QUARTERLY STATEMENT AequiCap Insurance Company AS OF September 30, 2010
advertisement
PROPERTY AND CASUALTY COMPANIES - ASSOCIATION EDITION 24619201020100103 2010 QUARTERLY STATEMENT Document Code: 201 AS OF September 30, 2010 OF THE CONDITION AND AFFAIRS OF THE AequiCap Insurance Company NAIC Group Code 0000 , 0000 (Current Period) NAIC Company Code 24619 Employer's ID Number 59-2599788 (Prior Period) Organized under the Laws of Florida Country of Domicile , State of Domicile or Port of Entry Florida United States of America Incorporated/Organized 11/13/1985 Statutory Home Office Commenced Business 3000 West Cypress Creek Road 12/06/1985 , Fort Lauderdale, FL 33309 (Street and Number) (City, or Town, State and Zip Code) Main Administrative Office 3000 West Cypress Creek Road (Street and Number) Fort Lauderdale, FL 33309 (954)493-6565 (City or Town, State and Zip Code) Mail Address (Area Code) (Telephone Number) 3000 West Cypress Creek Road , Fort Lauderdale, FL 33309 (Street and Number or P.O. Box) (City, or Town, State and Zip Code) Primary Location of Books and Records 3000 West Cypress Creek Road (Street and Number) Fort Lauderdale, FL 33309 (954)493-6565 (City, or Town, State and Zip Code) (Area Code) (Telephone Number) Internet Web Site Address N/A Statutory Statement Contact Elvis R Rivera (954)493-6565-114 (Name) (Area Code)(Telephone Number)(Extension) elvis_rivera@aequicap.com (954)545-6975 (E-Mail Address) (Fax Number) OFFICERS Name Mark Stephenson Matthew Thomas Jones Deborah Sarvis Gardner Title Chief Executive Officer President Senior Vice President & CFO OTHERS Philip Edward Morgaman, Chairman Norman Baker, Vice President Bradford St. Pierre FCAS, MAAA, Vice President/Chief Actuary Mark Stephenson Charles King Neal Clark Nichols State of County of Florida Broward Mark Stephenson, Chief Executive Officer Marilyn Johnson Peterson, Vice President John Pecoraro, Vice President DIRECTORS OR TRUSTEES Deborah Sarvis Gardner Philip Edward Morgaman ss The officers of this reporting entity, being duly sworn, each depose and say that they are the described officers of the said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. (Signature) (Signature) (Signature) Mark Stephenson Matthew Thomas Jones Deborah Sarvis Gardner (Printed Name) 1. (Printed Name) 2. (Printed Name) 3. Chief Executive Officer President Senior Vice President & CFO (Title) (Title) (Title) Subscribed and sworn to before me this day of , 2010 (Notary Public Signature) a. Is this an original filing? b. If no, 1. State the amendment number 2. Date filed 3. Number of pages attached Yes[X] No[ ] STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company ASSETS 1. Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks: 3. 4. Current Statement Date 2 Assets Nonadmitted Assets 4 3 Net Admitted Assets (Cols. 1 - 2) December 31, Prior Year Net Admitted Assets . . . . . . . . . . . . . 860,417 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 860,417 . . . . . . . . . . ....................... 2.1 Preferred stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 2.2 Common stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649,726 . . . . . . . . . . . . . . . . . . . . . . . ....................... 1,497,121 ....................... . . . . . . . . . . . . . 649,726 . . . . . . . . . . . . . 716,151 Mortgage loans on real estate: 3.1 First liens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 3.2 1,775,000 Other than first liens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 1,775,000 ....................... .......... ....................... ....................... ....................... .......... .......... 2,025,000 ....................... Real estate: 4.1 Properties occupied by the company (less $.......9,200,000 encumbrances) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 4.3 5. 1 .......... 6,166,307 6,166,307 .......... 5,999,959 Properties held for the production of income (less $...............0 encumbrances) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... Properties held for sale (less $...............0 encumbrances) . . . . . . . . . . . ....................... ....................... ....................... ....................... ....................... .......... Cash ($.......2,247,237), cash equivalents ($...............0) and short-term investments ($.......2,832,301) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 6. Contract loans (including $...............0 premium notes) . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 7. Derivatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 8. Other invested assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 734,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 734,000 . . . . . . . . . . . . . 734,000 9. Receivables for securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 10. Aggregate write-ins for invested assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 11. Subtotals, cash and invested assets (Lines 1 to 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... ....................... ......... 12. Title plants less $...............0 charged off (for Title insurers only) . . . . . . . . . . . . . ....................... ....................... ....................... 13. Investment income due and accrued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................ 6,083 ....................... ................ 14. Premiums and considerations: .......... 2,251,305 ....................... .......... 2,251,305 .......... 4,183,239 unbilled premiums) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 8,076,818 . . . . . . . . . . . . . 167,018 . . . . . . . . . . 7,909,800 .......... 8,715,824 Accrued retrospective premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 14.1 15,264,988 5,079,538 15,264,988 6,083 .......... ......... 8,224,028 19,196,259 ....................... . . . . . . . . . . . . . 107,625 Uncollected premiums and agents' balances in the course of collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.2 5,079,538 Deferred premiums, agents' balances and installments booked but deferred and not yet due (including $...............0 earned but 14.3 15. ....................... ....................... ....................... Reinsurance: 15.1 Amounts recoverable from reinsurers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 15.2 Funds held by or deposited with reinsured companies . . . . . . . . . . . . . . . . ....................... 1,636,823 . . . . . . . . . . . . . 381,844 . . . . . . . . . . ....................... ....................... 1,254,979 ....................... 15.3 .......... 1,285,502 Other amounts receivable under reinsurance contracts . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 16. Amounts receivable relating to uninsured plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 17.1 Current federal and foreign income tax recoverable and interest thereon . . . .............. ....................... .............. 17.2 Net deferred tax asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595,648 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595,648 . . . . . . . . . . . . . 810,712 18. Guaranty funds receivable or on deposit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 19. Electronic data processing equipment and software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237,928 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237,928 . . . . . . . . . . . . . 276,523 20. Furniture and equipment, including health care delivery assets 73,935 ....................... 73,935 .............. 73,935 ....................... ($...............0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... 21. Net adjustments in assets and liabilities due to foreign exchange rates . . . . . ....................... ....................... ....................... ....................... 22. Receivables from parent, subsidiaries and affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 23. Health care ($...............0) and other amounts receivable . . . . . . . . . . . . . . . . . . . . . . ....................... 24. Aggregate write-ins for other than invested assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422,981 . . . . . . . . . . . . . 312,662 . . . . . . . . . . . . . 110,319 . . . . . . . . . . 25. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 11 to 24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. ......... 2,222,617 30,789,124 . . . . . . . . . . . . . 276,290 . . . . . . . . . . ....................... .......... 1,137,814 1,946,327 ....................... ......... 29,651,310 .......... 2,311,943 ....................... ......... 1,360,373 38,321,936 From Separate Accounts, Segregated Accounts and Protected Cell Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Total (Lines 25 and 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DETAILS OF WRITE-INS 1001. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1003. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1098. Summary of remaining write-ins for Line 10 from overflow page . . . . . . . . . . . . . . 1099. TOTALS (Lines 1001 through 1003 plus 1098) (Line 10 above) . . . . . . . . . . . . . . 2401. PREPAIDS/DEPOSITS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2402. ORGANIZATION COSTS/LEASEHOLD IMPR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2403. A/R DUE FROM TOWER FOR SALE OF W/C BOOK . . . . . . . . . . . . . . . . . . . . . . . . . 2498. Summary of remaining write-ins for Line 24 from overflow page . . . . . . . . . . . . . . 2499. TOTALS (Lines 2401 through 2403 plus 2498) (Line 24 above) . . . . . . . . . . . . . . ....................... ......... 30,789,124 ....................... .......... 1,137,814 ....................... ......... 29,651,310 ....................... ......... 38,321,936 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . 341,120 . . . . . . . . . . . . . 230,801 . . . . . . . . . . . . . 110,319 . . . . . . . . . . . . . 360,373 .............. 81,861 .............. 81,861 ....................... ....................... ....................... ....................... ....................... .......... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . 422,981 . . . . . . . . . . . . . 312,662 . . . . . . . . . . . . . 110,319 . . . . . . . . . . Q2 1,000,000 1,360,373 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company LIABILITIES, SURPLUS AND OTHER FUNDS 1 Current Statement Date 5,365,172 2 December 31, Prior Year 1. Losses (current accident year $.......3,735,000) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 2. Reinsurance payable on paid losses and loss adjustment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447,107 . . . . . . . . . . . . . 544,677 3. Loss adjustment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 4. Commissions payable, contingent commissions and other similar charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 5. Other expenses (excluding taxes, licenses and fees) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325,116 . . . . . . . . . . . . . 376,034 6. Taxes, licenses and fees (excluding federal and foreign income taxes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 653,235 . . . . . . . . . . . . . 516,879 7.1 Current federal and foreign income taxes (including $...............0 on realized capital gains (losses)) . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 7.2 Net deferred tax liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 8. Borrowed money $...............0 and interest thereon $...............0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 9. Unearned premiums (after deducting unearned premiums for ceded reinsurance of $.......1,101,271 and including 1,388,985 6,637,024 ......... 11,406,398 .......... 3,705,449 ....................... warranty reserves of $...............0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 10. Advance premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 11. Dividends declared and unpaid: .......... 4,679,044 11.1 Stockholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 11.2 Policyholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 12. Ceded reinsurance premiums payable (net of ceding commissions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 13. Funds held by company under reinsurance treaties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 14. Amounts withheld or retained by company for account of others . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160,168 . . . . . . . . . . . . . 160,168 15. Remittances and items not allocated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 16. Provision for reinsurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................ 17. Net adjustments in assets and liabilities due to foreign exchange rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 18. Drafts outstanding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 19. Payable to parent, subsidiaries and affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ................ 20. Derivatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 21. Payable for securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 22. Liability for amounts held under uninsured plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 23. Capital notes $...............0 and interest thereon $...............0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 24. Aggregate write-ins for liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 450,986 . . . . . . . . . . . . . 403,061 25. Total liabilities excluding protected cell liabilities (Lines 1 through 24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... 26. Protected cell liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... 27. Total liabilities (Lines 25 and 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... 28. Aggregate write-ins for special surplus funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250,000 . . . . . . . . . . . . . 250,000 29. Common capital stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 30. Preferred capital stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 31. Aggregate write-ins for other than special surplus funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 32. Surplus notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 33. Gross paid in and contributed surplus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... 34. Unassigned funds (surplus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... 35. Less treasury stock, at cost: 36. 4,699,961 4,498 20,132,253 20,132,253 2,350,000 41,839,190 (34,920,133) .......... 4,079,469 ....................... ....................... ................ ......... 4,498 5,456 25,881,133 ....................... ......... 25,881,133 .......... ......... ....... 2,350,000 41,839,190 (31,998,387) 35.1 ...............0 shares common (value included in Line 29 $...............0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... 35.2 ...............0 shares preferred (value included in Line 30 $...............0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... Surplus as regards policyholders (Lines 28 to 34, less 35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37. Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DETAILS OF WRITE-INS 2401. OTHER LIABILITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2402. EQUITIES AND DEPOSITS IN POOLS & ASSOC. - NCCI & FJUA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2403. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2498. Summary of remaining write-ins for Line 24 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2499. TOTALS (Lines 2401 through 2403 plus 2498) (Line 24 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2801. SPECIAL SURPLUS FROM CEDED RETRO REINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2802. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2803. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2898. Summary of remaining write-ins for Line 28 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2899. TOTALS (Lines 2801 through 2803 plus 2898) (Line 28 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3101. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3102. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3103. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3198. Summary of remaining write-ins for Line 31 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3199. TOTALS (Lines 3101 through 3103 plus 3198) (Line 31 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Q3 9,519,057 ......... 12,440,803 29,651,310 ......... 38,321,936 .......... ......... . . . . . . . . . . . . . 264,380 . . . . . . . . . . . . . 267,282 . . . . . . . . . . . . . 186,606 . . . . . . . . . . . . . 135,780 ....................... ....................... ....................... ....................... . . . . . . . . . . . . . 450,986 . . . . . . . . . . . . . 403,061 . . . . . . . . . . . . . 250,000 . . . . . . . . . . . . . 250,000 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . 250,000 . . . . . . . . . . . . . 250,000 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company STATEMENT OF INCOME UNDERWRITING INCOME Premiums earned 1.1 Direct (written $......19,875,349) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 Assumed (written $........(49,373)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 Ceded (written $.......1,591,525) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Net (written $......18,234,451) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DEDUCTIONS: 2. Losses incurred (current accident year $.......7,929,095) 2.1 Direct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Assumed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 Ceded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 Net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Loss adjustment expenses incurred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Other underwriting expenses incurred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Aggregate write-ins for underwriting deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Total underwriting deductions (Lines 2 through 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Net income of protected cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Net underwriting gain or (loss) (Line 1 minus Line 6 + Line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . INVESTMENT INCOME 9. Net investment income earned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Net realized capital gains (losses) less capital gains tax of $...............0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Net investment gain (loss) (Lines 9 + 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OTHER INCOME 12. Net gain or (loss) from agents' or premium balances charged off (amount recovered $...............0 amount charged off $...............0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Finance and service charges not included in premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Aggregate write-ins for miscellaneous income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Total other income (Lines 12 through 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Net income before dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Lines 8 + 11 + 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Dividends to policyholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Net income, after dividends to policyholders, after capital gains tax and before all other federal and foreign income taxes (Line 16 minus Line 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Federal and foreign income taxes incurred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Net income (Line 18 minus Line 19) (to Line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CAPITAL AND SURPLUS ACCOUNT 21. Surplus as regards policyholders, December 31 prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Net income (from Line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Net transfers (to) or from Protected Cell accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Change in net unrealized capital gains or (losses) less capital gains tax of $...............0 . . . . . . . . . . . . . . . . . . 25. Change in net unrealized foreign exchange capital gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Change in net deferred income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Change in nonadmitted assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Change in provision for reinsurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Change in surplus notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30. Surplus (contributed to) withdrawn from Protected cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31. Cumulative effect of changes in accounting principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32. Capital changes: 32.1 Paid in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.2 Transferred from surplus (Stock Dividend) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.3 Transferred to surplus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33. Surplus adjustments: 33.1 Paid in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2 Transferred to capital (Stock Dividend) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3 Transferred from capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34. Net remittances from or (to) Home Office . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35. Dividends to stockholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36. Change in treasury stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37. Aggregate write-ins for gains and losses in surplus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38. Change in surplus as regards policyholders (Lines 22 through 37) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39. Surplus as regards policyholders, as of statement date (Lines 21 plus 38) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DETAILS OF WRITE-INS 0501. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0502. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0503. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0598. Summary of remaining write-ins for Line 5 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0599. TOTALS (Lines 0501 through 0503 plus 0598) (Line 5 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1401. OTHER INCOME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1402. SALE OF W/C BOOK TO TOWER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1403. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1498. Summary of remaining write-ins for Line 14 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1499. TOTALS (Lines 1401 through 1403 plus 1498) (Line 14 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3701. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3702. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3703. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3798. Summary of remaining write-ins for Line 37 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3799. TOTALS (Lines 3701 through 3703 plus 3798) (Line 37 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Current Year to Date 2 Prior Year to Date 3 Prior Year Ended December 31 1. Q4 ......... 21,419,794 11,481 . . . . . . . . . . 5,154,803 . . . . . . . . . 16,276,472 ......... .............. . . . . . . . . . . . . . 828,797 . . . . . . . . . . . . . 924,948 18,184,838 20,233,749 ......... ......... ......... 22,774,595 26,910,551 8,761,521 ......... 14,533,965 ......... 19,282,790 .......... ......... 37,589,790 ......... 48,760,198 . . . . . . . . . . . . . 495,407 . . . . . . . . . . . . . 489,541 . . . . . . . . . . . . . 525,061 .......... .......... .......... .......... 1,327,833 7,929,095 2,492,144 6,720,117 ....................... ......... 17,141,356 ....................... .......... .......... .......... 7,710,733 7,312,773 6,185,517 7,786,495 ....................... ......... 21,284,785 ....................... 6,803,289 13,004,562 . . . . . . . . . . 8,003,921 . . . . . . . . . . 9,616,033 .......... ......... ....................... ......... 30,624,516 ....................... (864,884) ........ (1,051,036) ........ (3,713,965) (1,340,423) (130,037) (1,470,460) ........ (1,178,807) (101,736) (1,280,543) ........ (1,615,573) ........... ........ .......... ........... ........... . . . . . . . . . . . . . 408,923 ........ ........ ........ (1,206,650) ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . . . . . . 50 . . . . . . . . . . . . . 997,404 ....................... . . . . . . . . . . . . . . . . . . . . 50 . . . . . . . . . . . . . 997,404 ........ (2,335,344) ....................... ........ (2,335,344) ....................... ........ (2,331,530) ....................... ........ (2,331,530) ....................... ........ (3,923,211) ....................... ........ (3,923,211) ....................... ........ (2,335,344) ........ (2,331,530) ........ (3,923,211) ......... 12,440,803 (2,335,344) ......... 15,021,220 (2,331,530) ......... 15,021,220 (3,923,211) ........ ....................... ........... (123,285) ....................... ........... ........... (215,064) (248,053) ........ ....................... .............. 32,743 ....................... ........... (817,154) ........ ....................... ............ (42,538) ....................... ........... (842,429) . . . . . . . . . . . . . 299,069 . . . . . . . . . . . . . 226,000 1,762 ....................... ....................... ................ ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... .......... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... (2,921,746) . . . . . . . . . . 9,519,057 ........ (2,816,871) . . . . . . . . . 12,204,349 ........ ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . . . . . . 50 . . . . . . . . . . . . . . ....................... ....................... .......... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . . . . . . 50 . . . . . . . . . . . . . 997,404 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ........ ......... 2,000,000 (2,580,417) 12,440,803 (2,596) 1,000,000 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company CASH FLOW 1 Current Year To Date 2 Prior Year To Date 3 Prior Year Ended December 31 Cash from Operations 1. Premiums collected net of reinsurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 21,592,902 2. Net investment income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... 3. Miscellaneous income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 4. Total (Lines 1 to 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 20,638,506 .... 18,953,485 .... 28,406,905 5. Benefit and loss related payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 14,080,044 .... 17,054,379 .... 24,625,273 6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 7. Commissions, expenses paid and aggregate write-ins for deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 8. Dividends paid to policyholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. 9. Federal and foreign income taxes paid (recovered) net of $...............0 tax on capital gains (losses) . . . . . . . . . . . . . . . . . . . . . . . .................. ........ 10. Total (Lines 5 through 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 25,523,331 .... 11. Net cash from operations (Line 4 minus Line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... (4,884,825) .. (954,397) 11,443,287 .... 19,786,983 .... 28,621,346 (833,548) .... (1,211,845) ...... ............... 50 .................. .... 15,020,042 (10,509) 32,063,912 (13,110,427) ........ 997,404 .................. .... 18,694,642 .................. ........ .... .. (10,509) 43,309,405 (14,902,500) Cash from Investments 12. 13. Proceeds from investments sold, matured or repaid: 12.1 Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 383,286 12.2 Stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 12.3 Mortgage loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 12.4 Real estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.5 290,000 . . . . . . 1,082,373 . . . . . . 1,475,646 ........ 660,342 . . . . . . 1,756,470 .................. .................. .................. .................. .................. Other invested assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .... 12.6 Net gains or (losses) on cash, cash equivalents and short-term investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. 12.7 Miscellaneous proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66,426 . . . . . . . . 12.8 Total investment proceeds (Lines 12.1 to 12.7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 739,712 .... 10,113,600 176,145 12,032,460 .... 10,113,603 .................. ........ .... 263,165 13,608,884 Cost of investments acquired (long-term only): 13.1 Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. ........ 