Establishing secure connection… Loading editor… Preparing document…
Navigation

Fill and Sign the Unum Provident Policy Issued 2007 Form

Fill and Sign the Unum Provident Policy Issued 2007 Form

How it works

Open the document and fill out all its fields.
Apply your legally-binding eSignature.
Save and invite other recipients to sign it.

Rate template

4.4
61 votes
PROPERTY AND CASUALTY COMPANIES—ASSOCIATION EDITION COMBINED ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2003 OF THE CONDITION AND AFFAIRS OF THE ALLSTATE INSURANCE COMPANY and its affiliated property and casualty insurers NAIC Group Code Mail Address 0008 3075 SANDERS ROAD, SUITE H1A (Street and Number or P.O. Box) Combined Statement Contact 00086 NAIC Combined Company Code , NORTHBROOK, IL 60062-7127 (City or Town, State and Zip Code) LYNN CIRRINCIONE 847-402-3029 (Name) (Area Code) (Telephone Number) (Extension) NAME OF COMPANIES INCLUDED IN THIS STATEMENT Name of Company ENCOMPASS INSURANCE COMPANY ALLSTATE FLORIDIAN INDEMNITY COMPANY ALLSTATE NEW JERSEY INSURANCE COMPANY ALLSTATE NORTH AMERICAN INSURANCE COMPANY ENCOMPASS INSURANCE COMPANY OF NEW JERSEY ENCOMPASS INDEMNITY COMPANY ALLSTATE PROPERTY AND CASUALTY INSURANCE COMPANY ALLSTATE INSURANCE COMPANY ALLSTATE INDEMNITY COMPANY ALLSTATE TEXAS LLOYD'S ALLSTATE COUNTY MUTUAL ALLSTATE FIRE AND CASUALTY INSURANCE COMPANY ALLSTATE FLORDIAN INSURANCE COMPANY NORTHBROOK INDEMNITY COMPANY DEERBROOK INSURANCE COMPANY NAIC Company Code 10358 10835 10852 11110 11599 15130 17230 19232 19240 26530 29335 29688 30511 36455 37907 State of Domicile ILLINOIS ILLINOIS ILLINOIS ILLINOIS ILLINOIS ILLINOIS ILLINOIS ILLINOIS ILLINOIS TEXAS TEXAS ILLINOIS ILLINOIS ILLINOIS ILLINOIS Note: This annual statement contains combined data for the property and casualty insurance companies listed above, compiled in accordance with the NAIC instructions for the completion of annual statements. a. Is this an original filing? b. If no, 1. State the amendment number 2. Date filed 3. Number of pages attached COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS ASSETS 1. Bonds (Schedule D) 2. Stocks (Schedule D): 2.1 Preferred stocks 2.2 Common stocks 3. Mortgage loans on real estate (Schedule B): 3.1 First liens 3.2 Other than first liens 4. Real estate (Schedule A): 4.1 Properties occupied by the company (less $ encumbrances) 4.2 Properties held for the production of income (less $ encumbrances) 4.3 Properties held for sale (less $ encumbrances) 5. Cash ($ , Schedule E, Part 1), cash equivalents ($ , Schedule E, Part 2) and short -term investments ($ , Schedule DA) 6. Contract loans, (including $ premium notes) 7. Other invested assets (Schedule BA) 8. Receivable for securities 9. Aggregate write-ins for invested assets 10. Subtotals, cash and invested assets (Lines 1 to 9) 11. Investment income due and accrued 12. Premiums and considerations: 12.1 Uncollected premiums and agents’ balances in the course of collection 12.2 Deferred premiums, agents’ balances and installments booked but deferred and not yet due (including $ earned but unbilled premium) 12.3 Accrued retrospective premium 13. Reinsurance: 13.1 Amounts recoverable from reinsurers 13.2 Funds held by or deposited with reinsured companies 13.3 Other amounts receivable under reinsurance contracts 14. Amounts receivable relating to uninsured plans 15.1 Current federal and foreign income tax recoverable and interest thereon 15.2 Net deferred tax asset 16. Guaranty funds receivable or on deposit 17. Electronic data processing equipment and software 18. Furniture and equipment, including health care delivery assets ($ ) 19. Net adjustment in assets and liabilities due to foreign exchange rates 20. Receivables from parent, subsidiaries and affiliates 21. Health care ($ ) and other amounts receivable 22. Other assets nonadmitted 23. Aggregate write-ins for other than invested assets 24. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 10 to 23) 25. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 26. Total (Lines 24 and 25) DETAILS OF WRITE-INS 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 0901 thru 0903 plus 0998)(Line 9 above) 2398. Summary of remaining write-ins for Line 23 from overflow page 2399. Totals (Lines 2301 thru 2303 plus 2398)(Line 23 above) 2 1 Current Year 2 3 Prior Year 4 Assets Nonadmitted Assets Net Admitted Assets (Cols. 1 - 2) Net Admitted Assets COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS LIABILITIES, SURPLUS AND OTHER FUNDS 1 Current Year 1. Losses (Part 2A, Line 34, Column 8) 2. Reinsurance payable on paid loss and loss adjustment expenses (Schedule F, Part 1, Column 6) 3. Loss adjustment expenses (Part 2A, Line 34, Column 9) 4. Commissions payable, contingent commissions and other similar charges 5. Other expenses (excluding taxes, licenses and fees) 6. Taxes, licenses and fees (excluding federal and foreign income taxes) 7.1Current federal and foreign income taxes (including $ on realized capital gains (losses)) 7.2 Net deferred tax liability 8. Borrowed money $ and interest thereon $ 9. Unearned premiums (Part 1A, Line 37, Column 5) (after deducting unearned premiums for ceded reinsurance of $ reserves of $ ) and including warranty 10. Advance premiums 11. Dividends declared and unpaid: 11.1 Stockholders 11.2 Policyholders 12. Ceded reinsurance premiums payable (net of ceding commissions) 13. Funds held by company under reinsurance treaties (Schedule F, Part 3, Column 19) 14. Amounts withheld or retained by company for account of others 15. Remittances and items not allocated 16. Provision for reinsurance (Schedule F, Part 7) 17. Net adjustments in assets and liabilities due to foreign exchange rates 18. Drafts outstanding 19. Payable to parent, subsidiaries and affiliates 20. Payable for securities 21. Liability for amounts held under uninsured accident and health plans 22. Capital Notes $ and interest thereon $ 23. Aggregate write-ins for liabilities 24. Total liabilities excluding protected cell liabilities (Lines 1 through 23) 25. Protected cell liabilities 26. Total liabilities (Lines 24 and 25) 27. Aggregate write-ins for special surplus funds 28. Common capital stock 29. Preferred capital stock 30. Aggregate write-ins for other than special surplus funds 31. Surplus notes 32. Gross paid in and contributed surplus 33. Unassigned funds (surplus) 34. Less treasury stock, at cost: 34.1 shares common (value included in Line 28 $ ) 34.2 shares preferred (value included in Line 29 $ ) 35. Surplus as regards policyholders (Lines 27 to 33, less 34) (Page 4, Line 38) 36. TOTALS (Page 2, Line 26, Col. 3) DETAILS OF WRITE-INS 2398. Summary of remaining write-ins for Line 23 from overflow page 2399. Totals (Lines 2301 thru 2303 plus 2398) (Line 23 above) 2798. Summary of remaining write-ins for Line 27 from overflow page 2799. Totals (Lines 2701 thru 2703 plus 2798) (Line 27 above) 3098. Summary of remaining write-ins for Line 30 from overflow page 3099. Totals (Lines 3001 thru 3003 plus 3098) (Line 30 above) 3 2 Prior Year COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT STATEMENT OF INCOME 1 Current Year UNDERWRITING INCOME 1. Premiums earned (Part 1, Line 34, Column 4) DEDUCTIONS 2. 3. 4. 5. 