New York State seal

September 4, 1975

SUBJECT: INSURANCE

WITHDRAWN

Circular Letter No. 8 (1975)

TO ALL INSURERS AUTHORIZED TO WRITE PERSONAL INJURY LIABILITY INSURANCE IN NEW YORK STATE

SUBJECT: SUPPLEMENT A TO SCHEDULE VII OF QUARTERLY STATEMENTS FOR JUNE 30, AND SEPTEMBER 30, 1975

The N.A.I.C. has adopted the attached form as Supplement A to Schedule VII of the Quarterly Statement. Companies which wrote medical malpractice insurance during 1975 or had unpaid medical malpractice claims this year, are required to complete Supplement A as of June 30 and September 30, 1975. If none of the above mentioned transactions took place, insert the company name, and mark the form "None".

As indicated on the form, a separate page is required for each of the four designated types of health care providers. Note that, as in the quarterly statements, amounts reported in Supplement A are cumulative. Direct Losses Incurred as reported in Column 7 of the supplement, are the Direct Losses Paid (Col. 5) plus the Direct Losses Unpaid (Col. 8) minus the Direct Losses Unpaid on December 31, 1974 (both unpaid amounts to include provision for Incurred But Not Reported Losses).

If you provide medical malpractice coverage on an excess basis, please provide full information by footnote.

If, in any state, your medical malpractice insurance is written either as a claims-made basis policy or as a claims made-reporting endorsement, please so indicate by a footnote, specifying the total of both coverages so written.

You are requested to exclude your share of the business of the Medical Malpractice Insurance Association since that Association will submit its own Supplement A forms.

Please note that the track symbol ([++]) in the upper right corner of the form should be a single dagger (+).

Within 30 days of receipt of this letter, kindly return the completed Supplement A forms for the period ended June 30, 1975 to:

Mr. Fred Tizzio

New York State Insurance Department

Audit and Training Bureau

Two World Trade Center

New York, NY 10047

Supplement A forms for the period ended September 30, 1975 are to be filed with the Quarterly Statement for that period. The 1975 Annual Statement will probably require the information shown on Supplement A. If it does not require such information, we will require that Supplement A forms for the year-ended December 31, 1975 be filed with the Annual Statement.

Blank copies of the Supplement are not being provided. You are requested to prepare reasonable facsimiles thereof.

[SIGNATURE]

THOMAS A. HARNETT

Superintendent of Insurance