U.S. Homeowners Multi-Peril Form

OMB No. [XXXX-XXXX]
Expiration: Mon. Day, 202X

Instructions for Federal Insurance Office (FIO)
Climate Data Collection: U.S. Homeowners Multi-Peril Form
General Guidelines
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All data should be aggregated and reported:
o On a consolidated insurer group basis, unless reporting for a single insurer;
o On a direct business basis before impact of reinsurance;
o At the five-digit United States Postal Service ZIP Code (ZIP Code) level and for all ZIP
Codes provided in cells C11 to C41101 of the data template;
o Where possible (premiums, losses, and claims data fields), in accordance with Statutory
Accounting Principles;
o Where appropriate, in U.S dollars with the full values stated (i.e., not reported in millions
or thousands).
Data should include:
o Information associated with the Homeowners Multi-Peril Line of Business (Homeowners
LOB);
o Only HO-3 policies;
o Coverage corresponding to Coverages A, B, C, and D in policy forms.
Data should exclude, if possible:
o Coverage related to earthquakes;
o Coverage other than the Homeowners LOB for bundled policies.
For all fields reported on an accident year (AY) basis that are associated with homeowners
businesses divested prior to the 2022 Annual Statement filing, data should be provided up to the
last year that results for that business were reported.
ZIP Code values have been pre-populated in column C. Data for ZIP Codes that are not on the
pre-populated list should be added at the end starting in row 41102.
Each cell should be reported. No cells should be left blank. Report value “0” in the case of zero
exposure, business, or losses. In case a data element is not available, report “NA”.
FIO is requesting data from 2017-2022. Each tab of the data template represents one reporting
year, beginning in 2017. Respondents should populate each tab separately for each of the six
years.
Data Template Field Instructions

As a guide, the table below provides associated sections, cell numbers, and field names with
information about each specific cell.

Page 1 of 4

OMB No. [XXXX-XXXX]
Expiration: Mon. Day, 202X

Section i. Insurance Group Information
Cell(s)

Field Name

D5

NAIC Group Code

E5

Insurer Group Name

F5

NAIC Company Codes of
Homeowners Insurance
Entities Included in the Group
Reporting Below

Comments
• Provide the NAIC Group Code used for state
regulatory reporting purposes.
• If not part of a group, provide the NAIC entity
code.
• Provide the NAIC Group Name used for state
regulatory reporting purposes.
• If not part of a group, provide the individual
company name.
• Provide the NAIC Codes corresponding to each
insurance entity included in group-level
reporting for a given year used for state
regulatory reporting purposes.
• Separate each company code with a comma
without additional spaces.

Page 2 of 4

OMB No. [XXXX-XXXX]
Expiration: Mon. Day, 202X

Section ii. Policy Information
Cell(s)

Field Name

C11C41101

USPS ZIP Code

D11D41101

Number of Policy In-Force
Exposures (CY)

E11E41101

Total $ Value of Coverage for
Dwelling, Other Structures,
Personal Property, and Loss of
Use (CY)

F11F41101

Number of Policies Not
Renewed or Retained (CY)

Comments
• Prepopulated five-digit ZIP Codes for alignment
with aggregated data.
• No entry of data necessary, however if given
five-digit ZIP Code is not on pre-populated list,
it should be added at the end starting in row
41102.
• Provide the total number of homeowners
policies in force at the end of the reporting
period (December 31) corresponding to the
calendar year.
• For the purposes of this field, an individual
home should be counted once irrespective of the
number of coverages that exist.
• Provide the aggregate estimated value of the
insured exposure(s) recorded at the effective
date of the policy or most recent renewal.
• Data should be reported corresponding to the
calendar year.
• Provide the total number of homeowners
policies not renewed or retained at any time
during the reporting period corresponding to the
calendar year.
• Number of Policies not Renewed or Retained
for dwelling coverage defined for state
regulatory purposes on the group’s MCAS for
year of reporting at: Row 43 (Number of
company-initiated non-renewals during the
period) + Row 44 (Number of cancellations for
non-pay or non-sufficient funds) + Row 45
(Number of cancellations at the insured’s
request).

Section iii. Premiums
Cell(s)

G11G41101

Field Name

Direct Premiums Written (CY)

Comments
• Provide data in accordance with Direct
Premiums Written as defined for state
regulatory purposes on the Annual Statement at:
Exhibit of Premiums and Losses for States, Line
4, Column 1.
• Data should be reported in accordance with
Statutory Accounting Principles on a CY basis.

Page 3 of 4

OMB No. [XXXX-XXXX]
Expiration: Mon. Day, 202X

Section iv. Losses
Cell(s)

Field Name

H11H41101

Total Direct Losses Paid (AY)

I11I41101

Total Direct Incurred Losses
(AY)

Comments
• Definition: Provide data matching the field
description of Total Direct Losses Paid as
reported for state regulatory purposes on the
Annual Statement for year of reporting at:
Exhibit of Premiums and Losses for States, Line
4, Column 5.
• Reporting framework: Additionally, data
should be reported cumulatively on an AY basis
as of December 31, 2022 and in accordance
with Statutory Accounting Principles. The AY
reporting should be aligned with the
methodology used for Schedule P – Part 3A.
• Definition: Provide data matching the field
description of Total Direct Incurred Losses as
reported for state regulatory purposes on the
Annual Statement for year of reporting at:
Exhibit of Premiums and Losses for States, Line
4, Column 6.
• Reporting framework: Additionally, data
should be reported cumulatively on an AY basis
as of December 31, 2022 and in accordance
with Statutory Accounting Principles. The AY
reporting should be aligned with the
methodology used for Schedule P – Part 2A.

Section v. Claims
Cell(s)

J11J41101

Field Name

Cumulative Number of Claims
Closed with Loss Payment
(Direct, AY)

Comments
• Definition: Provide data in accordance with
Cumulative Number of Claims Closed with
Loss Payment as defined for state regulatory
purposes on the Annual Statement at: Schedule
P – Part 5A – Section 1 – Summary Schedules.
Do not include any claims associated with
assumed business.
• Reporting framework: Data should be reported
in accordance with Statutory Accounting
Principles on an AY basis.

Page 4 of 4