6. Losses incurred (Part 2, Line 34, Column 7) Loss expenses incurred (Part 3, Line 25, Column 1) Other underwriting expenses incurred (Part 3, Line 25, Column 2) Aggregate write-ins for underwriting deductions Total underwriting deductions (Lines 2 through 5) 7. Net income of protected cells 8. Net underwriting gain or (loss) (Line 1 minus Line 6 plus Line 7) INVESTMENT INCOME 9. Net investment income earned (Exhibit of Net Investment Income, Line 17) 10. Net realized capital gains or (losses) (Exhibit of Capital Gains (Losses)) 11. Net investment gain or (loss) (Lines 9 + 10) OTHER INCOME 12. Net gain or (loss) from agents' or premium balances charged off (amount recovered $ charged off $ ) 13. Finance and service charges not included in premiums 14. Aggregate write-ins for miscellaneous income 15. Total other income (Lines 12 through 14) 16. 17. 18. 19. 20. Net income before dividends to policyholders and before federal and foreign income taxes (Lines 8 + 11 + 15) Dividends to policyholders Net income, after dividends to policyholders but before federal and foreign income taxes (Line 16 minus Line 17) Federal and foreign income taxes incurred Net income (Line 18 minus Line 19) (to Line 22) CAPITAL AND SURPLUS ACCOUNT 21. Surplus as regards policyholders, December 31 prior year (Page 4, Line 38, Column 2) GAINS AND (LOSSES) IN SURPLUS 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. Net income (from Line 20) Change in net unrealized capital gains or (losses) Change in net unrealized foreign exchange capital gain (loss) Change in net deferred income tax Change in nonadmitted assets (Exhibit 1, Line 5, Col. 3) 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: 31.1. Paid in 31.2. Transferred from surplus (Stock Dividend) 31.3. Transferred to surplus Surplus adjustments: 32.1. Paid in 32.2. Transferred to capital (Stock Dividend) 32.3. Transferred from capital Net remittances from or (to) Home Office Dividends to stockholders Change in treasury stock (Page 3, Lines 34.1 and 34.2, Column 2 minus Column 1) Aggregate write-ins for gains and losses in surplus 33. 34. 35. 36. 37. Change in surplus as regards policyholders for the year (Lines 22 through 36) 38. Surplus as regards policyholders, December 31 current year (Line 21 plus Line 37) (Page 3, Line 35) DETAILS OF WRITE-INS 0598. Summary of remaining write-ins for Line 5 from overflow page 0599. Totals (Lines 0501 thru 0503 plus 0598) (Line 5 above) 1498. Summary of remaining write-ins for Line 14 from overflow page 1499. Totals (Lines 1401 thru 1403 plus 1498) (Line 14 above) 3698. Summary of remaining write-ins for Line 36 from overflow page 3699. Totals (Lines 3601 thru 3603 plus 3698) (Line 36 above) 4 amount 2 Prior Year COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS CASH FLOW 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Cash from Operations Premiums collected net of reinsurance Net investment income Miscellaneous income Total (Lines 1 to 3) Benefits and loss related payments Net transfers to Separate, Segregated Accounts and Protected Cell Accounts Commissions, expenses paid and aggregate write-ins for deductions Dividends paid to policyholders Federal and foreign income taxes paid (recovered) $ net tax on capital gains (losses) Total (Lines 5 through 9) Net cash from operations (Line 4 minus Line 10) Cash from Investments Proceeds from investments sold, matured or repaid: 12.1 Bonds 12.2 Stocks 12.3 Mortgage loans 12.4 Real estate 12.5 Other invested assets 12.6 Net gains or (losses) on cash and short-term investments 12.7 Miscellaneous proceeds 12.8 Total investment proceeds (Lines 12.1 to 12.7) Cost of investments acquired (long-term only): 13.1 Bonds 13.2 Stocks 13.3 Mortgage loans 13.4 Real estate 13.5 Other invested assets 13.6 Miscellaneous applications 13.7 Total investments acquired (Lines 13.1 to 13.6) Net increase (or decrease) in policy loans and premium notes Net cash from investments (Line 12.8 minus Line 13.7 and Line 14) Cash from Financing and Miscellaneous Sources Cash provided (applied): 16.1 Surplus notes, capital notes 16.2 Capital and paid in surplus, less treasury stock 16.3 Borrowed funds received 16.4 Net deposits on deposit-type contracts and other insurance liabilities 16.5 Dividends to stockholders 16.6 Other cash provided (applied) Net cash from financing and miscellaneous sources (Line 16.1 to Line 16.4 minus Line 16.5 plus Line 16.6) RECONCILIATION OF CASH AND SHORT-TERM INVESTMENTS Net change in cash and short-term investments (Line 11 plus Line 15 plus Line 17) Cash and short-term investments: 19.1 Beginning of year 19.2 End of period (Line 18 plus Line 19.1) 5 1 Current Year To Date 2 Prior Year Ended December 31 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT PART 1 - PREMIUMS EARNED 1 Lines of Business 1. Fire 2. Allied lines 3. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 10. Financial guaranty 11.1 Medical malpractice - occurrence 11.2 Medical malpractice - claims-made 12. Earthquake 13. Group accident and health 14. Credit accident and health (group and individual) 15. Other accident and health 16. Net Premiums Written per Column 6, Part 1B Workers' compensation 17.1 Other liability - occurrence 17.2 Other liability - claims-made 18.1 Products liability - occurrence 18.2 Products liability - claims-made 19.1,19.2 Private passenger auto liability 19.3,19.4 Commercial auto liability 21. Auto physical damage 22. Aircraft (all perils) 23. Fidelity 24. Surety 26. Burglary and theft 27. Boiler and machinery 28. Credit 29. International 30. Reinsurance - Nonproportional Assumed Property 31. Reinsurance - Nonproportional Assumed Liability 32. Reinsurance - Nonproportional Assumed Financial Lines 33. Aggregate write-ins for other lines of business 34. TOTALS DETAILS OF WRITE-INS 3398. Summary of remaining write-ins for Line 33 from overflow page 3399. Totals (Lines 3301 thru 3303 plus 3398) (Line 33 above) 6 2 3 Unearned Premiums Unearned Premiums Dec. 31 Prior Year Dec. 31 Current per Col. 3, Last Year’s Year - per Col. 5 Part 1 Part 1A 4 Premiums Earned During Year (Cols. 1 + 2 - 3) COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT PART 1A - RECAPITULATION OF ALL PREMIUMS (a) Gross premiums (less reinsurance) and unearned premiums on all unexpired risks and reserve for return premiums under rate credit or retrospective rating plans based upon experience, viz: 1 2 3 4 Amount Unearned Amount Unearned Reserve for Rate (Running One Year or (Running More Than Credits and Less from Date of One Year from Date Earned Retrospective Policy) of Policy) but Adjustments Based Line of Business (b) (b) Unbilled Premium on Experience 1. Fire 2. Allied lines 3. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 10. Financial guaranty 11.1 Medical malpractice - occurrence 11.2 Medical malpractice - claims-made 12. Earthquake 13. Group accident and health 14. Credit accident and health (group and individual) 15. Other accident and health 16. Workers' compensation 17.1 Other liability - occurrence 17.2 Other liability - claims-made 18.1 Products liability - occurrence 18.2 Products liability - claims-made 19.1,19.2 Private passenger auto liability 19.3,19.4 Commercial auto liability 21. Auto physical damage 22. Aircraft (all perils) 23. Fidelity 24. Surety 26. Burglary and theft 27. Boiler and machinery 28. Credit 29. International 30. Reinsurance - Nonproportional Assumed Property 31. Reinsurance - Nonproportional Assumed Liability 32. Reinsurance - Nonproportional Assumed Financial Lines 33. Aggregate write-ins for other lines of business 34. TOTALS 35. Accrued retrospective premiums based on experience 36. Earned but unbilled premiums 37. Balance (Sum of Line 34 through 36) DETAILS OF WRITE-INS 3398. Summary of remaining write-ins for Line 33 from overflow page 3399. Totals (Lines 3301 thru 3303 plus 3398) (Line 33 above) (a) By gross premiums is meant the aggregate of all the premiums written in the policies or renewals in force. Are they so returned in this statement? (b) State here basis of computation used in each case . 