13.2 Stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 13.3 Mortgage loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40,000 . . . . . . . . . . . . . . . . . . .................. 13.4 Real estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 13.5 Other invested assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 13.6 Miscellaneous applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 13.7 Total investments acquired (Lines 13.1 to 13.6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 450,738 490,738 14. Net increase (or decrease) in contract loans and premium notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. 15. Net cash from investments (Line 12.8 minus Lines 13.7 and 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 248,974 ........ ........ 455,672 455,672 .................. .... 11,576,788 ........ ........ 117,339 605,672 723,011 .................. .... 12,885,873 Cash from Financing and Miscellaneous Sources 16. 17. Cash provided (applied): 16.1 Surplus notes, capital notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 16.2 Capital and paid in surplus, less treasury stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. . . . . . . 2,000,000 16.3 Borrowed funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 16.4 Net deposits on deposit-type contracts and other insurance liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 16.5 Dividends to stockholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. 16.6 Other cash provided (applied) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,491,361 . . . . . . . . 288,238 ...... Net cash from financing and miscellaneous sources (Lines 16.1 through 16.4 minus Line 16.5 plus Line 16.6) . . . . . . . . . . . . . . . . 1,491,361 . . . . . . . . 288,238 . . . . . . 1,873,568 (126,432) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) . . . . . . . . . . . . . . . . . . . . . . . . . 19. Cash, cash equivalents and short-term investments: 20.0001 20.0002 .... (3,144,489) 19.1 Beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.2 End of period (Line 18 plus Line 19.1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,079,538 Note: Supplemental Disclosures of Cash Flow Information for Non-Cash Transactions: .... (1,245,401) ...... (143,059) . . . . . . 8,224,028 . . . . . . 8,367,087 . . . . . . 8,367,087 . . . . . . 7,121,685 . . . . . . 8,224,028 .............................................................................................................................................. .................. .................. .................. .............................................................................................................................................. .................. .................. .................. Q5 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Notes to Financial Statement Note 1 - Summary of Significant Accounting Policies A. Accounting Practices The financial statements of AequiCap Insurance Company ("AIC") are presented on the basis of accounting practices prescribed or permitted by the Department of Financial Services, Office of Insurance Regulation (OIR). The Department of Financial Services, Office of Insurance Regulation recognizes only statutory accounting practices prescribed or permitted by the State of Florida for determining and reporting the financial condition and results of operations of an insurance company, for determining its solvency under the Florida Insurance Law. The National Association of Insurance Commissioners' Accounting Practices and Procedures manual, version effective January 1, 2001, has been adopted as a component of prescribed or permitted practices by the State of Florida. AIC is also licensed in Georgia, Oklahoma, South Carolina and Texas. Note 2 - Accounting Changes and Corrections of Errors A. Change in Reporting Entity - Effective December 30, 2009, the OIR approved the merger of the Company’s wholly owned insurance subsidiary, AequiCap Property & Casualty Insurance Company (‘APC’), under Consent Order No.:108144-09-CO. As a result, there was a change in the reporting entity and the 2009 prior year to date statutory financial statements and schedules have been restated to reflect the consolidated results for the new reporting entity. Note 3 - Business Combinations and Goodwill None Note 4 - Discontinued Operations None Note 5 - Investments A. Mortgage Loans: (1) On April 1, 2010 the commercial mortgage loan note was amended and the company received an advance principal payment reducing the balance from $2,025,000 to $1,775,000. (2) The company reduced the interest rate on the outstanding commercial mortgage loan of $1,775,000 from 8% to 3%. (3) The maximum percentage of the loan to the value of collateral at the time of the loan was 70%. (4) As of year-end, the Company did not hold any mortgages with interest 180 days or more past due. (5) There were no taxes, assessments or amounts advanced and not included in the mortgage loan. (6-12) There were no impaired mortgage loans. B – G. No change Note 6 - Joint Ventures, Partnerships and Limited Liability Companies None Note 7 - Investment Income No Change Note 8 - Derivative Instruments None Note 9 - Income Taxes No Significant Change Note 10 - Information Concerning Parent, Subsidiaries and Affiliates (A) No Change (B) None Q6 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Notes to Financial Statement (C) No Change (D) At September 30, 2010, the company reported $1,946,327 as receivable from subsidiary and affiliates. The receivable is comprised of $500 from subsidiary, Viceroy Underwriters, Inc.; $458 from affiliate, AequiCap Claims Services and $1,945,369 from affiliate, AequiCap Program Administrators. The terms of the settlement require that these balances be paid within 90 days. (E) Not Applicable (F) AIC has an arrangement with AequiCap Claims Services, Inc., an affiliate, to pay claim fees in return for claim adjusting and processing services. AIC also has an agreement with AequiCap Program Administrators Inc., a licensed general agent affiliate, wherein AIC pays for underwriting and processing services in the form of commissions. (G) No Significant Change (H) Not Applicable (I) None (J) None (K) None (L) None Note 11 - Debt AIC has an outstanding secured mortgage loan in the amount of $9,200,000 recorded as an encumbrance against its home office. The mortgage loan is due June 2011 and has an effective interest rate of 6.74%. The remaining annual payments total $150,000 and $9,050,000 for 2010 and 2011 respectively. Note 12 - Retirement Plans, Deferred Compensation, Postemployment Benefits and Compensated Absences and Other Postretirement Benefit Plans None Note 13 - Capital and Surplus, Dividend Restrictions and Quasi-Reorganization A. B. C. D. E. F. G. H. I. J. No change No change No change None No change No change Not applicable No change No change The portion of unassigned funds (surplus) represented or reduced by cumulative unrealized gains and losses is $55,080. K. None L. None M. Not applicable Note 14 - Contingencies No Change Note 15 - Leases Not Applicable Q6. 1 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Notes to Financial Statement Note 16 - Information About Financial Instruments With Off-Balance Sheet Risk and Financial Instruments With Concentrations of Credit Risk No Change Note 17 - Sale, Transfer, and Servicing of Financial Assets and Extinguishment of Liabilities (A) Transfer of Receivables Reported as Sales: None (B) Transfer and Servicing of Financial Assets: None (C) Wash Sales: None Note 18 - Gain or Loss to the Reporting Entity from Uninsured Plans and Uninsured Portion of Partially Insured Plans Not Applicable Note 19 - Direct Premium Written/Produced by Managing General Agents/Third Party Administrators The Company uses a managing general agent (MGA) to write and administer commercial auto and workers compensation insurance products in specified territories. As reported in the following chart, AequiCap Program Administrators, Inc., the managing general agent, writes direct premiums greater than 5% of policyholders’ surplus. The terms of the General Agency Agreement gives the MGA authority for underwriting. Name and Address AequiCap Program Administrators Inc. 3000 Cypress Creek Road, Fort Lauderdale, FL 33309 FEI Number 65-0204614 Type of Exclusive Business Contract Written Yes Commercial Auto and Workers Compensation Type of Authority Granted U Direct Premium Written $19,875,349 Note 20 - Other Items (A) Not Applicable (B) Not Applicable (C) Special Disability Trust Fund (SDTF): Included in Schedule P is $160,592 for anticipated recoveries (D) (E) (F) (G) from the SDTF. Payments received amounted to $0 and $0 for 2010 and 2009, respectively. Assessments paid to the fund amounted to $245,404 and $1,151,479 in 2010 and 2009, respectively. None None None None Note 21 - Events Subsequent Castlepoint Insurance Company became an accredited reinsurer in the State of Florida in 2008; accordingly, on October 27, 2010, AequiCap Insurance Company authorized the release of the trust funds referred to in Note 22. Note 22 - Reinsurance A. AIC has unsecured aggregate recoverables from the following authorized reinsurers for losses and loss adjustment expenses, paid and unpaid, including IBNR, and unearned premium that exceed 3% of AIC’s policyholder surplus. Q6. 2 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Notes to Financial Statement Ace Prop & Cas Insurance Company Arch Reins Co Castlepoint FL Ins Co Clearwater Ins Co Coliseum Reins Co Everest Reins Co Federal Ins Co Midwest Employers Cas Co Platinum Underwriters Reins Co Transatlantic Rein Co Westport Insurance Corporation 06-0237820 06-1430254 26-3909921 13-2781282 36-2994662 22-2005057 13-1963496 31-1169435 52-1952955 13-5616275 48-0921045 $ $ $ $ $ $ $ $ $ $ $ 411,780 310,843 342,500 619,045 315,326 585,581 308,022 500,000 491,620 625,002 2,057,600 As of September 30, 2010, funds on deposit under the Maiden Re trust agreement (fka Motors Insurance Corporation) on behalf of AIC totaled $28,170,215. Funds on deposit under the Castlepoint Insurance Company trust agreement on behalf of AIC totaled $12,314,078. Additionally, letters of credit and/or trust funds for unauthorized reinsurers totaled $5,133,729. B. Reinsurance Recoverable in Dispute: None C. Reinsurance Assumed and Ceded : The following table summarizes ceded and assumed unearned premiums and the related commission equity as of September 30, 2010. All Other Total Assumed Reinsurance Premium Commission Reserve Equity $ 90 $ 29 $ 90 $ 29 Ceded Reinsurance Net Premium Commission Premium Commission Reserve Equity Reserve Equity $ 1,101,271 $ 18,498 $ (1,101,181) $ (18,469) $ 1,101,271 $ 18,498 $ (1,101,181) $ (18,469) Direct unearned premium reserve: $7,738,205 There are no contracts of reinsurance covering losses that have occurred prior to the inception of the contract, which have not been accounted for in conformity with Chapter 22 of the NAIC Accounting Practices and Procedures Manual. D. Uncollectible Reinsurance: No Significant Change E. Commutation of Ceded Reinsurance: None F. Retroactive Reinsurance: No change Note 23 - Retrospectively Rated Contracts & Contracts Subject to Redetermination None Note 24 - Change in Incurred Losses and Loss Adjustment Expenses Reserves as of December 31, 2009 were $15,111,000. As of September 30th, 2010, $16,814,000 has been paid for incurred claims and claim adjustment expenses attributable to insured events of prior years. Reserves remaining for prior years are now $3,018,000 as a result of re-estimation of unpaid claims and claim adjustment expenses principally on Commercial Auto and Workers Compensation lines of insurance. Therefore, there has been $4,721,000 unfavorable prior-year development from December 31, 2009 to September 30th, 2010. The adverse development is due to a combination of two things. The first is due to reduced, but continued leakage in Commercial Auto claims from AY's 2005 and prior. The second is due to adverse development on the runoff of the Workers Compensation claims. After the sale of the Workers Compensation renewals, the Company appointed an unaffiliated TPA to manage the runoff. Because the Company noted that the incurred losses were greater than expected, the Company hired a Senior Workers Compensation claims adjuster to provide additional oversight for these claims. In addition to this, the Company is in the process of bringing these claims back in house. The Company believes this will Q6. 3 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Notes to Financial Statement serve to stem the development experienced to date. Original estimates are increased, as additional information becomes known regarding individual claims. Loss and lae reserves for accident years 2007 and prior years reflect a negative value of $1,718,000 (see page Q13), due to recoverables due for MCS-90 claims in the amount of $4,942,000. In responding to the Company’s demands for MCS-90 recoveries, several insureds have indicated that their agent failed to properly administer their policies, thereby creating exposure for them under the MCS-90. These insureds have stated that they will be pursuing their agents (and their E&O) for indemnification of AIC’s claim, thus providing AIC with an additional source of funds in the prosecution of these recoveries. AIC anticipates that similar claims will be made by other insureds, thereby further strengthening its position with respect to such recoveries. Note 25 - Intercompany Pooling Arrangements None Note 26 - Structured Settlements None Note 27 - Health Care Receivables None Note 28 - Participating Policies None Note 29 - Premium Deficiency Reserves None Note 30 - High Deductibles None Note 31 - Discounting of Liabilities for Unpaid Losses or Unpaid Loss Adjustment Expenses None Note 32 - Asbestos/Environmental Reserves None Note 33 - Subscriber Savings Accounts Not Applicable Note 34 - Multiple Peril Crop Insurance None Note 35 - Financial Guaranty Insurance None Q6. 4 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company GENERAL INTERROGATORIES PART 1 - COMMON INTERROGATORIES GENERAL 1.1 Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State of Domicile, as required by the Model Act? 1.2 If yes, has the report been filed with the domiciliary state? Yes[ ] No[X] Yes[ ] No[ ] N/A[X] 2.1 Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity? 2.2 If yes, date of change: Yes[ ] No[X] ......................... 