New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter IV - Financial Condition Of Insurer and Reports to Superintendent
Subchapter C - Fire, Marine, Casualty And Surety Insurers
Part 112 - Loss Portfolio Transfers
Section 112.7 - Noncomplying transactions

Current through Register Vol. 46, No. 12, March 20, 2024

Loss portfolio transfers executed or entered into after November 30, 1984 that do not comply with section 112.5 of this Part, shall be reported in annual and interim statements, filed in New York, so that the consideration paid by the transferer for any such transaction shall be recorded as a deposit and reported as a nonadmitted asset in exhibit 1 of the annual and interim statements, with no deduction made from loss and loss adjustment expense reserves.

EXHIBIT OF LOSS PORTFOLIO TRANSFER
for purposes of Regulation 108
(As of 19)
As: Transferer Transferee
A. Initial Reserves Transferred:
Losses $ $
Loss Adjustment Expenses $ $
Total $ $
B. Consideration paid or received:
Losses $ $
Loss Adjustment Expenses $ $
Total $ $
C. Remaining Reserves Recoverable/Payable:
Losses $ $
Loss Adjustment Expenses $ $
Total $ $
D. Amount Recovered/Paid (cumulative):
Losses $ $
Loss Adjustment Expenses $ $
Total $ $

E. Incurred Year(s) of Losses transferred:

F. Lines of business subject to the Loss Portfolio Transfer and the U.S. dollar limits of the Agreement:

G. Identify the Transferee under each such Loss Portfolio Transfer entered into and the execution and effective dates thereof:

H. Identify the Transferer under each such Loss Portfolio Transfer entered into and the execution and effective dates thereof:

I. As to item (C), list separately letters of credit or funds furnished the Transferee, including the issuing bank, custodian or trustee, the market value of the amount of the security held, term and termination date of the letter of credit or trust agreement:

Signature: _________

Title: _________

Reporting Insurer: _________

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