Commutation. 1. Not less than 36 months or more than 60 months after the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives may, by mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract. 2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses. 3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties. 4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company and the SBA.
Appears in 4 contracts
Samples: Reimbursement Contract (Philadelphia Consolidated Holding Corp), Reimbursement Contract (Philadelphia Consolidated Holding Corp), Reimbursement Contract
Commutation. 1A. Either the Company or the Reinsurer may request commutation of that portion of any excess loss hereunder represented by any outstanding claim or claims after seven years from the date of an occurrence. Not less than 36 months If both parties desire to commute a claim or more than claims, then within 60 months days after the end of the Contract Yearsuch agreement, the Company shall report submit a statement of valuation of the outstanding claim or claims showing the elements considered reasonable to establish the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company ultimate net loss and the SBA or their respective representatives may, by mutual Reinsurer shall pay the amount requested. Commutation of loss will be calculated on the present value of the loss within the layer of coverage.
B. If agreement, determine as outlined in the capitalized value of all claims and lossesparagraph above, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after reached, the Company reports its claims and losses to the FHCFeffort can be abandoned or, alternately, the Company and the SBA Reinsurer may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims claim or lossesclaims. If both parties then agree, the SBA Reinsurer shall pay its portion proportion of the amount so determined to be the capitalized value of such claims claim or lossesclaims.
3. C. If the parties parties, as outlined in the paragraphs above, fail to agree, then they may abandon the effort or they may agree to settle any difference shall be settled by using a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not refuses or neglects to appoint an actuary within 30 60 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 60 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property Workers’ Compensation claims and losses and shall be members Fellows of the Casualty Actuarial Society and or Members of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. .
D. Each party shall submit its case to its actuary within 30 60 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in TallahasseeNorth Palm Beach, Florida, unless some other place is mutually agreed upon by the Company and the SBAReinsurer.
Appears in 3 contracts
Samples: Catastrophe Workers’ Compensation Reinsurance Contract (Amcomp Inc /Fl), Reinsurance Contract (Amcomp Inc /Fl), Reinsurance Contract (Amcomp Inc /Fl)
Commutation. 1. Not less than 36 months or more than 60 months after the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives mayshall attempt, by mutual agreement, to determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses.
3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company and the SBA.
Appears in 2 contracts
Samples: Reimbursement Contract (Homeowners Choice, Inc.), Reimbursement Contract (United Insurance Holdings Corp.)
Commutation. 1. Not less than 36 months A. The Company or more than 60 months after the end of the Contract Year, the Company shall report Reinsurer may at any time express its desire to the FHCF other party to commute all claims and losses, both reported and unreported, for the Contract Year losses which are not finally settled applicable to any Agreement year and which may be reimbursable losses under this Contractare still unsettled. The In such event the Company and the SBA or their respective representatives may, Reinsurer shall mutually determine and evaluate such losses and the payment by mutual agreement, determine the capitalized Reinsurer of its proportion of the amount so ascertained and mutually agreed to be the value of such losses shall relieve the Reinsurer of all claims and lossesfurther liability, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losseseach Agreement year, both reported and unreported, under this Contractin respect of known or unknown losses.
2B. In the event that the Company transfers control or institutes changes in its claims handling procedures or loss reserving process in a manner which materially affects the parties hereunder, the Reinsurer may express its desire to the Company to commute all losses which are applicable to each Agreement year and which are still unsettled upon 60 days prior written notice. Upon such event the Company and the Reinsurer shall mutually determine and evaluate such losses and the payment by the Reinsurer of its proportion of the amount so ascertained and mutually agreed to be the value of such losses shall relieve the Reinsurer of all further liability, in respect of each Agreement year both in respect of known or unknown losses.
C. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCFreached, the Company and the SBA Reinsurer may mutually appoint an actuary Actuary or appraiser Appraiser to investigate, determine and capitalize such claims claim or lossesclaims. If both parties then agree, the SBA Reinsurer shall pay its portion proportion of the amount so determined to be the capitalized value of such claims claim or lossesclaims.