3. Have there been any substantial changes in the organizational chart since the prior quarter end? If yes, complete the Schedule Y - Part 1 - organizational chart. Yes[ ] No[X] 4.1 Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? 4.2 If yes, provide the name of entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation. Yes[ ] No[X] 1 Name of Entity 2 NAIC Company Code ............................................................................... 3 State of Domicile ...................................... ...................................... 5. If the reporting entity is subject to a management agreement, including third-party administrator(s), managing general agent(s), attorney-in-fact, or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? If yes, attach an explanation. Yes[ ] No[X] N/A[ ] 6.1 State as of what date the latest financial examination of the reporting entity was made or is being made. 6.2 State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. 6.3 State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). 6.4 By what department or departments? Florida Department of Financial Services, Office of Insurance Regulation 6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? 6.6 Have all of the recommendations within the latest financial examination report been complied with? . . . . . . 12/31/2007 ................... . . . . . . 12/31/2007 ................... . . . . . . 06/17/2009 ................... Yes[ ] No[ ] N/A[X] Yes[X] No[ ] N/A[ ] 7.1 Has this reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? 7.2 If yes, give full information 8.1 8.2 8.3 8.4 Yes[ ] No[X] Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? If response to 8.1 is yes, please identify the name of the bank holding company. Is the company affiliated with one or more banks, thrifts or securities firms? If response to 8.3 is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Office of Thrift Supervision (OTS), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate's primary federal regulator.] 1 Affiliate Name ...................................... 2 Location (City, State) 3 FRB ................................ . Yes[ ] No[X] 4 OCC . Yes[ ] No[X] 5 OTS . Yes[ ] No[X] 6 FDIC . Yes[ ] No[X] Yes[ ] No[X] Yes[ ] No[X] 7 SEC . Yes[ ] No[X] 9.1 Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code. 9.11 If the response to 9.1 is No, please explain: 9.2 Has the code of ethics for senior managers been amended? 9.21 If the response to 9.2 is Yes, provide information related to amendment(s). 9.3 Have any provisions of the code of ethics been waived for any of the specified officers? 9.31 If the response to 9.3 is Yes, provide the nature of any waiver(s). Yes[X] No[ ] Yes[ ] No[X] Yes[ ] No[X] FINANCIAL 10.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement? 10.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount: Yes[X] No[ ] $. . . . . . . . . . . . . . . . . . . . . . . 0 INVESTMENT 11.1 Were any of the stocks, bonds, or other assets of the reporting entity loaned, placed under option agreement, or otherwise made available for use by another person? (Exclude securities under securities lending agreements.) 11.2 If yes, give full and complete information relating thereto: Yes[ ] No[X] 12. Amount of real estate and mortgages held in other invested assets in Schedule BA: $. . . . . . . . . . . . . . . 734,000 13. Amount of real estate and mortgages held in short-term investments: $. . . . . . . . . . . . . . . . . . . . . . . 0 14.1 Does the reporting entity have any investments in parent, subsidiaries and affiliates? Q7 Yes[X] No[ ] STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company GENERAL INTERROGATORIES (Continued) INVESTMENT 14.2 If yes, please complete the following: 14.21 14.22 14.23 14.24 14.25 14.26 14.27 Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Preferred Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Common Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Short-Term Investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mortgages Loans on Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . All Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Investment in Parent, Subsidiaries and Affiliates (Subtotal Lines 14.21 to 14.26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Investment in Parent included in Lines 14.21 to 14.26 above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.28 1 Prior Year-End Book/Adjusted Carrying Value 2 Current Quarter Book/Adjusted Carrying Value ....................... ....................... ....................... ....................... . . . . . . . . . . . . . 716,150 . . . . . . . . . . . . . 649,726 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . 716,150 . . . . . . . . . . . . . 649,726 ....................... ....................... 15.1 Has the reporting entity entered into any hedging transactions reported on Schedule DB? 15.2 If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? If no, attach a description with this statement. Yes[ ] No[X] Yes[ ] No[ ] N/A[X] 16. Excluding items in Schedule E - Part 3 - Special Deposits, real estate, mortgage loans and investments held physically in the reporting entity's offices, vaults or safety deposit boxes, were all stocks, bonds and other securities, owned throughout the current year held pursuant to a custodial agreement with a qualified bank or trust company in accordance with Section 3, III Conducting Examinations, F - Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? 16.1 For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following: 1 Name of Custodian(s) Yes[X] No[ ] 2 Custodian Address Bank One, N.A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P.O. Box 25848, Oklahoma City, OK 73125-0848 . . . . . U.S. Bank Trust and Custody Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1025 Connecticut Ave, Suite 517, Washington D.C. 20036 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.2 For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook, provide the name, location and a complete explanation: 1 Name(s) 2 Location(s) 3 Complete Explanation(s) ............................................................................... .................................................................. .................................................... 16.3 Have there been any changes, including name changes, in the custodian(s) identified in 16.1 during the current quarter? 16.4 If yes, give full and complete information relating thereto: 1 2 Old Custodian New Custodian .................................................... Yes[ ] No[X] 3 Date of Change .................................................... ..................... 4 Reason ............................................. 16.5 Identify all investment advisors, brokers/dealers or individuals acting on behalf of broker/dealers that have access to the investment accounts, handle securities and have authority to make investments on behalf of the reporting entity: 1 Central Registration Depository 2 3 Name(s) Address 291140100, 291140110 . . . . . . . . . . . . . . . . Morgan Asset Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1901 Sixth Avenue North, Suite 620, Birmingham, AL 35203 . . . . 17.1 Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Securities Valuation Office been followed? Yes[X] No[ ] 17.2 If no, list exceptions: Q7.1 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company GENERAL INTERROGATORIES PART 2 - PROPERTY & CASUALTY INTERROGATORIES 1. If the reporting entity is a member of a pooling arrangement, did the agreement or the reporting entity's participation change? If yes, attach an explanation. Yes[ ] No[ ] N/A[X] 2 . Has the reporting entity reinsured any risk with any other reporting entity and agreed to release such entity from liability, in whole or in part, from any loss that may occur on the risk, or portion thereof, reinsured? If yes, attach an explanation. Yes[ ] No[X] 3.1 Have any of the reporting entity's primary reinsurance contracts been canceled? 3.2 If yes, give full and complete information thereto Yes[ ] No[X] 4.1 Are any of the liabilities for unpaid losses and loss adjustment expenses other than certain workers' compensation liabilities tabular reserves (see annual statement instructions pertaining to disclosure of discounting for definition of "tabular reserves"), discounted at a rate of interest greater than zero? 4.2 If yes, complete the following schedule: Yes[ ] No[X] 1 Line of Business 04.2999 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Maximum Interest 3 Discount Rate 4 Unpaid Losses .............. TOTAL DISCOUNT 5 6 Unpaid LAE IBNR .............. 5. Operating Percentages: 5.1 A&H loss percent 5.2 A&H cost containment percent 5.3 A&H expense percent excluding cost containment expenses 6.1 6.2 6.3 6.4 .............. 7 TOTAL ............... DISCOUNT TAKEN DURING PERIOD 8 9 10 11 Unpaid Unpaid Losses LAE IBNR TOTAL .............. .............. .............. ............... ....................... ....................... ....................... Do you act as a custodian for health savings accounts? If yes, please provide the amount of custodial funds held as of the reporting date. Do you act as an administrator for health savings accounts? If yes, please provide the balance of the funds administered as of the reporting date. Q8 0% 0% 0% Yes[ ] No[X] $. . . . . . . . . . . . . . . . . . . . . . . 0 Yes[ ] No[X] $. . . . . . . . . . . . . . . . . . . . . . . 0 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE F - CEDED REINSURANCE Showing all new reinsurers - Current Year to Date 1 NAIC Company Code 2 3 4 Federal ID Number Name of Reinsurer Location NONE Q9 5 Is Insurer Authorized? (Yes or No) STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE T - EXHIBIT OF PREMIUMS WRITTEN Current Year to Date - Allocated by States and Territories 1 States, Etc. Active Status Direct Premiums Written 2 3 Current Year Prior Year To Date To Date Direct Losses Paid (Deducting Salvage) 4 5 Current Year Prior Year To Date To Date Direct Losses Unpaid 6 7 Current Year Prior Year To Date To Date 1. Alabama (AL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Alaska (AK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Arizona (AZ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Arkansas (AR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. California (CA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Colorado (CO) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Connecticut (CT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Delaware (DE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. District of Columbia (DC) . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Florida (FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L . . . . . . . . . 18,435,666 . . . . 26,372,067 . . . . 26,340,291 . . . . 25,591,762 . . . . 30,146,286 . . . . 40,057,206 11. Georgia (GA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L . . . . . . . . . . . . . 739,204 . . . . . . 1,342,873 . . . . . . . . 622,448 . . . . . . . . 813,572 . . . . . . 1,379,730 . . . . . . 2,398,887 12. Hawaii (HI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Idaho (ID) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Illinois (IL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Indiana (IN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Iowa (IA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Kansas (KS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Kentucky (KY) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Louisiana (LA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Maine (ME) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Maryland (MD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Massachusetts (MA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Michigan (MI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Minnesota (MN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Mississippi (MS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Missouri (MO) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Montana (MT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Nebraska (NE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Nevada (NV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30. New Hampshire (NH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31. New Jersey (NJ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32. New Mexico (NM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33. New York (NY) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34. North Carolina (NC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35. North Dakota (ND) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36. Ohio (OH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37. Oklahoma (OK) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L . . . . . . . . . . . . . . . 52,825 . . . . . . . . . . 53,975 . . . . . . . . . . . 4,552 . . . . . . . . . . 41,167 . . . . . . . . . . 44,221 . . . . . . . . . . 99,678 38. Oregon (OR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39. Pennsylvania (PA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40. Rhode Island (RI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41. South Carolina (SC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L . . . . . . . . . . . . . 647,654 . . . . . . . . 917,249 . . . . . . . . 941,561 . . . . . . . . 953,351 . . . . . . 1,403,140 . . . . . . 2,739,882 42. South Dakota (SD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43. Tennessee (TN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44. Texas (TX) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45. Utah (UT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46. Vermont (VT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47. Virginia (VA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48. Washington (WA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49. West Virginia (WV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50. Wisconsin (WI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51. Wyoming (WY) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52. American Samoa (AS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53. Guam (GU) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54. Puerto Rico (PR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55. U.S. Virgin Islands (VI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56. Northern Mariana Islands (MP) . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57. Canada (CN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58. Aggregate other alien (OT) . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59. Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (a). . . . . . . . . 5 . . . . 19,875,349 . . . . 28,686,164 . . . . 27,908,851 . . . . 27,399,852 . . . . 32,973,377 . . . . 45,295,652 DETAILS OF WRITE-INS 5801. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5802. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5803. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5898. Summary of remaining write-ins for Line 58 from overflow page . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5899. TOTALS (Lines 5801 through 5803 plus 5898) (Line 58 above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (L) Licensed or Chartered - Licensed Insurance Carrier or Domiciled RRG; (R) Registered - Non-domiciled RRGs; (Q) Qualified - Qualified or Accredited Reinsurer; (E) Eligible - Reporting Entities eligible or approved to write Surplus Lines in the state; (N) None of the above - Not allowed to write business in the state. (a) Insert the number of L responses except for Canada and Other Alien. Q10 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE Y - INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUP PART 1 - ORGANIZATIONAL CHART Q11 NONE STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company PART 1 - LOSS EXPERIENCE Line of Business 1. Fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Allied lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Farmowners multiple peril . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Homeowners multiple peril . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Commercial multiple peril . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Mortgage guaranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Ocean marine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Inland marine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Financial guaranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 Medical professional liability - occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 Medical professional liability - claims made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Earthquake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Group accident and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Credit accident and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Other accident and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Workers' compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1 Other liability - occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 Other liability - claims made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3 Excess Workers' Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.1 Products liability - occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.2 Products liability - claims made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 19.2 Private passenger auto liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 19.4 Commercial auto liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Auto physical damage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Aircraft (all perils) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Fidelity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Surety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Burglary and theft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Boiler and machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30. Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31. Reinsurance-Nonproportional Assumed Property . . . . . . . . . . . . . . . . . . . . . . . . . 32. Reinsurance-Nonproportional Assumed Liability . . . . . . . . . . . . . . . . . . . . . . . . . . 33. Reinsurance-Nonproportional Assumed Financial Lines . . . . . . . . . . . . . . . . . . 34. Aggregate write-ins for other lines of business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35. TOTALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DETAILS OF WRITE-INS 3401. ............................................................................... 3402. ............................................................................... 3403. ............................................................................... 3498. Summary of remaining write-ins for Line 34 from overflow page . . . . . . . . . . 3499. TOTALS (Lines 3401 through 3403 plus 3498) (Line 34 above) . . . . . . . . . . 1 Direct Premiums Earned Current Year to Date 2 Direct Losses Incurred 3 Direct Loss Percentage 4 Prior Year to Date Direct Loss Percentage ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . 9,781,659 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . 11,638,135 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . 4,250,907 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . 4,510,614 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . 43.458 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . 38.757 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . 47.495 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . . . . . 55.723 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... .......... 21,419,794 ........... 8,761,521 ............... 40.904 ............... 33.127 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... PART 2 - DIRECT PREMIUMS WRITTEN Line of Business 1. Fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Allied lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Farmowners multiple peril . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Homeowners multiple peril . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Commercial multiple peril . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Mortgage guaranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Ocean marine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Inland marine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Financial guaranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 Medical professional liability - occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 Medical professional liability - claims made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Earthquake . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Group accident and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Credit accident and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Other accident and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Workers' compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1 Other liability - occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 Other liability - claims made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3 Excess Workers' Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.1 Products liability - occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.2 Products liability - claims made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 19.2 Private passenger auto liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 19.4 Commercial auto liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Auto physical damage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Aircraft (all perils) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Fidelity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Surety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Burglary and theft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Boiler and machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30. Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31. Reinsurance-Nonproportional Assumed Property . . . . . . . . . . . . . . . . . . . . . . . . . 32. Reinsurance-Nonproportional Assumed Liability . . . . . . . . . . . . . . . . . . . . . . . . . . 33. Reinsurance-Nonproportional Assumed Financial Lines . . . . . . . . . . . . . . . . . . 34. Aggregate write-ins for other lines of business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35. TOTALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DETAILS OF WRITE-INS 3401. ............................................................................... 3402. ............................................................................... 3403. ............................................................................... 3498. Summary of remaining write-ins for Line 34 from overflow page . . . . . . . . . . 3499. TOTALS (Lines 3401 through 3403 plus 3498) (Line 34 above) . . . . . . . . . . Q12 1 Current Quarter 2 Current Year to Date 3 Prior Year Year to Date ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . 1,784,993 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . 4,838,541 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . . 8,734,110 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . 11,141,342 ....................... ....................... ....................... . . . . . . . . . . . . . . . . . (103) ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . 15,793,285 ....................... ....................... ....................... ....................... ....................... ....................... . . . . . . . . . . 12,888,945 ....................... ....................... ....................... . . . . . . . . . . . . . . . . 3,933 ....................... ....................... ....................... ....................... ....................... ....... X X X ....... ....... X X X ....... ....... X X X ....... ....................... ........... 6,623,535 .......... 19,875,349 .......... 28,686,164 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company PART 3 (000 omitted) LOSS AND LOSS ADJUSTMENT EXPENSE RESERVES SCHEDULE Years in Which Losses Occurred 1. 2. 3. 4. 5. 6. 7. Q13 8. 2007 + Prior . . . . . . . . . . . . . . . . . . . . . . . 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtotals 2008 + Prior . . . . . . . . . . . 2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtotals 2009 + Prior . . . . . . . . . . . 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Prior Year-End's Surplus As Regards Policyholders . . . . . . . . . . . 1 2 3 4 5 6 Prior Year-End Known Case Loss and LAE Reserves Prior Year-End IBNR Loss and LAE Reserves Total Prior Year-End Loss and LAE Reserves (Cols. 1 + 2) 2010 Loss and LAE Payments on Claims Reported as of Prior Year-End 2010 Loss and LAE Payments on Claims Unreported as of Prior Year-End Total 2010 Loss and LAE Payments (Cols. 4 + 5) 3,048 2,645 . . . . . . . . . . . 5,693 . . . . . . . . . . . 3,877 . . . . . . . . . . . 9,570 ..... X X X .... . . . . . . . . . . . 9,570 1,598 237 . . . . . . . . . . . 1,835 . . . . . . . . . . . 3,706 . . . . . . . . . . . 5,541 ..... X X X .... . . . . . . . . . . . 5,541 4,646 2,882 . . . . . . . . . . . 7,528 . . . . . . . . . . . 7,583 . . . . . . . . . . 15,111 ..... X X X .... . . . . . . . . . . 15,111 7 Q.S. Date Known Case Loss and LAE Reserves on Claims Reported and Open as of Prior Year-End ........... ........... ........... . . . . . . . . . . 11,175 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,175 . . . . . . . . . . . . . ........... ............. ........... ........... 1,750 . . . . . . . . . . 12,925 . . . . . . . . . . . 3,889 . . . . . . . . . . 16,814 ..... X X X .... . . . . . . . . . . 16,814 ........... 1,750 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,925 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,889 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,814 . . . . . . . . . . . 1,966 . . . . . . . . . . . 1,966 . . . . . . . . . . . 1,966 . . . . . . . . . . 18,780 .................. (1,718) 1,277 . . . . . . . . . . . . . . . . (441) . . . . . . . . . . . . . . . 3,019 . . . . . . . . . . . . . . . 2,578 ....... X X X ...... . . . . . . . . . . . . . . . 2,578 ............... 8 Q.S. Date Known Case Loss and LAE Reserves on Claims Reported or Reopened Subsequent to Prior Year-End 9 10 Q.S. Date IBNR Loss and LAE Reserves Total Q.S. Loss and LAE Reserves (Cols. 7 + 8 + 9) 18 110 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 440 . . . . . . . . . . . . . . . 2,049 . . . . . . . . . . . 1,686 . . . . . . . . . . . . . . . 2,049 . . . . . . . . . . . 2,126 (1,700) 1,387 . . . . . . . . . . . . (313) . . . . . . . . . . . 3,331 . . . . . . . . . . . 3,018 . . . . . . . . . . . 3,735 . . . . . . . . . . . 6,753 11 Prior Year-End Known Case Loss and LAE Reserves Developed (Savings)/ Deficiency (Cols. 4 + 7 minus Col. 1) 6,409 382 6,791 3,031 9,822 (1,580) (127) ............... . . . . . . . . . . . . . (1,707) ............... . . . . . . . . . . . . . (3,394) ............... . . . . . . . . . . . . . (5,101) ....... X X X ...... ....... X X X ...... . . . . . . . . . . . . . . . 9,822 . . . . . . . . . . . . . (5,101) ...................... ............... ......... ............... ...................... ............. ........... ................. Col. 11, Line 7 As % of Col. 1 Line 7 . . . . . . . . . . 12,441 12 Prior Year-End IBNR Loss and LAE Reserves Developed (Savings)/ Deficiency (Cols. 5 + 8 + 9 minus Col. 2) 13 Prior Year-End Total Loss and LAE Reserves Developed (Savings)/ Deficiency (Cols. 11 + 12) 4,829 255 . . . . . . . . . . . 5,084 . . . . . . . . . . . . (363) . . . . . . . . . . . 4,721 ..... X X X .... . . . . . . . . . . . 4,721 ............. ........... ................ ............. Col. 12, Line 7 As % of Col. 2 Line 7 Col. 13, Line 7 As % of Col. 3 Line 7 1.. . . . . . . . . . 102.633 2.. . . . . . . . . (92.059) 3.. . . . . . . 31.242 Col. 13, Line 7 Line 8 ...................................... 4.. . . . . . . 37.947 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES The following supplemental reports are required to be filed as part of your statement filing. However, in the event that your company does not transact the type of business for which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a "NONE" report and a bar code will be printed below. If the supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions. RESPONSES 1. Will the Trusteed Surplus Statement be filed with the state of domicile and the NAIC with this statement? No 2. Will Supplement A to Schedule T (Medical Professional Liability Supplement) be filed with this statement? No 3. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC with this statement? No Explanations: Bar Codes: Trusteed Surplus Statement 24619201049000003 Supplement A to Schedule T 2010 Document Code: 490 24619201045500003 Medicare Part D Coverage Supplement 24619201036500003 2010 Document Code: 365 Q14 2010 Document Code: 455 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company OVERFLOW PAGE FOR WRITE-INS Q15 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE A - VERIFICATION Real Estate 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Book/adjusted carrying value, December 31 of prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cost of acquired 2.1 Actual cost at time of acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Additional investment made after acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Current year change in encumbrances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total gain (loss) on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amounts received on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total foreign exchange change in book/adjusted carrying value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct current year's other than temporary impairment recognized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct current year's depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Book/adjusted carrying value at the end of current period (Lines 1 + 2 + 3 + 4 - 5 + 6 - 7 - 8 ) . . . . . . . . . . . . . . . . . . . . . . . Deduct total nonadmitted amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statement value at end of current period (Line 9 minus Line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Prior Year Ended Year To Date December 31 . . . . . . . . . . 5,999,959 . . . . . . . . . . 5,773,424 ....................... ....................... 738 . . . . . . . . . . . . . 450,000 ................ ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... .................. 5,672 . . . . . . . . . . . . . 600,000 . . . . . . . . . . . . . 284,389 . . . . . . . . . . . . . 379,137 .......... 6,166,307 ....................... .......... 6,166,307 .......... 5,999,959 ....................... .......... 5,999,959 SCHEDULE B - VERIFICATION Mortgage Loans 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Book value/recorded investment excluding accrued interest, December 31 of prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cost of acquired: 2.1 Actual cost at time of acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Additional investment made after acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Capitalized deferred interest and other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accrual of discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unrealized valuation increase (decrease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total gain (loss) on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amounts received on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amortization of premium and mortgage interest points and commitment fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total foreign exchange change in book value/recorded investment excluding accrued interest . . . . . . . . . . . . . . . . . . . . . . Deduct current year's other than temporary impairment recognized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Book value/recorded investment excluding accrued interest at end of current period (Lines 1 + 2 + 3 + 4 + 5 + 6 - 7 - 8 + 9 - 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total valuation allowance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtotal (Line 11 plus Line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct total nonadmitted amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statement value at end of current period (Line 13 minus Line 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Prior Year Ended Year To Date December 31 . . . . . . . . . . 2,025,000 . . . . . . . . . . 2,025,000 ....................... ....................... 40,000 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... .............. . . . . . . . . . . . . . 290,000 . . . . . . . . . . . . . . . . . . . . . . . ....................... ....................... ....................... ....................... ....................... ....................... .......... 1,775,000 ....................... .......... 1,775,000 ....................... .......... 1,775,000 .......... 2,025,000 ....................... .......... 2,025,000 ....................... .......... 2,025,000 SCHEDULE BA - VERIFICATION Other Long-Term Invested Assets 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Book/adjusted carrying value, December 31 of prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cost of acquired: 2.1 Actual cost at time of acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Additional investment made after acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Capitalized deferred interest and other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accrual of discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unrealized valuation increase (decrease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total gain (loss) on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amounts received on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amortization of premium and depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total foreign exchange change in book/adjusted carrying value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct current year's other than temporary impairment recognized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Book/adjusted carrying value at end of current period (Lines 1 + 2 + 3 + 4 + 5 + 6 - 7 - 8 + 9 - 10) . . . . . . . . . . . . . . . . . . Deduct total nonadmitted amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statement value at end of current period (Line 11 minus Line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Prior Year Ended Year To Date December 31 . . . . . . . . . . . . . 734,000 . . . . . . . . . 10,847,600 ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ....................... ......... ....................... ....................... ....................... ....................... ....................... ....................... 10,113,600 . . . . . . . . . . . . . 734,000 . . . . . . . . . . . . . 734,000 ....................... ....................... . . . . . . . . . . . . . 734,000 . . . . . . . . . . . . . 734,000 SCHEDULE D - VERIFICATION Bonds and Stocks 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Book/adjusted carrying value of bonds and stocks, December 31 of prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cost of bonds and stocks acquired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accrual of discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unrealized valuation increase (decrease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total gain (loss) on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct consideration for bonds and stocks disposed of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amortization of premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total foreign exchange change in book/adjusted carrying value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct current year's other than temporary impairment recognized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Book/adjusted carrying value at end of current period (Lines 1 + 2 + 3 + 4 + 5 - 6 - 7 + 8 - 9) . . . . . . . . . . . . . . . . . . . . . Deduct total nonadmitted amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statement value at end of current period (Line 10 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . QSI01 105 (189,710) . . . . . . . . . . . (130,037) . . . . . . . . . . . . . 383,286 . . . . . . . . . . . . . . . . . . 200 2 Prior Year Ended December 31 . . . . . . . . . . 8,375,721 . . . . . . . . . . . . . 117,339 . . . . . . . . . . . . . . . . . . 961 . . . . . . . . . . . (233,391) . . . . . . . . . . . (150,261) . . . . . . . . . . 5,896,572 . . . . . . . . . . . . . . . . . . 525 ....................... ....................... ....................... ....................... Year To Date 2,213,272 .......... ....................... .................. ........... .......... 1,510,143 ....................... .......... 1,510,143 .......... 2,213,272 ....................... .......... 2,213,272 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE D - PART 1B Showing the Acquisitions, Dispositions and Non-Trading Activity During the Current Quarter for all Bonds and Preferred Stock by Rating Class 1 Book/Adjusted Carrying Value Beginning of Current Quarter 2 3 4 Acquisitions During Current Quarter Dispositions During Current Quarter Non-Trading Activity During Current Quarter 5 Book/Adjusted Carrying Value End of First Quarter 6 Book/Adjusted Carrying Value End of Second Quarter 7 Book/Adjusted Carrying Value End of Third Quarter 8 Book/Adjusted Carrying Value December 31 Prior Year QSI02 BONDS 1. Class 1 (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,019,777 . . . . . . . . . . . 948,779 . . . . . . . . 1,030,337 . . . . . . . . . . . 183,215 . . . . . . . . 3,313,331 . . . . . . . . 5,019,777 . . . . . . . . 5,121,434 . . . . . . . . 3,828,610 2. Class 2 (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100,000 . . . . . . . . . . . 100,000 . . . . . . . . . . . 100,000 . . . . . . . . . . . 649,977 3. Class 3 (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 344,630 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,575 . . . . . . . . . . . 185,405 . . . . . . . . . . . 344,630 . . . . . . . . . . . 353,205 . . . . . . . . . . . . . . . . . . . . . 4. Class 4 (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Class 5 (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Class 6 (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Total Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,464,407 . . . . . . . . . . . 948,779 . . . . . . . . 1,030,337 . . . . . . . . . . . 191,790 . . . . . . . . 3,598,736 . . . . . . . . 5,464,407 . . . . . . . . 5,574,639 . . . . . . . . 4,478,587 PREFERRED STOCK 8. Class 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Class 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Class 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Class 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Class 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Class 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Total Preferred Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Total Bonds & Preferred Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,464,407 . . . . . . . . . . . 948,779 . . . . . . . . 1,030,337 . . . . . . . . . . . 191,790 . . . . . . . . 3,598,736 . . . . . . . . 5,464,407 . . . . . . . . 5,574,639 . . . . . . . . 4,478,587 Book/Adjusted Carrying Value column for the end of the current reporting period includes the following amount of non-rated short-term and cash equivalent bonds by NAIC designation: NAIC 1 $.......1,738,122; NAIC 2 $...............0; NAIC 3 $...............0; NAIC 4 $...............0; NAIC 5 $...............0; NAIC 6 $...............0 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE DA - PART 1 Short - Term Investments 1 Book/Adjusted Carrying Value 9199999. Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 2,832,301 2 3 4 Par Value Actual Cost Interest Collected Year To Date ....... X X X ...... .......... 2,832,301 ............ (13,423) 5 Paid for Accrued Interest Year To Date ...................... SCHEDULE DA - Verification Short-Term Investments 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Book/adjusted carrying value, December 31 of prior year . . . . . . . . . . . . . . . . . Cost of short-term investments acquired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accrual of discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unrealized valuation increase (decrease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total gain (loss) on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct consideration received on disposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct amortization of premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total foreign exchange change in book/adjusted carrying value . . . . . . . . . Deduct current year's other than temporary impairment recognized . . . . Book/adjusted carrying value at end of current period (Lines 1 + 2 + 3 + 4 + 5 - 6 - 7 + 8 - 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduct total nonadmitted amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statement value at end of current period (Line 10 minus Line 11) . . . . . . . QSI03 2 Prior Year Ended Year To Date December 31 . . . . . . . . . . 2,981,467 . . . . . . . . . . 3,444,341 . . . . . . . . . . 3,127,691 . . . . . . . . . . 1,983,313 ....................... ....................... . . . . . . . . . . . . . . . . . . . . 51 . . . . . . . . . . . . . . . . . . . . . . . (51) 3,276,857 .................. ....................... .......... .......... 2,446,187 ....................... ....................... ....................... ....................... ....................... ....................... .......... 2,832,301 ....................... .......... 2,832,301 .......... 2,981,467 ....................... .......... 2,981,467 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SI04 Schedule DB - Part A Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE SI04 Schedule DB - Part B Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE SI05 Schedule DB Part C Section 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE SI06 Schedule DB Part C Section 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE SI07 Schedule DB - Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE SI08 Schedule E - Verification (Cash Equivalents) . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE QSI04, SI05, SI06, SI07, SI08 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE A - PART 2 Showing all Real Estate ACQUIRED AND ADDITIONS MADE During the Current Quarter 1 Location 2 Description of Property City 4 5 8 Book/Adjusted Actual Cost Carrying at Time Amount of Value Less of Acquisition Encumbrances Encumbrances 3 State Date Acquired Name of Vendor 6 7 .................. .................. 