7 5 Total Reserve for Unearned Premiums Cols. 1 + 2 + 3 + 4 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT PART 1B - PREMIUMS WRITTEN Gross Premiums (Less Return Premiums), Including Policy and Membership Fees Written and Renewed During Year Reinsurance Assumed Reinsurance Ceded 1 Direct 2 3 4 5 Business From From To To Line of Business (a) Affiliates Non-Affiliates Affiliates Non-Affiliates 1. Fire 2. Allied lines 3. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 10. Financial guaranty 11.1 Medical malpractice occurrence 11.2 Medical malpractice claims-made 12. Earthquake 13. Group accident and health 14. Credit accident and health (group and individual) 15. Other accident and health 16. Workers' compensation 17.1 Other liability - occurrence 17.2 Other liability - claims-made 18.1 Products liability occurrence 18.2 Products liability claims-made 19.1,19.2 Private passenger auto liability 19.3,19.4 Commercial auto liability 21. Auto physical damage 22. Aircraft (all perils) 23. Fidelity 24. Surety 26. Burglary and theft 27. Boiler and machinery 28. Credit 29. International 30. Reinsurance Nonproportional Assumed Property XXX 31. Reinsurance Nonproportional Assumed Liability XXX 32. Reinsurance Nonproportional Assumed Financial Lines XXX 33. 34. Aggregate write-ins for other lines of business TOTALS DETAILS OF WRITE-INS 3398. Summary of remaining writeins for Line 33 from overflow page 3399. Totals (Lines 3301 thru 3303 plus 3398) (Line 33 above) (a) Does the company’s direct premiums written include premiums recorded on an installment basis? If yes: 1. The amount of such installment premiums $ 2. Amount at which such installment premiums would have been reported had they been reported on an annualized basis $ 8 6 Net Premiums Written Cols. 1+2+3-4-5 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT PART 2 - LOSSES PAID AND INCURRED 1 9 Line of Business 1. Fire 2. Allied lines 3. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 10. Financial guaranty 11.1 Medical malpractice - occurrence 11.2 Medical malpractice - claims-made 12. Earthquake 13. Group accident and health 14. Credit accident and health (group and individual) 15. Other accident and health 16. Workers' compensation 17.1 Other liability - occurrence 17.2 Other liability - claims-made 18.1 Products liability - occurrence 18.2 Products liability - claims-made 19.1,19.2 Private passenger auto liability 19.3,19.4 Commercial auto liability 21. Auto physical damage 22. Aircraft (all perils) 23. Fidelity 24. Surety 26. Burglary and theft 27. Boiler and machinery 28. Credit 29. International 30. Reinsurance - Nonproportional Assumed Property 31. Reinsurance - Nonproportional Assumed Liability 32. Reinsurance - Nonproportional Assumed Financial Lines 33. Aggregate write-ins for other lines of business 34. TOTALS DETAILS OF WRITE-INS 3398. Summary of remaining write-ins for Line 33 from overflow page 3399. Totals (Lines 3301 thru 3303 plus 3398) (Line 33 above) Direct Business Losses Paid Less Salvage 2 3 Reinsurance Assumed Reinsurance Recovered 4 Net Payments (Cols. 1 + 2 - 3) 5 6 7 Net Losses Unpaid Current Year (Part 2A, Col. 8) Net Losses Unpaid Previous Year Losses Incurred Current Year (Cols. 4 + 5 - 6) 8 Percentage of Losses Incurred (Col. 7, Part 2) to Premiums Earned (Col. 4, Part 1) ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! XXX XXX XXX ! ! ! ! ! COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT PART 2A - UNPAID LOSSES AND LOSS ADJUSTMENT EXPENSES Reported Losses 1 10 Line of Business 1. Fire 2. Allied lines 3. Farmowners multiple peril 4. Homeowners multiple peril 5. Commercial multiple peril 6. Mortgage guaranty 8. Ocean marine 9. Inland marine 10. Financial guaranty 11.1 Medical malpractice - occurrence 11.2 Medical malpractice - claims-made 12. Earthquake 13. Group accident and health 14. Credit accident and health (group and individual) 15. Other accident and health 16. Workers' compensation 17.1 Other liability - occurrence 17.2 Other liability - claims-made 18.1 Products liability - occurrence 18.2 Products liability - claims-made 19.1,19.2 Private passenger auto liability 19.3,19.4 Commercial auto liability 21. Auto physical damage 22. Aircraft (all perils) 23. Fidelity 24. Surety 26. Burglary and theft 27. Boiler and machinery 28. Credit 29. International 30. Reinsurance - Nonproportional Assumed Property 31. Reinsurance - Nonproportional Assumed Liability 32. Reinsurance - Nonproportional Assumed Financial Lines 33. Aggregate write-ins for other lines of business 34. TOTALS DETAILS OF WRITE-INS 3398. Summary of remaining write-ins for Line 33 from overflow page 3399. Totals (Lines 3301 thru 3303 plus 3398) (Line 33 above) (a) Including $ for present value of life indemnity claims. Direct XXX XXX XXX 2 Reinsurance Assumed 3 Deduct Reinsurance Recoverable from Authorized and Unauthorized Companies 4 Net Losses Excl. Incurred But Not Reported (Cols. 1 + 2 - 3) 5 Incurred But Not Reported 6 7 Direct Reinsurance Assumed Reinsurance Ceded XXX XXX XXX 8 9 Net Losses Unpaid (Cols. 4 +5 + 6 - 7) Unpaid Loss Adjustment Expenses COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS UNDERWRITING AND INVESTMENT EXHIBIT PART 3 - EXPENSES 1 Loss Adjustment Expenses 2 Other Underwriting Expenses 3 Investment Expenses 4 Total 1. Claim adjustment services: 1.1 Direct 1.2 Reinsurance assumed 1.3 Reinsurance ceded 1.4 Net claim adjustment service (1.1 + 1.2 - 1.3) 2. Commission and brokerage: 2.1 Direct excluding contingent 2.2 Reinsurance assumed excluding contingent 2.3 Reinsurance ceded excluding contingent 2.4 Contingent-direct 2.5 Contingent-reinsurance assumed 2.6 Contingent-reinsurance ceded 2.7 Policy and membership fees 2.8 Net commission and brokerage (2.1 + 2.2 - 2.3 + 2.4 + 2.5 - 2.6 + 2.7) 3. Allowances to managers and agents 4. Advertising 5. Boards, bureaus and associations 6. Surveys and underwriting reports 7. Audit of assureds' records 8. Salary and related items: 8.1 Salaries 8.2 Payroll taxes 9. Employee relations and welfare 10. Insurance 11. Directors' fees 12. Travel and travel items 13. Rent and rent items 14. Equipment 15. Cost or depreciation of EDP equipment and software 16. Printing and stationery 17. Postage, telephone and telegraph, exchange and express 18. Legal and auditing 19. Totals (Lines 3 to 18) 20. Taxes, licenses and fees: 20.1 State and local insurance taxes deducting guaranty association credits of $ 20.2 Insurance department licenses and fees 20.3 Gross guaranty association assessments 20.4 All other (excluding federal and foreign income and real estate) 20.5 Total taxes, licenses and fees (20.1 + 20.2 + 20.3 + 20.4) 21. Real estate expenses 22. Real estate taxes 23. Reimbursements by uninsured accident and health plans 24. Aggregate write-ins for miscellaneous expenses 25. Total expenses incurred (a) 26. Less unpaid expenses - current year 27. Add unpaid expenses - prior year 28. Amounts receivable relating to uninsured accident and health plans, prior year 29. Amounts receivable relating to uninsured accident and health plans, current year 30. TOTAL EXPENSES PAID (Lines 25 - 26 + 27 - 28 + 29) DETAILS OF WRITE-INS 2498. Summary of remaining write-ins for Line 24 from overflow page 2499. Totals (Lines 2401 thru 2403 plus 2498) (Line 24 above) (a) Includes management fees of $ paid to affiliates and $ paid to non-affiliates. 11 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS EXHIBIT OF NET INVESTMENT INCOME 1 Collected During Year 1. 