TRIP Data Call [Cap on Annual Liability]

Control Number______________

(Treasury use)

TERRORISM RISK INSURANCE PROGRAM

Data Call – General Instructions

The Terrorism Risk Insurance Act of 2002, as amended, (TRIA) imposes notice to Congress and determination requirements on Treasury with respect to recoupment of the Federal share of compensation and with regard to the cap on annual liability for insured losses of $100 billion. To meet these requirements Treasury will need information regarding aggregate insured losses to determine the amount, if any, of recoupment or imposition of pro ration of loss payments to insureds.

Treasury regulation, 31 C.F.R. 50.71(d), provides that, “For the purpose of determining initial or recalculated recoupment amounts, Treasury may issue a data call to insurers for insured loss information by Program Year. Treasury’s determination of the aggregate amount of insured losses from Program Trigger Events of all insurers for a Program Year will be based on the loss amounts reported in response to [this] data call and any other information Treasury in its discretion considers appropriate.” Similarly 31 C.F.R. 50.94 provides that, “For the purpose of determining initial or recalculated Pro Rata Loss Percentages Treasury may issue a data call to insurers for insured loss information. Submission of data in response to a data call shall be on a form promulgated by Treasury.”

Insurers are to report aggregate insured losses arising out of Program Trigger Events broken out by cat code and line of business. Paid losses and reserves must be reported as separate fields. Losses allocated to an insurer from a residual market mechanism should be included, and losses ceded to such a mechanism should be excluded.

DATA SUBMISSION

Descriptions for each data element and field follow. ALL fields are required for each line (record), unless otherwise noted or instructed.

HEADER INFORMATION

INSURER NAME - Enter the name of the insurer for which loss information is being reported.

INSURER (Group) NAIC # - Enter the corresponding NAIC number for the referenced insurer.

INSURER TIN – If the insurer referenced above does not have a NAIC number, enter the insurer’s tax payer ID.

DATE - Enter the “as of” date for the information compiled below.

PROGRAM YEAR – Enter the four-digit TRIA Program Year.

submitting Insurer Deductible Estimate – This is the estimated portion of the insurer deductible, normally calculated in the aggregate for all affiliated insurers, attributable to the individual insurer entity submitting data in response to the data call. Although this is an estimate and not a final calculation, see Certification of Loss Schedule A (OMB 1505-0200) for guidance.

DATA CALL - INFORMATION DETAIL

Information should be sorted by catastrophe code (Cat Code) and then by line of business (LOB).

1. CAT CODE - Enter the numeric code assigned to the event by the Property Catastrophe Services of the Insurance Services Office (ISO).

2. LOB – Line of Business - Provide the code for the line of business under which the claims have been paid, using the following table. Codes 50.0, 51.0, 52.0, and 80.0 are to be used only if the claim cannot be identified under one of the other codes. These four codes will be used to accommodate reporting of losses from alien surplus lines insurers and losses allocated to participating insurers from residual market mechanisms where there is not a one to one correspondence with another code.

Description	Code
Fire	1.0
Allied Lines	2.1
Commercial Multi-Peril (non-liability)	5.1
Commercial Multi-Peril (liability)	5.2
Ocean Marine	8.0
Inland Marine	9.0
Workers’ Compensation	16.0
Other Liability	17.0
Products Liability	18.0
Aircraft (all perils)	22.0
Boiler and Machinery	27.0
Energy	50.0
All Other Property Risks	51.0
All Other Casualty Risks	52.0
Residual Market (Multiple Coverages)	80.0

3. TOTAL CUMULATIVE LOSS PAYMENTS – Enter the amount of cumulative loss payments to date, net of punitive damages paid and salvage and subrogation recovered. Do not net out reinsurance recoveries or any Federal share received under TRIA. Exclude lines of business not covered under the Program¹. Also, some losses for lines of business listed in 2., above, are not to be included, specifically losses for types of insurance that do not meet the definition of commercial property and casualty insurance under TRIA, even if reported under a line of business otherwise included. If no losses have been paid, enter zero.

4. ALAE PAID - Enter allocated loss adjustment expenses paid to date. Include cumulative amounts paid electronically or via check or draft as of the date of the report. Expenses incurred but not yet paid are not included. For TRIP, ALAE includes loss adjustment expenses incurred by an insurer in connection with the insured loss, and that are allocated and identified by claim file in insurer records, including expenses incurred in the investigation, adjustment and defense of claims, but excluding staff salaries, overhead and other insurer expenses that would have been incurred notwithstanding the insured loss. If no ALAE have been paid, enter zero.

5. LOSS CASE RESERVES - For open or reopened claims, report the total outstanding case reserve for loss payments as of the date of this report.  Follow guidance as provided in number 3. If all claims are closed, enter zero.

6. ALAE CASE RESERVES – For open or reopened claims, report the total amount of allocated loss adjustment expenses reserved in association with the loss case reserves reported in number 5.

7. LOSS IBNR – Enter amount of incurred but not reported loss expenses. Follow guidance as provided in number 3.

8. ALAE IBNR – Enter the amount of allocated loss adjustment expenses reserved in association with the loss amounts reported in number 7.

9. TOTAL ESTIMATED LOSS AND ALLOCATED LOSS ADJUSTMENT – Enter the total amount of loss and allocated loss adjustment expenses incurred. Follow guidance as provided in number 3. If there has been no determination by the Secretary of a Pro Rata Loss Percentage applicable to these losses, then this amount should be equal to the sum of numbers 3, 4, 5, 6, 7, and 8. If the Secretary has determined an applicable Pro Rata Loss Percentage, then this entry should be the total un-prorated amount of loss and allocated loss adjustment expenses incurred.

SUMMARY INFORMATION

Grand totals (control totals) are to be provided for all columns having dollar values.

Notice Under the Paperwork Reduction Act

We estimate it will take you about 5 hours to complete this form. However, you are not required to provide information requested unless a valid OMB control number is displayed on the form. Any comments or suggestions regarding this form should be sent to the Terrorism Risk Insurance Program Office, 1425 New York Avenue, NW, Washington, DC 20220. Do not send completed form to this address. Submit forms according to instructions provided at www.treas.gov/trip.

1 Federal crop insurance issued or reinsured under the Federal Crop Insurance Act; any other type of crop or livestock insurance that is privately issued or reinsured (including crop insurance reported on either Line 2.1 – Allied Lines or Line 2.2. – Multiple Peril Crop); Line 3 – Farmowners Multiple Peril; Line 19.3 – Commercial Auto No-Fault (personal injury protection); Line 19.4 – Other Commercial Auto Liability; Line 21.2 –Commercial Auto Physical Damage; Line 24 – Surety; Line 26 – Burglary and Theft; Professional Liability insurance as defined in 31 CFR 50.5(j)1; private mortgage insurance; title insurance; financial guaranty insurance when issued by a monoline financial guaranty insurance corporation; medical malpractice insurance; health or life insurance, including group life insurance; Federal flood insurance; earthquake insurance reported under Line 12 of Statutory Page 14; and reinsurance or retrocessional reinsurance.

OMB No. 1505-0207/0208 Expiration: November 30, 2015

TRIP 05 (6/2012)