Article 1. Reserves Of Insurers of California Insurance Code >> Division 2. >> Part 3. >> Chapter 1. >> Article 1.

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

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

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.

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.

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.

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.

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.

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.

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.