3. D. If the parties parties, as outlined in paragraph C above, fail to agree, then they may agree to settle any difference shall be settled by using a panel of three actuariesActuaries, one to be chosen by each party and the third by the two so chosen. If either party does not refuses or neglects to appoint an actuary Actuary within 30 days, the other party may appoint two actuariesActuaries. If the two actuaries Actuaries fail to agree on the selection of a third actuary Actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one one, and the decision shall be made by drawing lots. All the actuaries Actuaries shall be regularly engaged in the valuation of property Medical Malpractice claims and losses and shall be members Fellows of the Casualty Actuarial Society and or of the American Academy of Actuaries. None of the actuaries Actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary Actuary within 30 days of the appointment of the third actuaryActuary. The decision in writing of any two actuariesActuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries Actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahasseethe Venue of Commutation (e.g., FloridaCompany’s head office), unless some other place is mutually agreed upon by the Company and the SBAReinsurer.
Appears in 2 contracts
Samples: Excess of Loss Reinsurance Agreement, Excess of Loss Reinsurance Agreement (Scpie Holdings Inc)
Commutation. 1. Not less than 36 months A. As respects all losses, known or more than 60 months unknown, that may cause a claim under this Contract, the losses shall be commuted two years after the end expiration date of the Contract Yearthis Contract. As promptly as possible after such date, the Company shall report submit a statement of valuation of the outstanding claim or claims showing the elements considered reasonable to establish the FHCF all claims and lossescommutation amount, both reported and unreportedand, for if the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives may, by mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA Reinsurer concurs with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by calculation, it shall promptly pay the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contractrequested.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses.
3. B. If the parties fail to agreeagree on the commutation amount determined under paragraph A above, then they shall settle any difference by mutually selecting an actuary to determine the commutation amount. If the parties cannot agree on a single actuary within 15 days after the Reinsurer’s notice that it does not concur with the Company’s statement of valuation, the parties shall be settled settle the difference by using a panel of three actuaries. In that event, one to be chosen by each party and the third by the two so chosen. If either party does not shall appoint an actuary within 30 daysdays after receipt of the written request for commutation. Upon such appointment, the other party may two actuaries shall appoint two actuariesa third actuary. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name twothree individuals, of whom the other shall decline one two, and the decision shall be made by drawing lots. The actuary or actuaries shall then investigate and capitalize such loss(es). All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members fellows of the Casualty Actuarial Society and of or the American Academy of Actuaries. None , and shall be disinterested in the outcome of the actuaries commutation.
C. The Reinsurer’s proportion of the amount so determined shall be under considered the control Reinsurer’s total liability for the losses, and the Reinsurer shall pay the commutation amount promptly after execution by both parties of either party to this Contracta commutation and release agreement. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and Payment of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon amount by the Company Reinsurer, and acceptance of that payment by the SBA.Company, shall constitute a complete release of both parties from all further liability hereunder. Effective: October 1, 2010 U4VT0004 15 of 36 DOC: December 23, 2010
Appears in 2 contracts
Samples: Interests and Liabilities Agreement (Affirmative Insurance Holdings Inc), Interests and Liabilities Agreement (Affirmative Insurance Holdings Inc)
Commutation. 1. Not less than 36 months or more than 60 months after the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives may, by mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion proportion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion proportion of the amount so determined to be the capitalized value of such claims or losses.
3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company and the SBA.
Appears in 2 contracts
Samples: Reimbursement Contract, Reimbursement Contract (Philadelphia Consolidated Holding Corp)
Commutation. 1. Not less than 36 months or more than 60 months after the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives may, by FHCF-2006K Rule 19-8.010 F.A.C. mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s 's certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s 's certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses.
3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company and the SBA.
Appears in 2 contracts
Samples: Reimbursement Contract (Philadelphia Consolidated Holding Corp), Reimbursement Contract (Philadelphia Consolidated Holding Corp)
Commutation. 1. Not less than 36 months or more than 60 months after the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives may, by mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s 's certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s 's certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses.