1.1 1.2 1.3 2.1 2.11 2.2 2.21 3. 4. 5. 6. 7. 8. 9. 10. 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/short-term investments Derivative instruments Other invested assets Aggregate write-ins for investment income Total gross investment income 11. 12. 13. 14. 15. 16. 17. Investment expenses Investment taxes, licenses and fees, excluding federal income taxes Interest expense Depreciation on real estate and other invested assets Aggregate write-ins for deductions from investment income Total (Lines 11 through 15) Net Investment Income - (Line 10 minus Line 16) 0998. 0999. 1598. 1599. 2 Earned During Year (a) (a) (a) (a) (b) (b) (c) (d) (e) (f) (g) (g) (h) (i) DETAILS OF WRITE-INS Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 0901 through 0903 plus 0998) (Line 9, above) Summary of remaining write-ins for Line 15 from overflow page Total (Lines 1501 through 1503 plus 1598) (Line 15, above) (a) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (b) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued dividends on purchases. (c) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (d) Includes $ interest on encumbrances. for company’s occupancy of its own buildings; and excludes $ (e) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (f) Includes $ accrual of discount less $ amortization of premium. (g) Includes $ investment expenses and $ investment taxes, licenses and fees, excluding federal income taxes, attributable to segregated and Separate Accounts. (h) Includes $ interest on surplus notes and $ interest on capital notes. (i) Includes $ depreciation on real estate and $ depreciation on other invested assets. EXHIBIT OF CAPITAL GAINS (LOSSES) 1 2 3 Realized Gain (Loss) On Sales or Maturity Other Realized Adjustments Increases (Decreases) by Adjustment 1. 1.1 1.2 1.3 2.1 2.11 2.2 2.21 3. 4. 5. 6. 7. 8. 9. 10. 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/Short-term investments Derivative instruments Other invested assets Aggregate write-ins for capital gains (losses) Total capital gains (losses) DETAILS OF WRITE-INS 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 0901 through 0903 plus 0998) (Line 9, above) 12 4 Net Gain (Loss) from Change in Difference Between Basis Book/ Adjusted Carrying and Admitted Values 5 Total COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - SUMMARY BY COUNTRY Description BONDS Governments (Including all obligations guaranteed by governments) States, Territories and Possessions (Direct and guaranteed) Political Subdivisions of States, Territories and Possessions (Direct and guaranteed) Special revenue and special assessment obligations and all non-guaranteed obligations of agencies and authorities of governments and their political subdivisions Public Utilities (unaffiliated) Industrial and Miscellaneous and Credit Tenant Loans (unaffiliated) Parent, Subsidiaries and Affiliates PREFERRED STOCKS Public Utilities (unaffiliated) Banks, Trust and Insurance Companies (unaffiliated) Industrial and Miscellaneous (unaffiliated) Parent, Subsidiaries and Affiliates COMMON STOCKS Public Utilities (unaffiliated) Banks, Trust and Insurance Companies (unaffiliated) Industrial and Miscellaneous (unaffiliated) Parent, Subsidiaries and Affiliates Long-Term Bonds and Stocks OWNED December 31 of Current Year 1 2 Book/Adjusted Carrying Value Fair Value (a) 1. 2. 3. United States Canada Other Countries 4. Totals 5. 6. 7. United States Canada Other Countries 8. Totals 9. 10. 11. United States Canada Other Countries 12. Totals 13. 14. 15. United States Canada Other Countries 16. Totals 17. 18. 19. United States Canada Other Countries 20. Totals 21. 22. 23. United States Canada Other Countries 24. Totals 25. Totals 26. Total Bonds 27. 28. 29. United States Canada Other Countries 30. Totals 31. 32. 33. United States Canada Other Countries 34. Totals 35. 36. 37. United States Canada Other Countries 38. Totals 39. Totals 40. Total Preferred Stocks 41. 42. 43. United States Canada Other Countries 44. Totals 45. 46. 47. United States Canada Other Countries 48. Totals 49. 50. 51. United States Canada Other Countries 52. Totals 53. Totals 54. Total Common Stocks 55. Total Stocks 56. Total Bonds and Stocks (a) The aggregate value of bonds which are valued at other than actual fair value is $ 3 4 Actual Cost Par Value of Bonds . SCHEDULE D - VERIFICATION BETWEEN YEARS 1. 2. 3. 4. 5. Book/adjusted carrying value of bonds and stocks, prior year Cost of bonds and stocks acquired, Column 6, Part 3 Increase (decrease) by adjustment: 3.1 Column 16, Part 1 3.2 Column 12, Part 2, Sec. 1 3.3 Column 10, Part 2, Sec. 2 3.4 Column 10, Part 4 Total gain (loss), Col. 14, Part 4 Deduct consideration for bonds and stocks disposed of Column 6, Part 4 6. 7. 8. 9. 10. 11. 28 Foreign Exchange Adjustment: 6.1 Column 17, Part 1 6.2 Column 13, Part 2, Sec. 1 6.3 Column 11, Part 2, Sec. 2 6.4 Column 11, Part 4 Book/adjusted carrying value at end of current period Total valuation allowance Subtotal (Lines 7 plus 8) Total nonadmitted amounts Statement value of bonds and stocks, current period COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - PART 1A - SECTION 1 1 Quality and Maturity Distribution of All Bonds Owned December 31, at Book/Adjusted Carrying Values by Major Types of Issues and NAIC Designations 2 3 4 5 6 7 8 Over 1 Year Through Over 5 Years Through Over 10 Years Col. 6 as a Total from Col. 6 Over 20 Years Total Current Year 5 Years 10 Years Through 20 Years % of Line 10.7 Prior Year 29 1 Year or Less Quality Rating per the NAIC Designation 1. U.S. Governments, Schedules D & DA (Group 1) 1.1 Class 1 1.2 Class 2 1.3 Class 3 1.4 Class 4 1.5 Class 5 1.6 Class 6 1.7 Totals 2. All Other Governments, Schedules D & DA (Group 2) 2.1 Class 1 2.2 Class 2 2.3 Class 3 2.4 Class 4 2.5 Class 5 2.6 Class 6 2.7 Totals 3. States, Territories and Possessions etc., Guaranteed, Schedules D & DA (Group 3) 3.1 Class 1 3.2 Class 2 3.3 Class 3 3.4 Class 4 3.5 Class 5 3.6 Class 6 3.7 Totals 4. Political Subdivisions of States, Territories and Possessions, Guaranteed, Schedules D & DA (Group 4) 4.1 Class 1 4.2 Class 2 4.3 Class 3 4.4 Class 4 4.5 Class 5 4.6 Class 6 4.7 Totals 5. Special Revenue & Special Assessment Obligations etc., Non-Guaranteed, Schedules D & DA (Group 5) 5.1 Class 1 5.2 Class 2 5.3 Class 3 5.4 Class 4 5.5 Class 5 5.6 Class 6 5.7 Totals 9 % From Col. 7 Prior Year 10 Total Publicly Traded ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 11 Total Privately Placed (a) COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - PART 1A - SECTION 1 (continued) 1 Quality and Maturity Distribution of All Bonds Owned December 31, at Book/Adjusted Carrying Values by Major Types of Issues and NAIC Designations 2 3 4 5 6 7 8 Over 1 Year Through Over 5 Years Through Over 10 Years Col. 6 as a Total from Col. 6 Over 20 Years Total Current Year 5 Years 10 Years Through 20 Years % of Line 10.7 Prior Year 30 1 Year or Less Quality Rating per the NAIC Designation 6. Public Utilities (Unaffiliated), Schedules D & DA (Group 6) 6.1 Class 1 6.2 Class 2 6.3 Class 3 6.4 Class 4 6.5 Class 5 6.6 Class 6 6.7 Totals 7. Industrial & Miscellaneous (Unaffiliated), Schedules D & DA (Group 7) 7.1 Class 1 7.2 Class 2 7.3 Class 3 7.4 Class 4 7.5 Class 5 7.6 Class 6 7.7 Totals 8. Credit Tenant Loans, Schedules D & DA (Group 8) 8.1 Class 1 8.2 Class 2 8.3 Class 3 8.4 Class 4 8.5 Class 5 8.6 Class 6 8.7 Totals 9. Parent, Subsidiaries and Affiliates, Schedules D & DA (Group 9) 9.1 Class 1 9.2 Class 2 9.3 Class 3 9.4 Class 4 9.5 Class 5 9.6 Class 6 9.7 Totals ! ! ! ! ! ! ! ! ! ! ! 