Ins 6.30(1)(b)(b) Instructions relating to operating expense classifications. Include the following expenses when in connection with the investigation and adjustment of policy claims:
Independent Adjusters: Fees and expenses of independent adjusters or settling agents.
Legal: Fees and expenses of lawyers for legal services in the defense, trial, or appeal of suits, or for other legal services.
Bonds: Premium costs of bonds.
Appeal Costs and Expenses: Appeal bond premiums; charges for printing records; charges for printing briefs; court fees incidental to appeals.
General Court Costs and Fees: Entry fees and other court costs, and other fees not includable in Losses. Note: Interest and costs assessed as part of or subsequent to judgment are includable in Losses.
Medical Testimony: Fees and expenses of medical witnesses for attendance or testimony at trials or hearings (“Medical” includes physicians, surgeons, chiropractors, chiropodists, dentists, osteopaths, veterinarians, and hospital representatives).
Expert Witnesses: Fees and expenses of expert witnesses for attendance or testimony at trials or hearings.
Lay Witnesses: Fees and expenses of lay witnesses for attendance or testimony at trials or hearings.
Service of Process: Constables’, sheriffs’ and other fees and expenses for service of process, including subpoenas.
Transcripts of Testimony: Stenographers’ fees and fees for transcripts of testimony.
Medical Examinations: Fees for medical examinations, fees for performing autopsies, fees for impartial examination, x-rays, etc., for the purpose of trial and determining questions of liability. This does not include fees for medical examinations, x-rays, etc., made to determine necessary treatment, or made solely to determine the extent or continuation of disability, or first aid charges, as such fees and charges are includable in Losses.
Miscellaneous: Costs of appraisals, expert examinations, surveys, plans, estimates, photographs, maps, weather reports, detective reports, audits, credit or character reports, watchperson. Charges for hospital records and records of other kinds, notary fees, certified copies of certificates and legal documents. Charges for Claim Adjustment Services by underwriting syndicates, pools and associations.
Exclude:
Compensation to employees (see Salaries).
Expenses of salaried employees (see Travel and Travel Items).
Items includable in Allowances to Managers and Agents.
Payments to State Industrial Commissions (see Taxes, Licenses and Fees).
Payments to claim adjusting organizations except where the expense is billed specifically to individual companies (see Boards, Bureaus and Associations).
Cost of services of medical examiners for underwriting purposes (see Surveys and Underwriting Reports.)
Salvage and subrogation recovery expense, rewards, lost and found advertising, expenses for disposal of salvage. Such expenses shall be deducted from salvage.
Any expenses which by these instructions are includable elsewhere.
Separation of Claim Adjustment Services:
The Statistical Plans filed by certain rating bureaus contain definitions of “Allocated Loss Adjustment Expenses” which exclude for rating purposes certain types of claim adjustment services as defined herein. For the lines of business thus affected, companies which are members of such rating bureaus shall maintain records necessary to the reporting of Claim Adjustment Services-Direct, as defined in Statistical Plans, and other than as defined in Statistical Plans.
Include: Claim adjustment expenses in bills rendered by ceding companies.
Include: Claim adjustment expenses billed to assuming insurers.
Include:
All payments, reimbursements and allowances, on direct writings, computed as a percentage of premiums for production, management or other services to managers, supervising general agents, general agents, regional and district agents, local agents, office agents, brokers, solicitors, and other producers and agents.
Commissions and brokerage to employees when the activities for which the commissions are paid are not a part of their duties as employees.
Exclude:
Compensation to employees except as noted above (see Salaries.)
Allowances, reimbursements and payments not computed as a percentage of premiums (see Allowances to Managers and Agents).
Expenses involved in transactions between insurance companies (see Joint Expenses; Commission and Brokerage-Reinsurance Assumed and Ceded; Expenses for Account of Another; and Income from Special Services).
Contingent commission (see Commission and Brokerage-Contingent).
Fees of investment counsel (see Legal and Auditing).
Expenses includable in Boards, Bureaus and Associations.
Taxes on premiums (see Taxes, Licenses and Fees).
Commission received for special services such as loss adjustment and inspection not related to policies issued by the company (see Income from Special Services).
Commission and allowances of every nature on reinsurance assumed including tax and board allowances and reinsurance brokerage, except contingent commission, shall be included in Commission and Brokerage-Reinsurance Assumed.
Exception: Where commission and allowances under reinsurance assumed take the form of accurate proportions of actual expenses incurred, as in some quota share and pooling agreements, entries shall be made to the actual expenses.
Commission and allowances of every nature on reinsurance ceded including tax and board allowances and reinsurance brokerage, except contingent commission, shall be included in Commission and Brokerage-Reinsurance Ceded.
Exception: Where commission and allowances under reinsurance ceded take the form of accurate proportions of actual expenses incurred, as in some quota share and pooling agreements, entries shall be made to the actual expenses.
Ins 6.30 NoteNote: Examples Relating to the Treatment of Commission on Reinsurance Assumed and Reinsurance Ceded:
Ins 6.30 Note1. Company A cedes business to Company B under a treaty specifying a commission of 35% and an allowance for taxes and board fees of 5%. On the statement filed by Company A, both the 35% and the 5% shall be entered in Commission and Brokerage-Reinsurance Ceded. On the statement filed by Company B, both the 35% and the 5% shall be entered in Commission and Brokerage-Reinsurance Assumed.
Ins 6.30 Note2. Company A cedes 10% of all its business to Company B under an agreement whereby Company B pays 10% of all actual expenses, on such business, incurred by Company A. Assume the expenses of Company A on the business reinsured as follows:
Ins 6.30 NoteNote: These are not intended to show the complete list of expenses involved but are given only for illustration purposes.
Ins 6.30 NoteOn the statement filed by Company A the commission and allowances by Company B shall be credited as follows:
