Revised Field #

Other Liability, Medical Malpractice, Earthquake (REQ), BOP, Excess Insurance & Commercial Auto

Homeowners & Residential Fire

Private Passenger Auto Liability

Private Passenger Physical Damage

1

FEIN

FEIN

FEIN

FEIN

2

Filing Method

Filing Method

Filing Method

Filing Method

3

Line of Business

Line of Business

Line of Business

Line of Business

4

State ID

State ID

State ID

State ID

5

Class Code

Class Code

Class Code

Class Code

6

Statistical Year

Statistical Year

Statistical Year

Statistical Year

7

Not used

Zip Code

Zip Code

Zip Code

8

Form Type

Not used

BI Written Premium

Comp Written Premium

9

Written Premium

Written Premium

BI Earned Premium

Comp Earned Premium

10

Earned Premium

Earned Premium

BI Paid Loss

Comp Paid Loss

11

Paid Losses

Paid Losses

BI OS Loss

Comp OS Loss

12

Outstanding Losses

Outstanding Losses

BI PD ALAE

# Comp Wr. Exposure

13

Paid ALAE

Written Exposures

BI OS ALAE

# Comp Paid Claims

14

OS ALAE

# Paid Claims

# BI Written Exposure

# Comp OS Claims

15

Written Exposures

# OS Claims

#BI Paid Claims

Collision Wr. Premium

16

# Paid Claims

#BI OS Claims

Collision Er. Premium

17

# OS Claims

PD Written Premium

Collision Paid Loss

18

PD Earned Premium

Collision OS Loss

19

PD Paid Loss

# Collision Paid Claims

20

PD OS Loss

# Collision OS Claims

21

PD Paid ALAE

Other Written Premium

22

PD OS ALAE

Other Earned Premium

23

# PD Paid Claims

Other Paid Loss

24

#PD OS Claims

Other OS Loss

25

UM/UIM Written Prem

# Other Paid Claims

26

UM/UIM Earned Prem

# Other OS Claims

27

UM/UIM Paid Loss

28

UM/UIM OS Loss

29

UM/UIM Paid ALAE

30

UM/UIM OS ALAE

31

# UM/UIM Paid Claims

32

# UM/UIM OS Claims

33

Med Pay Written Prem

34

Med Pay Earned Prem

35

Med Pay Paid Loss

36

Med Pay OS Loss

37

Med Pay Paid ALAE

38

Med Pay OS ALAE

39

# Med Pay Paid Claims

40

# Med Pay  OS Claims

41

Other Written Prem

42

Other Earned Prem

43

Other Paid Loss

44

Other OS Loss

45

Other Paid ALAE

46

Other OS ALAE

47

# Other Paid Claims

48

# Other OS Claims

49

# SL Written Exposures

50

SL Written Prem

51

SL Earned Prem

52

BI SL Paid Loss

53

BI SL OS Loss

54

BI SL Paid ALAE

55

BI SL OS ALAE

56

# BI SL Paid Claims

57

# BI SL OS Claims

58

PD SL Paid Loss

59

PD SL OS Loss

60

PD SL Paid ALAE

61

PD SL OS ALAE

62

# PD SL Paid Claims

63

# PD SL OS Claims