9 % From Col. 7 Prior Year 10 Total Publicly Traded 11 Total Privately Placed (a) COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - PART 1A - SECTION 1 (continued) 1 Quality and Maturity Distribution of All Bonds Owned December 31, at Book/Adjusted Carrying Values by Major Types of Issues and NAIC Designations 2 3 4 5 6 7 8 Over 1 Year Through Over 5 Years Through Over 10 Years Col. 6 as a Total from Col. 6 Over 20 Years Total Current Year 5 Years 10 Years Through 20 Years % of Line 10.7 Prior Year 9 % From Col. 7 Prior Year 10 Total Publicly Traded 11 Total Privately Placed (a) 31 1 Year or Less Quality Rating per the NAIC Designation 10. Total Bonds Current Year 10.1 Class 1 ! 10.2 Class 2 ! 10.3 Class 3 ! 10.4 Class 4 ! (c) 10.5 Class 5 ! (c) 10.6 Class 6 ! (b) 10.7 Totals ! 10.8 Line 10.7 as a % of Col. 6 ! ! ! ! ! ! ! ! 11. Total Bonds Prior Year 11.1 Class 1 ! 11.2 Class 2 11.3 Class 3 11.4 Class 4 (c) 11.5 Class 5 (c) 11.6 Class 6 (b) 11.7 Totals ! 11.8 Line 11.7 as a % of Col. 8 ! ! ! ! ! ! ! 12. Total Publicly Traded Bonds 12.1 Class 1 ! ! 12.2 Class 2 ! 12.3 Class 3 ! 12.4 Class 4 ! 12.5 Class 5 ! 12.6 Class 6 ! 12.7 Totals ! ! 12.8 Line 12.7 as a % of Col. 6 ! ! ! ! ! ! ! 12.9 Line 12.7 as a % of Line 10.7, ! ! ! ! ! ! ! Col. 6, Section 10 13. Total Privately Placed Bonds 13.1 Class 1 ! 13.2 Class 2 ! 13.3 Class 3 ! 13.4 Class 4 ! 13.5 Class 5 ! 13.6 Class 6 ! 13.7 Totals ! 13.8 Line 13.7 as a % of Col. 6 ! ! ! ! ! ! ! 13.9 Line 13.7 as a % of Line 10.7, ! ! ! ! ! ! ! Col. 6, Section 10 (a) Includes $ freely tradable under SEC Rule 144 or qualified for resale under SEC Rule 144A. (b) Includes $ current year, $ prior year of bonds with Z designations and $ , current year, $ prior year of bonds with Z* designations. The letter “Z” means the NAIC designation was not assigned by the Securities Valuation Office (SVO) at the date of the statement. “Z*” means the SVO could not evaluate the obligation because valuation procedures for the security class is under regulatory review. (c) Includes $ current year, $ prior year of bonds with 5* designations and $ , current year, $ prior year of bonds with 6* designations. “5*” means the NAIC designation was assigned by the SVO in reliance on the insurer’s certification that the issuer is current in all principal and interest payments. “6*” means the NAIC designation was assigned by the SVO due to inadequate certification of principal and interest payments. COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - PART 1A - SECTION 2 Distribution by Type Maturity Distribution of All Bonds Owned December 31, at Book/Adjusted Carrying Values by Major Type and Subtype of Issues 1 2 3 4 5 6 7 Over 1 Year Over 5 Years Over 10 Years Col. 6 as a % 1 Year or Less Over 20 Years Total Current Year Through 5 Years Through 10 Years Through 20 Years of Line 10.7 1. U.S. Governments, Schedules D & DA (Group 1) 1.1 Issuer Obligations 1.2 Single Class Mortgage-Backed/Asset-Backed Securities 1.7 Totals 2. All Other Governments, Schedules D & DA (Group 2) 2.1 Issuer Obligations 2.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 2.3 Defined 2.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSETBACKED SECURITIES 2.5 Defined 2.6 Other 2.7 Totals 3. States, Territories, and Possessions Guaranteed, Schedules D & DA (Group 3) 32 3.1 Issuer Obligations 3.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 3.3 Defined 3.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSETBACKED SECURITIES 3.5 Defined 3.6 Other 3.7 Totals 4. Political Subdivisions of States, Territories and Possessions, Guaranteed, Schedules D & DA (Group 4) 4.1 Issuer Obligations 4.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 4.3 Defined 4.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSETBACKED SECURITIES 4.5 Defined 4.6 Other 4.7 Totals 5. Special Revenue & Special Assessment Obligations etc., Non-Guaranteed, Schedules D & DA (Group 5) 5.1 Issuer Obligations 5.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 5.3 Defined 5.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSETBACKED SECURITIES 5.5 Defined 5.6 Other 5.7 Totals ! ! ! ! ! ! ! ! ! ! ! ! ! 8 Total from Col 6 Prior Year 9 % From Col. 7 Prior Year ! ! 10 Total Publicly Traded 11 Total Privately Placed COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - PART 1A - SECTION 2 (continued) 1 33 Distribution by Type 1 Year or Less 6. Public Utilities (Unaffiliated), Schedules D & DA (Group 6) 6.1 Issuer Obligations 6.2 Single Class Mortgage-Backed/Asset-Based Securities MULTI-CLASS RESIDENTIAL MORTGAGEBACKED SECURITIES 6.3 Defined 6.4 Other MULTI-CLASS COMMERCIAL MORTGAGEBACKED/ASSET-BACKED SECURITIES 6.5 Defined 6.6 Other 6.7 Totals 7. Industrial & Miscellaneous (Unaffiliated), Schedules D & DA (Group 7) 7.1 Issuer Obligations 7.2 Single Class Mortgage-Backed/Asset-Based Securities MULTI-CLASS RESIDENTIAL MORTGAGEBACKED SECURITIES 7.3 Defined 7.4 Other MULTI-CLASS COMMERCIAL MORTGAGEBACKED/ASSET-BACKED SECURITIES 7.5 Defined 7.6 Other 7.7 Totals 8. Credit Tenant Loans, Schedules D & DA (Group 8) 8.1 Issuer Obligations 8.7 Totals 9. Parents, Subsidiaries and Affiliates, Schedules D & DA (Group 9) 9.1 Issuer Obligations 9.2 Single Class Mortgage-Backed/Asset-Based Securities MULTI-CLASS RESIDENTIAL MORTGAGEBACKED SECURITIES 9.3 Defined 9.4 Other MULTI-CLASS COMMERCIAL MORTGAGEBACKED/ASSET-BACKED SECURITIES 9.5 Defined 9.6 Other 9.7 Totals Maturity Distribution of All Bonds Owned December 31, at Book/Adjusted Carrying Values by Major Type and Subtype of Issues 3 5 6 7 8 2 4 Over 5 Years Col. 6 as a Total from Col. 6 Over 1 Year Through Over 10 Years Through 10 Years % of Line 10.7 Prior Year 5 Years Through 20 Years Over 20 Years Total Current Year ! ! ! ! ! ! ! ! ! 9 % From Col. 7 Prior Year 10 Total Publicly Traded 11 Total Privately Placed COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE D - PART 1A - SECTION 2 (continued) Maturity Distribution of All Bonds Owned December 31, at Book/Adjusted Carrying Values by Major Type and Subtype of Issues 1 2 3 4 5 6 7 8 9 Over 1 Year Over 5 Years Over 10 Years Total Col. 6 as a % Total From Col. 6 % From Col. 7 1 Year or Less Through 5 Years Through 10 Years Through 20 Years Over 20 Years Current Year of Line 10.7 Prior Year Prior Year 34 Distribution by Type 10. Total Bonds Current Year 10.1 Issuer Obligations 10.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 10.3 Defined 10.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSET-BACKED SECURITIES 10.5 Defined 10.6 Other 10.7 Totals 10.8 Line 10.7 as a % of Col. 6 11. Total Bonds Prior Year 11.1 Issuer Obligations 11.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 11.3 Defined 11.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSET-BACKED SECURITIES 11.5 Defined 11.6 Other 11.7 Totals 11.8 Line 11.7 as a % of Col. 8 12. Total Publicly Traded Bonds 12.1 Issuer Obligations 12.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 12.3 Defined 12.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSET-BACKED SECURITIES 12.5 Defined 12.6 Other 12.7 Totals 12.8 Line 12.7 as a % of Col. 6 12.9 Line 12.7 as a % of Line 10.7, Col. 6, Section 10 13. Total Privately Placed Bonds 13.1 Issuer Obligations 13.2 Single Class Mortgage-Backed/Asset-Backed Securities MULTI-CLASS RESIDENTIAL MORTGAGE-BACKED SECURITIES 13.3 Defined 13.4 Other MULTI-CLASS COMMERCIAL MORTGAGE-BACKED/ASSET-BACKED SECURITIES 13.5 Defined 13.6 Other 13.7 Totals 13.8 Line 13.7 as a % of Col. 6 13.9 Line 13.7 as a % of Line 10.7, Col. 6, Section 10 10 Total Publicly Traded 11 Total Privately Placed ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 1 1 2 Federal ID Number " " " " " " " NAIC Company Code #$$% % & #$$% % & '!