3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company and the SBA.
Appears in 2 contracts
Samples: Reimbursement Contract (Philadelphia Consolidated Holding Corp), Reimbursement Contract (Philadelphia Consolidated Holding Corp)
Commutation. 1A. The Company or the Reinsurer may request a commutation of this Contract at any time, upon providing written notice of a request to commute. Not less than 36 months or more than 60 months after If the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives mayReinsurer agree to commute they shall, by mutual agreement, determine the capitalized value Commutation Value or, in the absence of all claims and lossesmutual agreement as to the Commutation Value, both reported and unreported, resulting from Loss Occurrences commencing during submit the Contract Year, and determination of the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuaryCommutation Value to arbitration as set forth below. Payment by the SBA Reinsurer of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary Commutation Value shall constitute a complete and final release of the SBA in respect Reinsurer of all claims and lossesclaims, both reported and unreported. For the avoidance of doubt, under neither party shall have the unilateral right to require a commutation of this Contract.
2B. The Commutation Value shall be the amount necessary to compensate the Company for the reassumption of the remaining Reinsurer’s obligations under this Contract, including the associated risks. To the extent possible, the Commutation Value shall be determined in a manner consistent with the determination of the original pricing of this Contract, as adjusted to be consistent with the remaining Reinsurer’s obligations and associated risks, relevant economic factors at the time of determination of the Commutation Value, and incorporating additional information that has emerged between the execution date of this Contract and the determination of the Commutation Value.
C. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCFreached, the Company and the SBA may Reinsurer shall mutually appoint an actuary or appraiser to investigate, investigate and determine and capitalize such claims or lossesthe appropriate Commutation Value. If both parties then agree, the SBA Reinsurer shall pay its portion of the amount Commutation Value so determined to be the capitalized value of such claims or lossesdetermined.
3. D. If the parties fail to agree, then any difference the Company and the Reinsurer shall be settled determine the Commutation Value by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not refuses or neglects to appoint an actuary within 30 daysdays of a request by the other party, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses which are the subject of this Contract and shall be members Fellows of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. .
E. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and considered the determination of the panel. The determination of the panel shall be binding on both the parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in TallahasseeSchaumburg, FloridaIllinois, unless some other place is mutually agreed upon by the Company and the SBAReinsurer.
Appears in 1 contract
Samples: Variable Annuity Reinsurance Contract (Kilico Variable Annuity Separate Account)
Commutation. A. The Company may request, in writing, on or after January 1, 2016, that this Contract be commuted effective January 1, 2016. Not less than 36 months or more than 60 months after the end Within 15 days of the Contract Yearthis written request, the Company shall report to the FHCF all claims and lossessubmit a statement of losses paid as of January 1, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses 2016 under this Contract. The commutation valuation shall be calculated as follows:
1. Net Premium Earned;
2. less: paid losses;
3. less: Commission at the paid loss ratio;
4. less: 5% Reinsurers Home Office Expense. Any positive balance outstanding will be remitted by the Reinsurer within 15 days of the agreed upon statement. All losses, known or unknown, that may cause claim under this Contract, shall then be the sole responsibility of the Company.
B. In the event the Company and the SBA or their respective representatives mayReinsurer cannot agree on the commutation value, by mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, Reinsurer and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an independent actuary or appraiser to investigatewho shall investigate and determine the commutation value. In the event the Reinsurer and the Company cannot reach an agreement on an independent actuary, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses.
3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not shall appoint an actuary within 30 daysdays after receipt of the written request for commutation. Upon such appointment, the other party may two actuaries shall appoint two actuariesa third actuary. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name twothree individuals, of whom the other shall decline one two, and the decision shall be made by drawing lots. The actuaries shall then investigate and determine the commutation value of such losses. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members fellows of the Casualty Actuarial Society and of or the American Academy of Actuaries. None , and shall be disinterested in the outcome of the commutation
C. If the Company does not request commutation on or after January 1, 2016 or the Company does not agree with the commutation value determined by the actuaries per paragraph B. above, neither party shall have an obligation to commute and, in addition to premium ceded to the Reinsurer, the Company shall pay the Reinsurer a Maintenance Fee. The Maintenance Fee shall be under the control calculated at 1.00% of either party to this Contract. Each party ceded premium hereunder, and shall submit its case to its actuary be payable within 30 days after January 1, 2016 (or within 30 days after the Company notifies the Reinsurer that it does not agree with the commutation value determined by the actuaries, if applicable).
