SECTIONS 11550-11557 - California Statutes

INSURANCE CODE

SECTION 11550-11557

11550. As used in this article, the term "liability" means
liability and common carrier liability insurance.

11551. As used in this article, the term "compensation" means
workers' compensation insurance.

11552. As used in this article, the term "earned premium," means
the amount remaining of the gross premiums charged on all policies
written, including all determined excess and additional premiums,
after deducting the aggregate of:
(a) Return premiums other than premiums returned to policyholders
as dividends.
(b) Reinsurance premiums and premiums on policies canceled.
(c) Unearned premiums on policies in force.

11553. As used in this article, the terms "loss payments," and
"loss expense payments," mean all payments to claimants or on account
of claims. Such payments include but are not restricted to those
for:
(a) Medical and surgical attendance.
(b) Legal expense.
(c) Salaries and expenses of investigators, adjusters and field
men.
(d) Rents.
(e) Stationery, telegraph and telephone charges.
(f) Postage.
(g) Salaries and expenses of office employees.
(h) Home office expenses, and all other payments made on account
of claims, whether or not such payments are allocated to specific
losses.

11554. In estimating the condition of any insurer admitted to
transact such liability or compensation insurance, the commissioner
shall charge as liabilities, among any other items, the following:
(a) All outstanding indebtedness of such insurer.
(b) A premium reserve on policies in force, equal to the unearned
portions of the gross premiums charged for covering the risks and
computed on each respective risk from the date of the issuance of the
policy.
(c) Proper reserves for outstanding losses, computed as set forth
in this article.

11555. An insurer transacting such compensation or liability
insurance shall include the following schedules in its annual
statement required by law:
(a) A schedule showing distribution of unallocated liability loss
expense payments.
(b) A schedule showing distribution of unallocated compensation
loss expense payments.
(c) A schedule of its experience under policies of such insurance,
in such form as the commissioner prescribes.

11555.2. Each insurer transacting insurance covering liability for
malpractice of any person licensed under the Dental Practice Act
(Chapter 4 (commencing with Section 1600) of Division 2 of the
Business and Professions Code), under the Medical Practice Act
(Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code), or under the State Bar Act (Chapter 4
(commencing with Section 6000) of Division 3 of the Business and
Professions Code), shall report all of the following statistics to
the commissioner, by profession and by medical specialty, upon
request of the commissioner:
(a) The total number of doctors or lawyers written during the
immediately preceding calendar year.
(b) The total amount of premiums received from insureds, both
written and earned (as reported in the annual statement), during the
immediately preceding calendar year.
(c) The number of claims reported to the insurer for the first
time separately by the year the claim occurred, and the number of
claims reported closed during a previous calendar year which were
reopened separately by the year the claim occurred.
(d) The total number of claims outstanding, together with the
monetary amount reserved for loss and allocated loss expense, in the
annual statement as of December 31 of the calendar year next
preceding, separately stated by the year the claim occurred.
(e) (1) The number of claims closed with payment to the claimant
during the calendar year next preceding, to be reported by the year
the claim occurred, (2) the total monetary amount paid thereon,
reported by the year the claim occurred, and (3) the total allocated
loss expense paid thereon, reported by the year the claim occurred.
(f) The monetary amount paid on claims during the calendar year
next preceding, to be reported separately by the year the claim
occurred, with allocated loss expense paid, to be reported separately
by the year the claim occurred.
(g) The number of claims closed without payment to the claimant
during the calendar year next preceding, by the year the claim
occurred, and the allocated loss expense paid thereon, separately by
the year the claim occurred.
(h) The monetary amount reserved in the annual statement for the
calendar year next preceding on claims incurred but not reported to
the insurer.
(i) The number of lawsuits filed against the insurer's insureds,
and the number of doctors, included therein, during the calendar year
next preceding, to be separately reported by the year the claim
occurred.
(j) A distribution by size of payment for those claims closed
during the calendar year next preceding, showing the number of claims
and total amount paid for each monetary category, as determined by
the commissioner.

11556. The reserve for outstanding losses and loss expenses under
such liability or compensation insurance shall be determined in
accordance with the regulations of the commissioner promulgated
pursuant to Section 923.5.

11557. Whenever the reserves for outstanding liability or
compensation losses and loss expenses of any insurer, computed
pursuant to this article, seem inadequate to the commissioner, he
shall require such insurer to maintain additional reserves.