(! ' $$% % , # -% % , # -% % , ) # -% % & '!(! * + 40 9999999 Totals 3 Name of Reinsured '!(! ) * + . ) / + , , 4 Domiciliary Jurisdiction 5 Assumed Premium Assumed Reinsurance as of December 31, Current Year (000 Omitted) Reinsurance On 9 6 7 8 Paid Losses and Loss Adjustment Expenses Known Case Losses and LAE Cols. 6 +7 Contingent Commissions Payable 10 Assumed Premiums Receivable 11 12 13 Unearned Premium Funds Held By or Deposited With Reinsured Companies Letters of Credit Posted 14 Amount of Assets Pledged or Compensating Balances to Secure Letters of Credit COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 2 1 Federal ID Number 2 NAIC Company Code Premium Portfolio Reinsurance Effected or (Canceled) during Current Year 3 4 Name of Company Date of Contract NONE 41 5 6 Original Premium Reinsurance Premium COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 3 1 2 Federal ID Number #+ " #+ #+ #+ " ' ' ' ' " " 3 NAIC Company Code Name of Reinsurer %0 ) #$$% % '!(! , #+ %0 ) #$$% % %0 ) & '!(! ' $$% % ) * + %0 ) , . ) , %0 ) & '!(! * + #+ %0 ) + %0 ) & '!(! ' $$% % ) * + + %0 ) , / + , + %0 ) & '!(! * + ' ) 1 + %0 ) & '!(! * + ' + %0 ) #+ %0 ) ) ' + %0 ) 4 Domiciliary Jurisdiction Ceded Reinsurance as of December 31, Current Year (000 Omitted) Reinsurance Recoverable On 6 7 8 9 10 11 12 5 Reinsurance Contracts Ceding 75% or More of Direct Reinsurance Premiums Premiums Written Ceded Paid Losses Paid LAE 42 9999999 Totals NOTE: Report the five largest provisional commission rates included in the cedant’s reinsurance treaties. The commission rate to be reported is by contract with ceded premium in excess of $50,000: 1 2 Name of Company Commission Rate 1. #.23*4# 32 4&3, ! 2. 5#3"6&37 ("2#. 8&*923 * ,24! : * (! 4&! ! 3. 4. 5. 3 Ceded Premium Known Case Known Case Loss LAE IBNR Loss Reserves Reserves Reserves IBNR LAE Reserves 13 14 15 Unearned Premiums Contingent Commissions Cols. 7 thru 14 Totals Reinsurance Payable 16 17 Ceded Balances Payable 18 19 Net Amount Recoverable Funds Held From By Company Other Reinsurers Under Amounts Cols. 15 - Reinsurance Due to [16 + 17] Treaties Reinsurers COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 4 1 2 3 4 Aging of Ceded Reinsurance as of December 31, Current Year (000 Omitted) Reinsurance Recoverable on Paid Losses and Paid Loss Adjustment Expenses Overdue 5 6 Federal ID Number #+ #+ #+ " ' ' ' " " NAIC Company Code Name of Reinsurer %0 ) & '!(! ' $$% % ) * + %0 ) , . ) , %0 ) & '!(! * + #+ %0 ) + %0 ) & '!(! ' $$% % ) * + + %0 ) , / + , + %0 ) & '!(! * + ' + %0 ) #+ %0 ) ) ' + %0 ) Domiciliary Jurisdiction Current 1 to 29 Days 7 30 - 90 Days 8 91 - 120 Days 9 Over 120 Days 12 13 Percentage Overdue Col. 10/Col. 11 ! Percentage more Than 120 Days Overdue Col. 9 / Col. 11 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 11 10 Total Overdue Cols. 6 + 7 + 8 + 9 Total Due Cols. 5 + 10 43 9999999 Totals COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 5 1 2 Federal ID Number & , & " 3 NAIC Company Code Name of Reinsurer '!(! ' $$% % ) * + / + '!(! * + #$$% % ) & Provision for Unauthorized Reinsurance as of December 31, Current Year (000 Omitted) 6 7 8 9 10 11 4 5 Domiciliary Jurisdiction Reinsurance Recoverable all Items Schedule F Part 3, Col. 15 Funds Held By Company Under Reinsurance Treaties Letters of Credit Ceded Balances Payable 44 9999999 Totals 1. Amounts in dispute totaling $ 2. Amounts in dispute totaling $ 3. Column 5 excludes $ are included in Column 5. are excluded from Column 13. recoverables on ceded IBNR on contracts in force prior to July 1, 1984 and not subsequently renewed. Miscellaneous Balances Other Allowed Offset Items Sum of Cols. 6 thru 10 but not in excess of Col. 5 12 13 14 15 Subtotal Col. 5 minus Col. 11 Recoverable Paid Losses & LAE Expenses Over 90 Days Past Due not in Dispute 20% of Amount in Col. 13 Smaller of Col. 11 or Col. 14 16 17 Total Provision for Smaller of Col. Unauthorized 11 or 20% of Reinsurance Smaller of Amount in Col.5 or Dispute Cols. Included in 12 +15 + 16 Col. 5 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 6 1 2 Federal ID Number NAIC Company Code 3 Name of Reinsurer Provision for Overdue Authorized Reinsurance as of December 31, Current Year 4 5 6 7 Reinsurance Total Reinsurance Recoverable on Paid Losses and LAE More Recoverable on Paid Than 90 Days Overdue Losses and Paid LAE Amounts Received Col. 4 divided by (a) (b) Prior 90 Days (Cols. 5 + 6) 45 9999999 Totals (a) From Schedule F - Part 4 Columns 8 + 9, total authorized, less $ (b) From Schedule F - Part 3 Columns 7 + 8, total authorized, less $ ! in dispute. in dispute. 8 9 10 11 Amounts in Col. 4 for Companies Reporting less than 20% in Col. 7 Amounts in Dispute Excluded from Col. 4 for Companies Reporting less than 20% in Col. 7 20% of Amount in Col. 9 Amount Reported in Col. 8 x 20% + Col. 10 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE F - PART 7 1 Federal ID Number 2 NAIC Company Code 3 Name of Reinsurer 4 Reinsurance Recoverable All Items Provision for Overdue Reinsurance as of December 31, Current Year 5 6 7 8 Funds Held By Ceded Balances Other Miscellaneous Company Under Reinsurance Treaties Payable Balances Letters of Credit 9 Other Allowed Offset Items 10 Sum of Cols. 5 thru 9 but not in excess of Col. 4 11 Col. 4 minus Col. 10 46 9999999 Totals 1. 2. 3. 4. 5. 6. Total Line 1 x .2 Schedule F - Part 6 Col. 11 Provision for Overdue Authorized Reinsurance (Lines 2 + 3) Provision for Unauthorized Reinsurance (Schedule F - Part 5 Col. 17 x 1000) Provision for Reinsurance (sum Lines 4 + 5) [Enter this amount on Page 3, Line 16] 12 Greater of Col. 11 or Schedule F - Part 4 Cols. 8 + 9 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE H - ACCIDENT AND HEALTH EXHIBIT Other Individual Contracts Group Accident and Health 3 4 Amount % Total 1 Amount 2 % Credit Accident and Health (Group and Individual) 5 6 Amount % Collectively Renewable 7 8 Amount % Non-Cancelable 9 10 Amount % PART 1 - ANALYSIS OF UNDERWRITING OPERATIONS 48 1. Premiums written 2. Premiums earned 3. Incurred claims 4. Increase in contract reserves 5. Commissions (a) 6. General insurance expenses 7. Taxes, licenses and fees 8. Total expenses incurred 9. Aggregate write-ins for deductions 10. Gain from underwriting before dividends or refunds 11. Dividends or refunds 12. Gain from underwriting after dividends or refunds ! ! ! ! ! ! DETAILS OF WRITE-INS 0998. Summary of remaining write-ins for Line 9 from overflow page 0999. Totals (Lines 0901 thru 0903 plus 0998) (Line 9 above) (a) Includes $ reported as “Contract, membership and other fees retained by agents.” Guaranteed Renewable 11 12 Amount % Non-Renewable for Stated Reasons Only 13 14 Amount % Other Accident Only 15 16 Amount % All Other 17 Amount 18 % COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE H - ACCIDENT AND HEALTH EXHIBIT (continued) 1 Total A. 1. 2. 3. 4. 5. 6. B. 1. 2. 3. 4. 5. C. 1. 2. 3. 3 5 6 Other Individual Contracts 7 8 9 Non-Cancelable Guaranteed Renewable Non-Renewable for Stated Reasons Only Other Accident Only All Other 4 Credit Accident and Health Group Accident and Collectively (Group and Individual) Health Renewable PART 2 - RESERVES AND LIABILITIES 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 Contract Reserves: Additional reserves Reserve for future contingent benefits Total contract reserves, current year Total contract reserves, prior year. Increase in contract reserves Claim Reserves and Liabilities: Total current year Total prior year Increase 49 1. Claims paid during the year: 1.1 On claims incurred prior to current year 1.2 On claims incurred during current year 2. Claim reserves and liabilities, December 31, current year: 2.1 On claims incurred prior to current year 2.2 On claims incurred during current year 3. Test: 3.1 Line 1.1 and 2.1 3.2 Claim reserves and liabilities, December 31, prior year 3.3 Line 3.1 minus Line 3.2 A. 1. 