D. If this Contract is not commuted pursuant to the above paragraphs the Company may request, in writing, on or after July 1, 2016, that this Contract be commuted, effective July 1, 2016. If the Company does not request commutation as of July 1, 2016 or the Company does not agree with the commutation value determined by the actuaries per Effective: June 30, 2014 DOC: July 31, 2014 U4VT0008 16 of 39 Final paragraph B. above, the Company shall have no obligation to commute and, in addition to premium ceded to the Reinsurer, the Company shall pay the Reinsurer an additional Maintenance Fee. This Maintenance Fee shall be an additional 1.00% of ceded premium hereunder, and shall be payable within 30 days after July 1, 2016 (or within 30 days after the Company notifies the Reinsurer that it does not agree with the commutation value determined by the actuaries, if applicable).
E. The Reinsurer’s proportion of the appointment of the third actuary. The decision amount so determined in writing of any two actuaries, when filed with the parties hereto, paragraph A. or B. above shall be final and binding on both parties.
4. The reasonable and customary expense of considered the actuaries and of Reinsurer’s total liability for the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company losses and the SBAlump sum payment thereof shall constitute a complete release of both parties from all further liability hereunder.
Appears in 1 contract
Samples: Automobile Quota Share Reinsurance Contract (Affirmative Insurance Holdings Inc)
Commutation. 1A. Either the Company or the Reinsurer may request commutation of that portion of any excess loss hereunder represented by any outstanding claim or claims after seven years from the date of an occurrence. Not less than 36 months If both parties desire to commute a claim or more than claims, then within 60 months days after the end of the Contract Yearsuch agreement, the Company shall report submit a statement of valuation of the outstanding claim or claims showing the elements considered reasonable to establish the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company ultimate net loss and the SBA or their respective representatives may, by mutual Reinsurer shall pay the amount requested. Commutation of loss will be calculated on the present value of the loss within the layer of coverage.
B. If agreement, determine as outlined in the capitalized value of all claims and lossesparagraph above, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after reached, the Company reports its claims and losses to the FHCFeffort can be abandoned or, alternately, the Company and the SBA Reinsurer may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims claim or lossesclaims. If both parties then agree, the SBA Reinsurer shall pay its portion proportion of the amount so determined to be the capitalized value of such claims claim or lossesclaims.
3. C. If the parties parties, as outlined in the paragraphs above, fail to agree, then they may abandon the effort or they may agree to settle any difference shall be settled by using a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not refuses or neglects to appoint an actuary within 30 60 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 60 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property Workers’ Compensation claims and losses and shall be members Fellows of the Casualty Actuarial Society and or Members of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. .
D. Each party shall submit its case to its actuary within 30 60 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in TallahasseeNorth Palm Beach, Florida, unless some other place is mutually agreed upon by the Company and the SBA.Reinsurer. Table of Contents
Appears in 1 contract
Commutation. 1A. Either the Company or the Reinsurer may request commutation of that portion of any excess loss hereunder represented by any outstanding claim or claims after seven years from the date of an occurrence. Not less than 36 months If both parties desire to commute a claim or more than claims, then within 60 months days after the end of the Contract Yearsuch agreement, the Company shall report submit a statement of valuation of the outstanding claim or claims showing the elements considered reasonable to establish the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company ultimate net loss and the SBA or their respective representatives may, by mutual Reinsurer shall pay the amount requested. Commutation of loss will be calculated on the present value of the loss within the layer of coverage.
B. If agreement, determine as outlined in the capitalized value of all claims and lossesparagraph above, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after reached, the Company reports its claims and losses to the FHCFeffort can be abandoned or, alternately, the Company and the SBA Reinsurer may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims claim or lossesclaims. If both parties then agree, the SBA Reinsurer shall pay its portion proportion of the amount so determined to be the capitalized value of such claims claim or lossesclaims.
3. C. If the parties parties, as outlined in the paragraphs above, fail to agree, then they may abandon the effort or they may agree to settle any difference shall be settled by using a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not refuses or neglects to appoint an actuary within 30 60 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 60 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property Workers' Compensation claims and losses and shall be members Fellows of the Casualty Actuarial Society and or Members of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. .
D. Each party shall submit its case to its actuary within 30 60 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in TallahasseeNorth Palm Beach, Florida, unless some other place is mutually agreed upon by the Company and the SBAReinsurer.
Appears in 1 contract
Samples: Catastrophe Workers' Compensation Reinsurance Contract (Amcomp Inc /Fl)
Commutation. 1. Not less than 36 months or more than 60 months after the end of the Contract Year, the Company shall report to the FHCF all claims and losses, both reported and unreported, for the Contract Year which are not finally settled and which may be reimbursable losses under this Contract. The Company and the SBA or their respective representatives may, by mutual agreement, determine the capitalized value of all claims and losses, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s 's certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s 's certifying actuary shall constitute a complete and final release of the SBA in respect of all claims and losses, both reported and unreported, under this Contract.
2. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCF, the Company and the SBA may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims or losses. If both parties then agree, the SBA shall pay its portion of the amount so determined to be the capitalized value of such claims or losses.
3. If the parties fail to agree, then any difference shall be settled by a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property claims and losses and shall be members of the Casualty Actuarial Society and of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Florida, unless some other place is mutually agreed upon by the Company and the SBA.
(4) ADVANCES 18 FHCF- 2004K
(a) The SBA may make advances for loss reimbursements as defined herein, at market interest rates, to the Company in accordance with Section 215.555(4)(e), Florida Statutes. The market interest rate shall be the average rate earned by the SBA for the FHCF for the first five months of the Contract Year. All interest charged will commence on the date the SBA issues a check for an advance and will cease at midnight on the date upon which the FHCF has received the Company's Proof of Loss Report for the Covered Event for which the advance was issued qualifying the Company for reimbursement equal to or exceeding the amount(s) of the advance(s). If it is determined that the Company received funds in excess of those to which it was entitled, the interest as to those sums will not cease on the date of the receipt of the Proof of Loss Report but will continue until the Company reimburses the FHCF for the overpayment. The Company's final reimbursement shall be reduced by an amount equal to the amount of the advance(s) and the interest thereon. The specific type of advances enumerated in the Statute follow.
1. Advances to Companies to prevent insolvency.
a. Section 215.555(4)(e)1., Florida Statutes, provides that the SBA shall advance to the Company amounts necessary to maintain the solvency of the Company, up to 50 percent of the SBA's estimate of the reimbursement due to the Company. In determining insolvency for this advance, a Company will be considered insolvent if it is unable to pay its policyholders for justifiable claims.
b. The requirements for an advance to a Company to prevent insolvency are that the Company demonstrates that it is likely to qualify for reimbursement, that the Company demonstrates that the immediate receipt of moneys from the SBA is likely to prevent the Company from becoming insolvent, and that the Company provides the information in (4)(b) below to aid in the SBA's determination to grant an advance.
c. The SBA's final decision regarding an application for an advance to prevent insolvency shall be based on whether or not, considering the totality of the circumstances, including the SBA's obligations to provide reimbursement for all Covered Events occurring during the Contract Year, granting an advance is essential to allowing the entity to continue to pay additional claims for a Covered Event in a timely manner.
