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:
Ins 6.30 NoteOn the statement filed by Company B the commission and allowances made to Company A shall be debited as follows:
Include:
Contingent or profit commission paid.
Contingent or profit commission received.
Contingent commission to employees when the activities for which the contingent commission is paid are not a part of their duties as employees.
Include:
Policy and membership fees retained by, or paid to, agents.
Policy and membership fees to employees when the activities for which the policy and membership fees are paid are not a part of their duties as employees.
Include:
Net allowances, reimbursements and payments for expenses of every nature, not computed as a percentage of premiums, to managers, agents, brokers, solicitors, and other producers.
Exclude:
Compensation to employees (see Salaries).
Expenses of salaried employees (see Travel and Travel Items).
Expenses of management where one insurance company has been appointed manager for another (see Joint Expenses; Commission and Brokerage-Reinsurance Assumed and Ceded; and Expenses for Account of Another).
Contingent commission (see Commission and Brokerage-Contingent).
Policy and membership fees (see Commission and Brokerage-Policy and Membership Fees).
Expenses in connection with owned real estate (see Real Estate Expenses).
Amounts representing exact reimbursements for Losses; Taxes, Licenses and Fees; Boards, Bureaus and Associations; and Advertising; where only the minimum space required by law is taken.
Amounts representing exact reimbursements for Claim Adjustment Services, Surveys and Underwriting Reports and Audit of Assureds’ Records when these services are performed by others than employees of managers, agents, brokers, solicitors or other producers.
Include:
Cost of the following: Services of advertising agents; public relations counsel; space in newspapers, periodicals, billboards, programs, and other publications; circulars, pamphlets, calendars and literature issued for advertising or promotional purposes; drawings, plates, etchings, etc., in connection with advertising; all charges for printing, paper, etc., in bills covering advertising; radio broadcasts; prospect and mailing lists; signs, frames, medals, etc., for agents; souvenirs for general distribution; directory listings; house organs and similar publications distributed to others than employees; and advertising required by law when more than the minimum space required to comply with the law is taken.
Exclude:
Compensation to employees (see Salaries).
Items includable in Travel and Travel Items, Claim Adjustment Services, and Boards, Bureaus and Associations.
Cost of literature, booklets, placards, signs, etc., issued solely for accident and loss prevention (see Surveys and Underwriting Reports).
Advertising and business development expenses allowed, reimbursed or paid to managers, agents, brokers, solicitors, and other producers (see Allowances to Managers and Agents).
Cost of help wanted advertising (see Employee Relations and Welfare).
Cost of advertising in connection with owned real estate (see Real Estate Expenses).
Cost of house organs and similar publications for the use of employees (see Printing and Stationery).
Donations to organized charities (see Miscellaneous).
Cost of souvenirs not generally distributed (see Travel and Travel Items).
Include:
Dues, assessments, fees and charges of: underwriters’ boards, rating organizations, statistical agencies, inspection and audit bureaus; underwriters’ advisory and service organizations including such organizations as Insurance Executives Association, and Association of Casualty and Surety Companies; accident and loss prevention organizations; claim organizations; underwriting syndicates, pools and associations such as Factory Insurance Association, Oil Insurance Association, assigned risk plans (except Commission and Brokerage; Claim Adjustment Services; and Taxes, Licenses and Fees); and specific payments to boards, bureaus and associations for rate manuals, revisions, fillers, rating plans and experience data.
Exclude:
Cost of inspection, engineering or accident and loss prevention billed specifically to individual companies (see Surveys and Underwriting Reports).
Loss adjustment expenses billed specifically to individual companies (see Claim Adjustment Services).
Allowances under reinsurance contracts for board and bureau expenses (see Commission and Brokerage-Reinsurance Assumed and Ceded).
Payments to State Industrial Commissions (see Taxes, Licenses and Fees).
Payments into State Security Funds (see Taxes, Licenses and Fees).