2. 3. 4. B. 1. 2. 3. 4. 2 PART 3 - TEST OF PRIOR YEAR'S CLAIM RESERVES AND LIABILITIES PART 4 - REINSURANCE Reinsurance Assumed: Premiums written Premiums earned Incurred claims Commissions Reinsurance Ceded: Premiums written Premiums earned Incurred claims Commissions COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - ANALYSIS OF LOSSES AND LOSS EXPENSES SCHEDULE P - PART 1 - SUMMARY Years in Which Premiums Were Earned and Losses Were Incurred 1. Prior 1 Premiums Earned 2 3 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Loss Payments 4 5 Direct and Assumed Ceded Net (Cols. 1 - 2) XXX XXX XXX Direct and Assumed Ceded Direct and Assumed Direct and Assumed Ceded Ceded 10 12 11 Salvage Total Net and Paid (Cols. Subrogation 4 - 5 + 6 Received 7 + 8 - 9) Number of Claims Reported Direct and Assumed XXX 2. 1994 XXX 3. 1995 XXX 4. 1996 XXX 5. 1997 XXX 6. 1998 XXX 7. 1999 XXX 8. 2000 XXX 9. 2001 XXX 10. 2002 XXX 11. 2003 12. Totals XXX XXX XXX XXX XXX Losses Unpaid Case Basis Bulk + IBNR 13 14 15 16 Direct and Assumed Ceded Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Ceded Direct and Assumed Ceded Direct and Assumed Ceded Adjusting and Other Unpaid 21 22 Direct and Assumed Ceded 23 24 25 Total Number of Salvage Net Claims and Losses OutstandSubrogand ing ation Expenses Direct and Anticipated Unpaid Assumed 1. XXX 2. XXX 3. XXX 4. XXX 5. XXX 6. XXX 7. XXX 8. XXX 9. XXX 10. XXX 11. XXX 12. Totals XXX Total Losses and Loss Expenses Incurred 26 27 28 1. Loss and Loss Expense Percentage (Incurred/Premiums Earned) 29 30 31 Direct and Assumed Ceded Net Direct and Assumed Ceded Net XXX XXX XXX XXX XXX XXX Nontabular Discount 32 33 Loss XXX 2. ! ! ! 3. ! ! ! 4. ! ! ! 5. ! ! ! 6. ! ! ! 7. ! ! ! 8. ! ! ! 9. ! ! ! 10. ! ! ! ! 11. 12. Totals XXX XXX XXX XXX ! Loss Expense Net Balance Sheet Reserves 34 After Discount InterCompany 35 36 Pooling Loss Participation Losses Expenses Percentage Unpaid Unpaid ! XXX XXX XXX Note: Parts 2 and 4 are gross of all discounting, including tabular discounting. Part 1 is gross of only nontabular discounting, which is reported in Columns 32 and 33 of Part 1. The tabular discount, if any, is reported in the Notes to Financial Statements which will reconcile Part 1 with Parts 2 and 4. 51 COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 2 - SUMMARY Years in Which Losses Were Incurred 1 INCURRED NET LOSSES AND DEFENSE AND COST CONTAINMENT EXPENSES REPORTED AT YEAR END ($000 OMITTED) 2 3 4 5 6 7 8 9 1994 1995 1996 1997 1998 1999 2000 2001 2002 DEVELOPMENT 11 12 10 2003 One Year Two Year 1. Prior 2. 1994 3. 1995 XXX 4. 1996 XXX XXX 5. 1997 XXX XXX XXX 6. 1998 XXX XXX XXX XXX 7. 1999 XXX XXX XXX XXX XXX 8. 2000 XXX XXX XXX XXX XXX XXX 9. 2001 XXX XXX XXX XXX XXX XXX XXX 10. 2002 XXX XXX XXX XXX XXX XXX XXX XXX 11. 2003 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 12. Totals SCHEDULE P - PART 3 - SUMMARY CUMULATIVE PAID NET LOSSES AND DEFENSE AND COST CONTAINMENT EXPENSES REPORTED AT YEAR END ($000 OMITTED) 1 2 3 4 5 6 7 8 9 10 Years in Which Losses Were Incurred 1. Prior 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 11 12 Number of Number of Claims Claims Closed Closed With Without Loss Loss Payment Payment 000 2. 1994 3. 1995 XXX 4. 1996 XXX XXX 5. 1997 XXX XXX XXX 6. 1998 XXX XXX XXX XXX 7. 1999 XXX XXX XXX XXX XXX 8. 2000 XXX XXX XXX XXX XXX XXX 9. 2001 XXX XXX XXX XXX XXX XXX XXX 10. 2002 XXX XXX XXX XXX XXX XXX XXX XXX 11. 2003 XXX XXX XXX XXX XXX XXX XXX XXX Years in Which Losses Were Incurred XXX SCHEDULE P - PART 4 - SUMMARY XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX BULK AND IBNR RESERVES ON NET LOSSES AND DEFENSE AND COST CONTAINMENT EXPENSES REPORTED AT YEAR END ($000 OMITTED) 1 2 3 4 5 6 7 8 9 10 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 1. Prior 2. 1994 3. 1995 XXX 4. 1996 XXX XXX 5. 1997 XXX XXX XXX 6. 1998 XXX XXX XXX XXX 7. 1999 XXX XXX XXX XXX XXX 8. 2000 XXX XXX XXX XXX XXX XXX 9. 2001 XXX XXX XXX XXX XXX XXX XXX 10. 2002 XXX XXX XXX XXX XXX XXX XXX XXX 11. 2003 XXX XXX XXX XXX XXX XXX XXX XXX 52 XXX COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 1A - HOMEOWNERS/FARMOWNERS Premiums Earned 2 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Years in Which Premiums Were Earned and Losses Were Incurred Direct and Assumed Ceded Net (Cols. 1 - 2) 1. Prior XXX XXX XXX XXX XXX XXX XXX XXX 1 3 Loss Payments 4 5 Direct and Assumed Direct and Assumed Ceded Direct and Assumed Ceded Ceded 10 11 Salvage and Subrogation Received Total Net Paid (Cols. 4 - 5 +6-7 + 8 - 9) 12 Number of Claims Reported Direct and Assumed 2. 1994 3. 1995 4. 1996 5. 1997 6. 1998 7. 1999 8. 2000 9. 2001 10. 2002 11. 2003 12. Totals Losses Unpaid Case Basis 13 14 Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Bulk + IBNR 15 16 Ceded Direct and Assumed Ceded Direct and Assumed Ceded Direct and Assumed Ceded Adjusting and Other Unpaid 21 22 Direct and Assumed Ceded 23 24 Total Salvage Net Losses and and Subrogation Expenses Anticipated Unpaid 25 Number of Claims Outstanding - Direct and Assumed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total Losses and Loss Expenses Incurred 26 27 28 1. Loss and Loss Expense Percentage (Incurred/Premiums Earned) 29 30 31 Direct and Assumed Ceded Net Direct and Assumed Ceded XXX XXX XXX XXX XXX Nontabular Discount 32 33 Net Loss XXX XXX 2. ! ! ! 3. ! ! ! 4. ! ! ! 5. ! 6. ! ! ! 7. ! ! ! 8. ! ! ! ! 9. ! ! ! 10. ! ! ! 11. ! ! ! 12. XXX XXX XXX XXX Loss Expense 34 InterCompany Pooling Participation Percentage XXX XXX 53 XXX Net Balance Sheet Reserves After Discount 35 36 Loss Losses Expenses Unpaid Unpaid COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 1B - PRIVATE PASSENGER AUTO LIABILITY/MEDICAL Premiums Earned 2 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Years in Which Premiums Were Earned and Losses Were Incurred Direct and Assumed Ceded Net (Cols. 1 - 2) 1. Prior XXX XXX XXX XXX XXX XXX XXX XXX 1 3 Loss Payments 4 5 Direct and Assumed Direct and Assumed Ceded Direct and Assumed Ceded Ceded 10 11 Salvage and Subrogation Received Total Net Paid (Cols. 4 - 5 +6-7 + 8 - 9) 12 Number of Claims Reported Direct and Assumed 2. 1994 3. 1995 4. 1996 5. 1997 6. 1998 7. 1999 8. 2000 9. 2001 10. 2002 11. 2003 12. Totals Losses Unpaid Case Basis 13 14 Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Bulk + IBNR 15 16 Ceded Direct and Assumed Ceded Direct and Assumed Ceded Direct and Assumed Ceded Adjusting and Other Unpaid 21 22 Direct and Assumed Ceded 23 24 Total Net Losses Salvage and and Subrogation Expenses Unpaid Anticipated 25 Number of Claims Outstanding - Direct and Assumed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total Losses and Loss Expenses Incurred 26 27 28 1. Loss and Loss Expense Percentage (Incurred/Premiums Earned) 29 30 31 Direct and Assumed Ceded Net Direct and Assumed Ceded Net XXX XXX XXX XXX XXX XXX Nontabular Discount 32 33 Loss XXX 2. ! ! ! 3. ! ! ! 4. ! ! ! 5. ! ! ! 6. ! ! ! 7. ! ! ! 8. ! ! ! 9. ! ! ! 10. ! ! ! 11. ! ! 