2. Advances to entities created pursuant to Section 627.351(6), Florida Statutes.
a. Section 215.555(4)(e)2., Florida Statutes, provides that the SBA may advance to an entity created pursuant to Section 627.351(6), Florida Statutes, up to 90% of the lesser of the SBA's estimate of the reimbursement due or the entity's share of the actual aggregate Reimbursement Premium for that Contract Year, multiplied by the current available liquid assets of the FHCF.
b. The requirements for an advance to entities created pursuant to Section 627.351(6), Florida Statutes are that the entity must demonstrate to the SBA that the advance is essential to allow the entity to pay claims for a Covered Event and that the entity provides the information in (4)(b) below to aid in the SBA's determination to grant an advance.
c. The SBA must determine that its assets are sufficient and sufficiently liquid to fulfill its obligations to other Companies under the Contract prior to granting an advance.
3. Advances to limited apportionment companies.
a. Section 215.555(4)(e)3., Florida Statutes, provides that the SBA may advance the amount of estimated reimbursement payable to limited apportionment companies.
Appears in 1 contract
Samples: Reimbursement Contract (Philadelphia Consolidated Holding Corp)
Commutation. 1. Not less than 36 months A. The Company or more than 60 months after the end of the Contract Year, the Company shall report Reinsurer may at any time express its desire to the FHCF other party to commute all claims and losses, both reported and unreported, for the Contract Year losses which are not finally settled applicable to the term of this Contract and which may be reimbursable losses under this Contractare still unsettled. The In such event the Company and the SBA or their respective representatives may, Reinsurer shall mutually determine and evaluate such losses and the payment by mutual agreement, determine the capitalized Reinsurer of its proportion of the amount so ascertained and mutually agreed to be the value of such losses shall relieve the Reinsurer of all claims and lossesfurther liability hereunder, both reported and unreported, resulting from Loss Occurrences commencing during the Contract Year, and the Company shall provide the SBA with a copy of a written opinion on such capitalized value by the Company’s certifying actuary. Payment by the SBA of its portion of any amount or amounts so mutually agreed and certified by the Company’s certifying actuary shall constitute a complete and final release of the SBA in respect of known or unknown losses.
B. In the event that the Company transfers control or institutes changes in its claims handling procedures or loss reserving process in a manner which materially affects the parties hereunder, the Reinsurer may express its desire to the Company to commute all claims losses which are applicable to the term of this Contract and losseswhich are still unsettled upon 60 days prior written notice. Upon such event the Company and the Reinsurer shall mutually determine and evaluate such losses and the payment by the Reinsurer of its proportion of the amount so ascertained and mutually agreed to be the value of such losses shall relieve the Reinsurer of all further liability, both reported and unreported, under this Contractin respect of known or unknown losses.
2. C. If agreement on capitalized value cannot be reached within 60 days after the Company reports its claims and losses to the FHCFreached, the Company and the SBA Reinsurer may mutually appoint an actuary or appraiser to investigate, determine and capitalize such claims claim or lossesclaims. If both parties then agree, the SBA Reinsurer shall pay its portion proportion of the amount so determined to be the capitalized value of such claims claim or lossesclaims.
3. D. If the parties parties, as outlined in paragraph C above, fail to agree, then they may agree to settle any difference shall be settled by using a panel of three actuaries, one to be chosen by each party and the third by the two so chosen. If either party does not refuses or neglects to appoint an actuary within 30 days, the other party may appoint two actuaries. If the two actuaries fail to agree on the selection of a third actuary within 30 days of their appointment, each of them shall name two, of whom the other shall decline one one, and the decision shall be made by drawing lots. All the actuaries shall be regularly engaged in the valuation of property medical malpractice claims and losses and shall be members Fellows of the Casualty Actuarial Society and or of the American Academy of Actuaries. None of the actuaries shall be under the control of either party to this Contract. Each party shall submit its case to its actuary within 30 days of the appointment of the third actuary. The decision in writing of any two actuaries, when filed with the parties hereto, shall be final and binding on both parties.
4. The reasonable and customary expense of the actuaries and of the commutation (as a result of 2. and 3. above) shall be equally divided between the two parties. Said commutation shall take place in Tallahassee, Floridaat the Company’s head office, unless some other place is mutually agreed upon by the Company and the SBAReinsurer.
Appears in 1 contract
Samples: Excess of Loss Reinsurance Contract (Scpie Holdings Inc)