 34 Dixie 54 Duval 02 Escambia 09 Flagler 61 Franklin 59 Gadsden 21 Gilchrist 55 Glades 60 Gulf 66 Hamilton 56 Hardee 30 Hendry 49 Hernando 40 Highlands 27 Hillsborough 03 Holmes 51 Indian River 32 Jackson 25 Jefferson 46 Lafayette 62 Lake 12 Lee 18 Leon 13 Levy 39 Liberty 67 Madison 35 Manatee 15 Marion 14 Martin 42 Monroe 38 Nassau 41 Okaloosa 43 Okeechobee 57 Orange 07 Osceola 26 Palm Beach 06 Pasco 28 Rule Page 9 of 12

10 Pinellas 04 Polk 05 Putnam 22 Santa Rosa 33 Sarasota 16 Seminole 17 St. Johns 20 St. Lucie 24 Sumter 44 Suwannee 31 Taylor 37 Union 63 Volusia 08 Wakulla 65 Walton 36 Washington 50 Rule Page 10 of 12

11 Row_ID Claim_Number Policy_Number Coverage_Type County_Code Loss_Occurence_Date Claim_Submission_Date Final_Claim_Disposition_Date Total_Insured_Value Total_Paid_To_Date Total_Loss_Claim Includes_Wind_Coverage Includes_Hurricane_Deductible Includes_Mitigation_Credit Includes_Content_Coverage Includes_ALE_Or_BI Provides_Law_Ordinance Rule Page 11 of 12

12 Claim_ID Claim ID unique identifer Claim_Number Claim Number company's Policy_Number Policy Number company's Coverage_Type Primary Policy Coverage Type: see Coverage_Type tab see Coverage_Type tab County_Code Florida County/Area of Loss Occurrence Code (The physical location of the loss) see County_Code tab see County_Code tab Loss_Occurence_Date Claim_Submission_Date Final_Claim_Disposition_Date Total_Insured_Value Total_Paid_To_Date Total_Loss_Claim Includes_Wind_Coverage Includes_Hurricane_Deductible Includes_Mitigation_Credit Includes_Content_Coverage Includes_ALE_Or_BI Provides_Law_Ordinance Date of Loss Occurrence Date of Claim Submission Date of Final Claim Disposition, if applicable Please provide Total Insured Value of the Policy (Policy limit for all coverages contained in the policy) Please provide the Total Indemity Paid to Date (Applicable deductions and reserves are not to be included) Does this claim meet your company's standards to be defined as a "Total Loss" claim? Does this policy include "Wind Coverage"? Does this claim include a HURRICANE Deductible? Does the policy contain HURRICANE Mitigation Credits? Does this claim include Content Coverage? Does this claim provide for Additional Living Expenses or Business Interruption Costs? Does this claim provide Law and Ordinance Coverages? mm/dd/yyyy in whole dollars 0 for "no" 1 for "yes" Rule Page 12 of 12