12. XXX XXX XXX XXX XXX Loss Expense 34 InterCompany Pooling Participation Percentage ! XXX 54 XXX Net Balance Sheet Reserves After Discount 35 36 Loss Losses Expenses Unpaid Unpaid COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 1C - COMMERCIAL AUTO/TRUCK LIABILITY/MEDICAL Premiums Earned 2 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Years in Which Premiums Were Earned and Losses Were Incurred Direct and Assumed Ceded Net (Cols. 1 - 2) 1. Prior XXX XXX XXX XXX XXX XXX XXX XXX 1 3 Loss Payments 4 5 Direct and Assumed Direct and Assumed Ceded Direct and Assumed Ceded Ceded 10 11 Salvage and Subrogation Received Total Net Paid (Cols. 4 - 5 +6-7 + 8 - 9) 12 Number of Claims Reported Direct and Assumed 2. 1994 3. 1995 4. 1996 5. 1997 6. 1998 7. 1999 8. 2000 9. 2001 10. 2002 11. 2003 12. Totals Losses Unpaid Case Basis 13 14 Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Bulk + IBNR 15 16 Ceded Direct and Assumed Ceded Direct and Assumed Ceded Direct and Assumed Ceded Adjusting and Other Unpaid 21 22 Direct and Assumed Ceded 23 24 Total Net Losses Salvage and and Subrogation Expenses Unpaid Anticipated 25 Number of Claims Outstanding - Direct and Assumed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total Losses and Loss Expenses Incurred 26 27 28 1. Loss and Loss Expense Percentage (Incurred/Premiums Earned) 29 30 31 Direct and Assumed Ceded Net Direct and Assumed Ceded Net XXX XXX XXX XXX XXX XXX Nontabular Discount 32 33 Loss XXX 2. ! ! ! 3. ! ! ! 4. ! ! ! 5. ! ! ! 6. ! ! ! 7. ! ! ! 8. ! ! ! 9. ! ! ! 10. ! ! ! 11. ! ! 12. XXX XXX XXX XXX XXX Loss Expense 34 InterCompany Pooling Participation Percentage ! XXX 55 XXX Net Balance Sheet Reserves After Discount 35 36 Loss Losses Expenses Unpaid Unpaid COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 1D - WORKERS' COMPENSATION Premiums Earned 2 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Years in Which Premiums Were Earned and Losses Were Incurred Direct and Assumed Ceded Net (Cols. 1 - 2) 1. Prior XXX XXX XXX XXX XXX XXX XXX XXX 1 3 Loss Payments 4 5 Direct and Assumed Direct and Assumed Ceded Direct and Assumed Ceded Ceded 10 11 Salvage and Subrogation Received Total Net Paid (Cols. 4 - 5 +6-7 + 8 - 9) 12 Number of Claims Reported Direct and Assumed 2. 1994 3. 1995 4. 1996 5. 1997 6. 1998 7. 1999 8. 2000 9. 2001 10. 2002 11. 2003 12. Totals Losses Unpaid Case Basis 13 14 Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Bulk + IBNR 15 16 Ceded Direct and Assumed Ceded Direct and Assumed Ceded Direct and Assumed Ceded Adjusting and Other Unpaid 21 22 Direct and Assumed Ceded 23 24 Total Salvage Net Losses and and Subrogation Expenses Anticipated Unpaid 25 Number of Claims Outstanding - Direct and Assumed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total Losses and Loss Expenses Incurred 26 27 28 1. Loss and Loss Expense Percentage (Incurred/Premiums Earned) 29 30 31 Direct and Assumed Ceded Net Direct and Assumed Ceded XXX XXX XXX XXX XXX Nontabular Discount 32 33 Net Loss XXX Loss Expense 34 InterCompany Pooling Participation Percentage XXX 2. ! ! ! 3. ! ! ! 4. ! ! ! 5. ! ! ! 6. ! ! ! 7. ! 8. ! ! ! ! 9. ! ! ! 10. ! ! 11. 12. XXX XXX XXX XXX XXX XXX 56 XXX Net Balance Sheet Reserves After Discount 35 36 Loss Losses Expenses Unpaid Unpaid COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 1E - COMMERCIAL MULTIPLE PERIL Premiums Earned 2 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Years in Which Premiums Were Earned and Losses Were Incurred Direct and Assumed Ceded Net (Cols. 1 - 2) 1. Prior XXX XXX XXX XXX XXX XXX XXX XXX 1 3 Loss Payments 4 5 Direct and Assumed Direct and Assumed Ceded Direct and Assumed Ceded Ceded 10 11 Salvage and Subrogation Received Total Net Paid (Cols. 4 - 5 +6-7 + 8 - 9) 12 Number of Claims Reported Direct and Assumed 2. 1994 3. 1995 4. 1996 5. 1997 6. 1998 7. 1999 8. 2000 9. 2001 10. 2002 11. 2003 12. Totals Losses Unpaid Case Basis 13 14 Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Bulk + IBNR 15 16 Ceded Direct and Assumed Ceded Direct and Assumed Ceded Direct and Assumed Ceded Adjusting and Other Unpaid 21 22 Direct and Assumed Ceded 23 24 Total Salvage Net Losses and and Subrogation Expenses Anticipated Unpaid 25 Number of Claims Outstanding - Direct and Assumed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total Losses and Loss Expenses Incurred 26 27 28 1. Loss and Loss Expense Percentage (Incurred/Premiums Earned) 29 30 31 Direct and Assumed Ceded Net Direct and Assumed Ceded XXX XXX XXX XXX XXX Nontabular Discount 32 33 Net Loss XXX XXX 2. ! ! ! 3. ! ! ! 4. ! ! ! 5. ! ! ! 6. ! ! ! 7. ! ! ! 8. ! ! ! ! ! 9. ! 10. ! 11. ! 12. XXX XXX XXX XXX Loss Expense 34 InterCompany Pooling Participation Percentage ! ! XXX ! XXX 57 XXX Net Balance Sheet Reserves After Discount 35 36 Loss Losses Expenses Unpaid Unpaid COMBINED STATEMENT FOR THE YEAR 2003 OF THE ALLSTATE INSURANCE COMPANY AND ITS AFFILIATED PROPERTY/CASUALTY INSURERS SCHEDULE P - PART 1F - SECTION 1 - MEDICAL MALPRACTICE OCCURRENCE Premiums Earned 2 ($000 Omitted) Loss and Loss Expense Payments Defense and Cost Adjusting and Other Containment Payments Payments 6 7 8 9 Years in Which Premiums Were Earned and Losses Were Incurred Direct and Assumed Ceded Net (Cols. 1 - 2) 1. Prior XXX XXX XXX XXX XXX XXX XXX XXX 1 3 Loss Payments 4 5 Direct and Assumed Ceded Direct and Assumed Direct and Assumed Ceded Ceded 10 11 Salvage and Subrogation Received Total Net Paid (Cols. 4 - 5 +6-7 + 8 - 9) 12 Number of Claims Reported Direct and Assumed 2. 1994 3. 1995 4. 1996 5. 1997 6. 1998 7. 1999 8. 2000 9. 2001 10. 2002 11. 2003 12. Totals Losses Unpaid Case Basis 13 14 Direct and Assumed Defense and Cost Containment Unpaid Case Basis Bulk + IBNR 17 18 19 20 Bulk + IBNR 15 16 Ceded Direct and Assumed C

Valuable suggestions for finishing your ‘Unum Provident Policy Issued 2007 Form’ online

Are you fed up with the inconvenience of handling paperwork? Look no further than airSlate SignNow, the premier electronic signature solution for individuals and businesses. Bid farewell to the monotonous task of printing and scanning documents. With airSlate SignNow, you can seamlessly complete and authorize paperwork online. Utilize the extensive features built into this user-friendly and budget-friendly platform and transform your approach to document management. Whether you need to authorize forms or collect eSignatures, airSlate SignNow manages it all effortlessly, with just a few clicks.

Follow this detailed guide:

  1. Access your account or sign up for a complimentary trial with our service.
  2. Click +Create to upload a file from your device, cloud, or our form library.
  3. Open your ‘Unum Provident Policy Issued 2007 Form’ in the editor.
  4. Click Me (Fill Out Now) to finalize the document on your end.
  5. Add and assign fillable fields for other participants (if required).
  6. Continue with the Send Invite settings to request eSignatures from others.
  7. Save, print your copy, or convert it into a reusable template.

Don’t fret if you need to collaborate with others on your Unum Provident Policy Issued 2007 Form or send it for notarization—our platform provides everything you require to accomplish such tasks. Sign up with airSlate SignNow today and elevate your document management to new levels!

Here is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Need help? Contact Support
Unum provident policy issued form pdf
Unum provident policy issued form download
Unum provident policy issued form online
Unum login
Unum claim forms
Unum claim form pdf
Unum customer service
Unum benefits
Sign up and try Unum provident policy issued 2007 form
  • Close deals faster
  • Improve productivity
  • Delight customers
  • Increase revenue
  • Save time & money
  • Reduce payment cycles