9 Additional Investment Made After Acquisition NONE 0399999 Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. SCHEDULE A - PART 3 Showing All Real Estate DISPOSED During the Quarter, Including Payments During the Final Year on "Sales Under Contract" 1 Location 2 QE01 Description of Property City 4 5 6 3 State Disposal Date Name of Purchaser Actual Cost 7 8 Expended for Additions, Book/Adjusted Permanent Carrying Value Improvements Less and Changes in Encumbrances Encumbrances Prior Year Change in Book/Adjusted Carrying Value Less Encumbrances 10 11 12 13 Current Year's Other Than Total Foreign Temporary Current Year's Total Change Exchange Current Year's Impairment Change in in B/A C.V. Change in Depreciation Recognized Encumbrances (11 - 9 - 10) B/A C.V. 14 15 16 17 18 19 20 Book/Adjusted Carrying Value Less Encumbrances on Disposal Amounts Received During Year Foreign Exchange Gain (Loss) on Disposal Realized Gain (Loss) on Disposal Total Gain (Loss) on Disposal Gross Income Earned Less Interest Incurred on Encumbrances Taxes, Repairs and Expenses Incurred ............. ............. ............. ............. ............... ............. ............. 9 NONE 0399999 Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............. ............. ............. ............. ............. ............. ............... ............. STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE B - PART 2 Showing All Mortgage Loans ACQUIRED AND ADDITIONS MADE During the Current Quarter 1 Location 2 4 5 6 7 8 9 Actual Cost at Time of Acquisition Additional Investment Made After Acquisition Value of Land and Buildings 3 City State Loan Type Loan Number Date Acquired Rate of Interest Restructured Mortgages - Commercial Mortgages - All Other 2033470 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fort Lauderdale . . . . . . . . . . . . . . . . . . . Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/19/2007 . . . . . . . 3.000 1399999 Subtotal - Restructured Mortgages - Commercial Mortgages - All Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1699999 Total - Restructured Mortgages (sum of Lines 0999999 - 1599999) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3399999 Total Mortgages (sum of Lines 0899999, 1699999, 2499999 and 3299999) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... . . . . . . . . . . . . . . 40,000 . . . . . . . . . . .......... 2,025,000 2,025,000 . . . . . . . . . . 2,025,000 . . . . . . . . . . 2,025,000 . . . . . . . . . . . . . . 40,000 . . . . . . . . . . 2,880,000 2,880,000 . . . . . . . . . . . . . . 40,000 . . . . . . . . . . 2,880,000 . . . . . . . . . . . . . . 40,000 . . . . . . . . . . 2,880,000 SCHEDULE B - PART 3 Showing All Mortgage Loans DISPOSED, Transferred or Repaid During the Current Quarter 1 Location 2 QE02 Loan Number City 4 5 6 3 State Loan Type Date Acquired Disposal Date 7 Book Value/Recorded Investment Excluding Accrued Interest Prior Year 8 Unrealized Valuation Increase (Decrease) Change in Book Value/Recorded Investment 10 11 12 Current Year's Total Other Than Capitalized Change Current Year's Temporary Deferred in (Amortization)/ Impairment Interest and Book Value Accretion Recognized Other (8+9-10+11) 9 Total Foreign Exchange Change in Book Value 14 Book Value/Recorded Investment Excluding Accrued Interest on Disposal ............... ............... ............... ............. ............. ............. 13 15 16 17 18 Consideration Foreign Exchange Gain (Loss) on Disposal Realized Gain (Loss) on Disposal Total Gain (Loss) on Disposal ............. ............. ............. ............. ............. ............. Mortgages with partial repayments 2033470 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fort Lauderdale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10/19/2007 ............. 0299999 Subtotal - Mortgages with partial repayments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0599999 Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,025,000 . . . . . . . . . . . . . . . . . 2,025,000 . . . . . . . . . . . . . . . . . 2,025,000 . . . . . . . . . . . . . ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. . . . . . . 290,000 . . . . . . . . . . . . . . . . . . . 290,000 . . . . . . . . . . . . . . . . . . . 290,000 . . . . . . . . . . . . . STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company E03 Schedule BA Part 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE E03 Schedule BA Part 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE E04 Schedule D Part 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE QE03, E04 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE D - PART 4 Show All Long-Term Bonds and Stocks Sold, Redeemed, or Otherwise Disposed of During the Current Quarter 1 CUSIP Identification 2 Description 3 F o r e i g n 4 5 6 7 8 9 10 11 Disposal Date Name of Purchaser Number of Shares of Stock Consideration Par Value Actual Cost Prior Year Book/ Adjusted Carrying Value ............. ............. ............. ... XXX ... ............. ... XXX ... ... XXX ... ............. ............. . . . . . . . 4,873.06 . . . . . . . 4,873.06 . . . . . . . 4,873.06 .... XXX ... . . . . . . . 4,873.06 .... XXX ... .... XXX ... .... XXX ... .... XXX ... . . . . . . . . . 4,895 . . . . . . . . . 4,895 . . . . . . . . . 4,895 .... XXX ... . . . . . . . . . 4,895 .... XXX ... .... XXX ... .............. . . . . . . . . . 4,895 . . . . . . . . . 1,458 . . . . . . . . . 1,458 . . . . . . . . . 1,458 .... XXX ... . . . . . . . . . 1,458 .... XXX ... .... XXX ... .............. . . . . . . . . . 1,458 Change in Book/Adjusted Carrying Value 12 13 14 Current Year's Unrealized Other Than Total Valuation Current Year's Temporary Change in Increase/ (Amortization)/ Impairment B./A.C.V. (Decrease) Accretion Recognized (11 + 12 - 13) 16 17 18 19 Total Foreign Exchange Change in B./A.C.V. Book/ Adjusted Carrying Value at Disposal Date Foreign Exchange Gain (Loss) on Disposal Realized Gain (Loss) on Disposal Total Gain (Loss) on Disposal ........... ........... ........... ... XXX .. ........... ... XXX .. ... XXX .. ........... ........... . . . . . . . . . 4,882 . . . . . . . . . 4,882 . . . . . . . . . 4,882 .... XXX ... . . . . . . . . . 4,882 .... XXX ... .... XXX ... .............. . . . . . . . . . 4,882 ............. ............. ............. ... XXX ... ............. ... XXX ... ... XXX ... ............. ............. . . . . . . . (4,882) . . . . . . . (4,882) . . . . . . . (4,882) ... XXX ... . . . . . . . (4,882) ... XXX ... ... XXX ... ............. . . . . . . . (4,882) . . . . . . . . (4,882) . . . . . . . . (4,882) . . . . . . . . (4,882) .... XXX ... . . . . . . . . (4,882) .... XXX ... .... XXX ... .............. . . . . . . . . (4,882) 20 21 22 15 Bond Interest/ Stock NAIC Dividends Designation Received Maturity or Market During Year Date Indicator (a) Bonds - Industrial and Miscellaneous (Unaffiliated) 073871BB0 . BEAR STEARNS ALT-A 2006-4 . . . . . . . . . . . 08/25/2010 VARIOUS . . . . . . . . . . . . . . . . 3899999 Subtotal - Bonds - Industrial and Miscellaneous (Unaffiliated) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8399997 Subtotal - Bonds - Part 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8399998 Summary Item from Part 5 for Bonds (N/A to Quarterly) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8399999 Subtotal - Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8999998 Summary Item from Part 5 for Preferred Stocks (N/A to Quarterly) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9799998 Summary Item from Part 5 for Common Stocks (N/A to Quarterly) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9899999 Subtotal - Preferred and Common Stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9999999 Total - Bonds, Preferred and Common Stocks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (a) For all common stock bearing the NAIC market indicator "U" provide: the number of such issues ...............0. .... .... .... .... .... .... .... .... .... XXX XXX XXX XXX XXX XXX XXX XXX XXX ... ... ... ... ... ... ... ... ... . . . . . . . . 3,425 . . . . . . . . 3,425 . . . . . . . . 3,425 ... XXX ... . . . . . . . . 3,425 ... XXX ... ... XXX ... ............. . . . . . . . . 3,425 ............. ............. ............. ... XXX ... ............. ... XXX ... ... XXX ... ............. ............. ............. ............. ............. ... XXX ... ............. ... XXX ... ... XXX ... ............. ............. . . . . . . . . 3,425 . . . . . . . . 3,425 . . . . . . . . 3,425 ... XXX ... . . . . . . . . 3,425 ... XXX ... ... XXX ... ............. . . . . . . . . 3,425 . . . . . . . . . 158 . . . . . . . . . 158 . . . . . . . . . 158 ... XXX ... . . . . . . . . . 158 ... XXX ... ... XXX ... ............. . . . . . . . . . 158 08/25/2036 . XXX . . XXX . . XXX . . XXX . . XXX . . XXX . . XXX . . XXX . 1Z* . . . . . . . .. XXX . .. XXX . .. XXX . .. XXX . .. XXX . .. XXX . .. XXX . .. XXX . QE05 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company E06 Schedule DB Part A Section 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE E07 Schedule DB Part B Section 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE E08 Schedule DB Part D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NONE QE06, E07, E08 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE E - PART 1 - CASH 1 Month End Depository Balances 2 3 4 5 Depository Code Rate of Interest Amount Amount of of Interest Interest Received Accrued During at Current Current Statement Quarter Date Regions Bank . . . . . . . . . . . . . . . . . . . . Orlando, FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State of Florida Treasury Cash Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tallahassee, FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SunTrust Bank . . . . . . . . . . . . . . . . . . . Orlando, FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0199998 Deposits in ...............2 depositories that do not exceed the allowable limit in any one depository (See Instructions) - open depositories . 0199999 Totals - Open Depositories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0299998 Deposits in ...............0 depositories that do not exceed the allowable limit in any one depository (See Instructions) - suspended depositories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0299999 Totals - Suspended Depositories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0399999 Total Cash On Deposit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0499999 Cash in Company's Office . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0599999 Total Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... .............. . . . . . . . 311 . . . . . . . . . . . . . . Book Balance at End of Each Month During Current Quarter 6 7 8 First Month Second Month Third Month 9 * open depositories . SD ....... 2.813 ....... .............. XXX XXX ... XXX XXX XXX XXX XXX ... ... ... ... ... ... .... 1,861 ........... ....... 1,836 .............. . . . . . . . 943,593 . . . . . (451,775) .... 1,146,319 X X X . . . . . . . 800,000 . . . . . . . 800,000 . . . . . . . 800,000 . . . . . . . 295,819 . . . . . . . 295,819 . . . . . . . 295,819 X X X .. X X X .. .......... 2 .............. X X X .. X X X .. X X X .. X X X .. X X X .. ........... .............. ................. ................. ................. ........... .............. ................. ................. ................. QE09 .... 2,174 ....... 1,836 5,099 2,044,511 5,099 .......... .......... .... . . . . . . . 649,143 . . . . XXX XXX 5,099 X X X 2,247,237 X X X .......... XXX XXX . . . . 2,174 . . . . . . . 1,836 . . . . 2,044,511 . . . . . . . 649,143 . . . . 2,247,237 X X X . X X X . ... X X X .. ................. ................. ................. X X X . . . . 2,174 . . . . . . . 1,836 . . . . 2,044,511 . . . . . . . 649,143 . . . . 2,247,237 X X X STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company SCHEDULE E - PART 2 - CASH EQUIVALENTS 1 Description Show Investments Owned End of Current Quarter 2 3 4 Code Date Acquired Rate of Interest 5 6 Book/Adjusted Carrying Value 7 Amount of Interest Due & Accrued Maturity Date 8 Amount Received During Year ....................... ....................... ....................... NONE 8699999 Total - Cash Equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . QE10 STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Designate the type of health care providers reported on this page: 24619201045500103 2010 Document Code: 455 Physicians, including surgeons and osteopaths SUPPLEMENT "A" TO SCHEDULE T EXHIBIT OF MEDICAL PROFESSIONAL LIABILITY PREMIUMS WRITTEN ALLOCATED BY STATES AND TERRITORIES 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 2 Direct Losses Paid 3 4 5 Direct Losses Unpaid 6 7 8 Amount Number of Claims Direct Losses Incurred Amount Reported Number of Claims Direct Losses Incurred but not Reported .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. 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States, Etc. Alabama (AL) . . . . . . . . . . . . . . . . . . . . . . . Alaska (AK) . . . . . . . . . . . . . . . . . . . . . . . . . Arizona (AZ) . . . . . . . . . . . . . . . . . . . . . . . . Arkansas (AR) . . . . . . . . . . . . . . . . . . . . . . California (CA) . . . . . . . . . . . . . . . . . . . . . . Colorado (CO) . . . . . . . . . . . . . . . . . . . . . . Connecticut (CT) . . . . . . . . . . . . . . . . . . . . Delaware (DE) . . . . . . . . . . . . . . . . . . . . . . District of Columbia (DC) . . . . . . . . . . . Florida (FL) . . . . . . . . . . . . . . . . . . . . . . . . . Georgia (GA) . . . . . . . . . . . . . . . . . . . . . . . . Hawaii (HI) . . . . . . . . . . . . . . . . . . . . . . . . . . Idaho (ID) . . . . . . . . . . . . . . . . . . . . . . . . . . . Illinois (IL) . . . . . . . . . . . . . . . . . . . . . . . . . . . Indiana (IN) . . . . . . . . . . . . . . . . . . . . . . . . . Iowa (IA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kansas (KS) . . . . . . . . . . . . . . . . . . . . . . . . Kentucky (KY) . . . . . . . . . . . . . . . . . . . . . . Louisiana (LA) . . . . . . . . . . . . . . . . . . . . . . Maine (ME) . . . . . . . . . . . . . . . . . . . . . . . . . Maryland (MD) . . . . . . . . . . . . . . . . . . . . . . Massachusetts (MA) . . . . . . . . . . . . . . . . Michigan (MI) . . . . . . . . . . . . . . . . . . . . . . . Minnesota (MN) . . . . . . . . . . . . . . . . . . . . . Mississippi (MS) . . . . . . . . . . . . . . . . . . . . Missouri (MO) . . . . . . . . . . . . . . . . . . . . . . . Montana (MT) . . . . . . . . . . . . . . . . . . . . . . . Nebraska (NE) . . . . . . . . . . . . . . . . . . . . . . Nevada (NV) . . . . . . . . . . . . . . . . . . . . . . . . New Hampshire (NH) . . . . . . . . . . . . . . . New Jersey (NJ) . . . . . . . . . . . . . . . . . . . . New Mexico (NM) . . . . . . . . . . . . . . . . . . . New York (NY) . . . . . . . . . . . . . . . . . . . . . . North Carolina (NC) . . . . . . . . . . . . . . . . North Dakota (ND) . . . . . . . . . . . . . . . . . . Ohio (OH) . . . . . . . . . . . . . . . . . . . . . . . . . . . Oklahoma (OK) . . . . . . . . . . . . . . . . . . . . . Oregon (OR) . . . . . . . . . . . . . . . . . . . . . . . . Pennsylvania (PA) . . . . . . . . . . . . . . . . . . Rhode Island (RI) . . . . . . . . . . . . . . . . . . . South Carolina (SC) . . . . . . . . . . . . . . . . South Dakota (SD) . . . . . . . . . . . . . . . . . Tennessee (TN) . . . . . . . . . . . . . . . . . . . . Texas (TX) . . . . . . . . . . . . . . . . . . . . . . . . . . Utah (UT) . . . . . . . . . . . . . . . . . . . . . . . . . . . Vermont (VT) . . . . . . . . . . . . . . . . . . . . . . . Virginia (VA) . . . . . . . . . . . . . . . . . . . . . . . . Washington (WA) . . . . . . . . . . . . . . . . . . . West Virginia (WV) . . . . . . . . . . . . . . . . . Wisconsin (WI) . . . . . . . . . . . . . . . . . . . . . . Wyoming (WY) . . . . . . . . . . . . . . . . . . . . . . American Samoa (AS) . . . . . . . . . . . . . . Guam (GU) . . . . . . . . . . . . . . . . . . . . . . . . . Puerto Rico (PR) . . . . . . . . . . . . . . . . . . . . U.S. Virgin Islands (VI) . . . . . . . . . . . . . Northern Mariana Islands (MP) . . . . Canada (CN) . . . . . . . . . . . . . . . . . . . . . . . . Aggregate other alien (OT) . . . . . . . . . Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Direct Premiums Written Direct Premiums Earned .................. .................. DETAILS OF WRITE-INS 5801. 5802. 5803. 5898. 5899. 0 .................. .................. .................. .................. .................. .................. .................. ...................................... .................. .................. .................. .................. .................. .................. .................. .................. ...................................... .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. Summary of remaining write-ins for Line 58 from overflow page . . . . . TOTALS (Lines 5801 through 5803 plus 5898) (Line 58 above) . . QSupp5 Physicians STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Designate the type of health care providers reported on this page: 24619201045500103 2010 Document Code: 455 Hospitals SUPPLEMENT "A" TO SCHEDULE T EXHIBIT OF MEDICAL PROFESSIONAL LIABILITY PREMIUMS WRITTEN ALLOCATED BY STATES AND TERRITORIES 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 2 Direct Losses Paid 3 4 5 Direct Losses Unpaid 6 7 8 Amount Number of Claims Direct Losses Incurred Amount Reported Number of Claims Direct Losses Incurred but not Reported .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. 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States, Etc. Alabama (AL) . . . . . . . . . . . . . . . . . . . . . . . Alaska (AK) . . . . . . . . . . . . . . . . . . . . . . . . . Arizona (AZ) . . . . . . . . . . . . . . . . . . . . . . . . Arkansas (AR) . . . . . . . . . . . . . . . . . . . . . . California (CA) . . . . . . . . . . . . . . . . . . . . . . Colorado (CO) . . . . . . . . . . . . . . . . . . . . . . Connecticut (CT) . . . . . . . . . . . . . . . . . . . . Delaware (DE) . . . . . . . . . . . . . . . . . . . . . . District of Columbia (DC) . . . . . . . . . . . Florida (FL) . . . . . . . . . . . . . . . . . . . . . . . . . Georgia (GA) . . . . . . . . . . . . . . . . . . . . . . . . Hawaii (HI) . . . . . . . . . . . . . . . . . . . . . . . . . . Idaho (ID) . . . . . . . . . . . . . . . . . . . . . . . . . . . Illinois (IL) . . . . . . . . . . . . . . . . . . . . . . . . . . . Indiana (IN) . . . . . . . . . . . . . . . . . . . . . . . . . Iowa (IA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kansas (KS) . . . . . . . . . . . . . . . . . . . . . . . . Kentucky (KY) . . . . . . . . . . . . . . . . . . . . . . Louisiana (LA) . . . . . . . . . . . . . . . . . . . . . . Maine (ME) . . . . . . . . . . . . . . . . . . . . . . . . . Maryland (MD) . . . . . . . . . . . . . . . . . . . . . . Massachusetts (MA) . . . . . . . . . . . . . . . . Michigan (MI) . . . . . . . . . . . . . . . . . . . . . . . Minnesota (MN) . . . . . . . . . . . . . . . . . . . . . Mississippi (MS) . . . . . . . . . . . . . . . . . . . . Missouri (MO) . . . . . . . . . . . . . . . . . . . . . . . Montana (MT) . . . . . . . . . . . . . . . . . . . . . . . Nebraska (NE) . . . . . . . . . . . . . . . . . . . . . . Nevada (NV) . . . . . . . . . . . . . . . . . . . . . . . . New Hampshire (NH) . . . . . . . . . . . . . . . New Jersey (NJ) . . . . . . . . . . . . . . . . . . . . New Mexico (NM) . . . . . . . . . . . . . . . . . . . New York (NY) . . . . . . . . . . . . . . . . . . . . . . North Carolina (NC) . . . . . . . . . . . . . . . . North Dakota (ND) . . . . . . . . . . . . . . . . . . Ohio (OH) . . . . . . . . . . . . . . . . . . . . . . . . . . . Oklahoma (OK) . . . . . . . . . . . . . . . . . . . . . Oregon (OR) . . . . . . . . . . . . . . . . . . . . . . . . Pennsylvania (PA) . . . . . . . . . . . . . . . . . . Rhode Island (RI) . . . . . . . . . . . . . . . . . . . South Carolina (SC) . . . . . . . . . . . . . . . . South Dakota (SD) . . . . . . . . . . . . . . . . . Tennessee (TN) . . . . . . . . . . . . . . . . . . . . Texas (TX) . . . . . . . . . . . . . . . . . . . . . . . . . . Utah (UT) . . . . . . . . . . . . . . . . . . . . . . . . . . . Vermont (VT) . . . . . . . . . . . . . . . . . . . . . . . Virginia (VA) . . . . . . . . . . . . . . . . . . . . . . . . Washington (WA) . . . . . . . . . . . . . . . . . . . West Virginia (WV) . . . . . . . . . . . . . . . . . Wisconsin (WI) . . . . . . . . . . . . . . . . . . . . . . Wyoming (WY) . . . . . . . . . . . . . . . . . . . . . . American Samoa (AS) . . . . . . . . . . . . . . Guam (GU) . . . . . . . . . . . . . . . . . . . . . . . . . Puerto Rico (PR) . . . . . . . . . . . . . . . . . . . . U.S. Virgin Islands (VI) . . . . . . . . . . . . . Northern Mariana Islands (MP) . . . . Canada (CN) . . . . . . . . . . . . . . . . . . . . . . . . Aggregate other alien (OT) . . . . . . . . . Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Direct Premiums Written Direct Premiums Earned .................. .................. DETAILS OF WRITE-INS 5801. 5802. 5803. 5898. 5899. Summary of remaining write-ins for Line 58 from overflow page . . . . . TOTALS (Lines 5801 through 5803 plus 5898) (Line 58 above) . . QSupp5 Hospitals STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Designate the type of health care providers reported on this page: 24619201045500103 2010 Document Code: 455 Other health care professionals, including dentists SUPPLEMENT "A" TO SCHEDULE T EXHIBIT OF MEDICAL PROFESSIONAL LIABILITY PREMIUMS WRITTEN ALLOCATED BY STATES AND TERRITORIES 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 2 Direct Losses Paid 3 4 5 Direct Losses Unpaid 6 7 8 Amount Number of Claims Direct Losses Incurred Amount Reported Number of Claims Direct Losses Incurred but not Reported .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. 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States, Etc. Alabama (AL) . . . . . . . . . . . . . . . . . . . . . . . Alaska (AK) . . . . . . . . . . . . . . . . . . . . . . . . . Arizona (AZ) . . . . . . . . . . . . . . . . . . . . . . . . Arkansas (AR) . . . . . . . . . . . . . . . . . . . . . . California (CA) . . . . . . . . . . . . . . . . . . . . . . Colorado (CO) . . . . . . . . . . . . . . . . . . . . . . Connecticut (CT) . . . . . . . . . . . . . . . . . . . . Delaware (DE) . . . . . . . . . . . . . . . . . . . . . . District of Columbia (DC) . . . . . . . . . . . Florida (FL) . . . . . . . . . . . . . . . . . . . . . . . . . Georgia (GA) . . . . . . . . . . . . . . . . . . . . . . . . Hawaii (HI) . . . . . . . . . . . . . . . . . . . . . . . . . . Idaho (ID) . . . . . . . . . . . . . . . . . . . . . . . . . . . Illinois (IL) . . . . . . . . . . . . . . . . . . . . . . . . . . . Indiana (IN) . . . . . . . . . . . . . . . . . . . . . . . . . Iowa (IA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kansas (KS) . . . . . . . . . . . . . . . . . . . . . . . . Kentucky (KY) . . . . . . . . . . . . . . . . . . . . . . Louisiana (LA) . . . . . . . . . . . . . . . . . . . . . . Maine (ME) . . . . . . . . . . . . . . . . . . . . . . . . . Maryland (MD) . . . . . . . . . . . . . . . . . . . . . . Massachusetts (MA) . . . . . . . . . . . . . . . . Michigan (MI) . . . . . . . . . . . . . . . . . . . . . . . Minnesota (MN) . . . . . . . . . . . . . . . . . . . . . Mississippi (MS) . . . . . . . . . . . . . . . . . . . . Missouri (MO) . . . . . . . . . . . . . . . . . . . . . . . Montana (MT) . . . . . . . . . . . . . . . . . . . . . . . Nebraska (NE) . . . . . . . . . . . . . . . . . . . . . . Nevada (NV) . . . . . . . . . . . . . . . . . . . . . . . . New Hampshire (NH) . . . . . . . . . . . . . . . New Jersey (NJ) . . . . . . . . . . . . . . . . . . . . New Mexico (NM) . . . . . . . . . . . . . . . . . . . New York (NY) . . . . . . . . . . . . . . . . . . . . . . North Carolina (NC) . . . . . . . . . . . . . . . . North Dakota (ND) . . . . . . . . . . . . . . . . . . Ohio (OH) . . . . . . . . . . . . . . . . . . . . . . . . . . . Oklahoma (OK) . . . . . . . . . . . . . . . . . . . . . Oregon (OR) . . . . . . . . . . . . . . . . . . . . . . . . Pennsylvania (PA) . . . . . . . . . . . . . . . . . . Rhode Island (RI) . . . . . . . . . . . . . . . . . . . South Carolina (SC) . . . . . . . . . . . . . . . . South Dakota (SD) . . . . . . . . . . . . . . . . . Tennessee (TN) . . . . . . . . . . . . . . . . . . . . Texas (TX) . . . . . . . . . . . . . . . . . . . . . . . . . . Utah (UT) . . . . . . . . . . . . . . . . . . . . . . . . . . . Vermont (VT) . . . . . . . . . . . . . . . . . . . . . . . Virginia (VA) . . . . . . . . . . . . . . . . . . . . . . . . Washington (WA) . . . . . . . . . . . . . . . . . . . West Virginia (WV) . . . . . . . . . . . . . . . . . Wisconsin (WI) . . . . . . . . . . . . . . . . . . . . . . Wyoming (WY) . . . . . . . . . . . . . . . . . . . . . . American Samoa (AS) . . . . . . . . . . . . . . Guam (GU) . . . . . . . . . . . . . . . . . . . . . . . . . Puerto Rico (PR) . . . . . . . . . . . . . . . . . . . . U.S. Virgin Islands (VI) . . . . . . . . . . . . . Northern Mariana Islands (MP) . . . . Canada (CN) . . . . . . . . . . . . . . . . . . . . . . . . Aggregate other alien (OT) . . . . . . . . . Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Direct Premiums Written Direct Premiums Earned .................. .................. DETAILS OF WRITE-INS 5801. 5802. 5803. 5898. 5899. Summary of remaining write-ins for Line 58 from overflow page . . . . . TOTALS (Lines 5801 through 5803 plus 5898) (Line 58 above) . . QSupp5 Other Healthcare Professionals STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company Designate the type of health care providers reported on this page: 24619201045500103 2010 Document Code: 455 Other health care facilities SUPPLEMENT "A" TO SCHEDULE T EXHIBIT OF MEDICAL PROFESSIONAL LIABILITY PREMIUMS WRITTEN ALLOCATED BY STATES AND TERRITORIES 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 2 Direct Losses Paid 3 4 5 Direct Losses Unpaid 6 7 8 Amount Number of Claims Direct Losses Incurred Amount Reported Number of Claims Direct Losses Incurred but not Reported .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. 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States, Etc. Alabama (AL) . . . . . . . . . . . . . . . . . . . . . . . Alaska (AK) . . . . . . . . . . . . . . . . . . . . . . . . . Arizona (AZ) . . . . . . . . . . . . . . . . . . . . . . . . Arkansas (AR) . . . . . . . . . . . . . . . . . . . . . . California (CA) . . . . . . . . . . . . . . . . . . . . . . Colorado (CO) . . . . . . . . . . . . . . . . . . . . . . Connecticut (CT) . . . . . . . . . . . . . . . . . . . . Delaware (DE) . . . . . . . . . . . . . . . . . . . . . . District of Columbia (DC) . . . . . . . . . . . Florida (FL) . . . . . . . . . . . . . . . . . . . . . . . . . Georgia (GA) . . . . . . . . . . . . . . . . . . . . . . . . Hawaii (HI) . . . . . . . . . . . . . . . . . . . . . . . . . . Idaho (ID) . . . . . . . . . . . . . . . . . . . . . . . . . . . Illinois (IL) . . . . . . . . . . . . . . . . . . . . . . . . . . . Indiana (IN) . . . . . . . . . . . . . . . . . . . . . . . . . Iowa (IA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kansas (KS) . . . . . . . . . . . . . . . . . . . . . . . . Kentucky (KY) . . . . . . . . . . . . . . . . . . . . . . Louisiana (LA) . . . . . . . . . . . . . . . . . . . . . . Maine (ME) . . . . . . . . . . . . . . . . . . . . . . . . . Maryland (MD) . . . . . . . . . . . . . . . . . . . . . . Massachusetts (MA) . . . . . . . . . . . . . . . . Michigan (MI) . . . . . . . . . . . . . . . . . . . . . . . Minnesota (MN) . . . . . . . . . . . . . . . . . . . . . Mississippi (MS) . . . . . . . . . . . . . . . . . . . . Missouri (MO) . . . . . . . . . . . . . . . . . . . . . . . Montana (MT) . . . . . . . . . . . . . . . . . . . . . . . Nebraska (NE) . . . . . . . . . . . . . . . . . . . . . . Nevada (NV) . . . . . . . . . . . . . . . . . . . . . . . . New Hampshire (NH) . . . . . . . . . . . . . . . New Jersey (NJ) . . . . . . . . . . . . . . . . . . . . New Mexico (NM) . . . . . . . . . . . . . . . . . . . New York (NY) . . . . . . . . . . . . . . . . . . . . . . North Carolina (NC) . . . . . . . . . . . . . . . . North Dakota (ND) . . . . . . . . . . . . . . . . . . Ohio (OH) . . . . . . . . . . . . . . . . . . . . . . . . . . . Oklahoma (OK) . . . . . . . . . . . . . . . . . . . . . Oregon (OR) . . . . . . . . . . . . . . . . . . . . . . . . Pennsylvania (PA) . . . . . . . . . . . . . . . . . . Rhode Island (RI) . . . . . . . . . . . . . . . . . . . South Carolina (SC) . . . . . . . . . . . . . . . . South Dakota (SD) . . . . . . . . . . . . . . . . . Tennessee (TN) . . . . . . . . . . . . . . . . . . . . Texas (TX) . . . . . . . . . . . . . . . . . . . . . . . . . . Utah (UT) . . . . . . . . . . . . . . . . . . . . . . . . . . . Vermont (VT) . . . . . . . . . . . . . . . . . . . . . . . Virginia (VA) . . . . . . . . . . . . . . . . . . . . . . . . Washington (WA) . . . . . . . . . . . . . . . . . . . West Virginia (WV) . . . . . . . . . . . . . . . . . Wisconsin (WI) . . . . . . . . . . . . . . . . . . . . . . Wyoming (WY) . . . . . . . . . . . . . . . . . . . . . . American Samoa (AS) . . . . . . . . . . . . . . Guam (GU) . . . . . . . . . . . . . . . . . . . . . . . . . Puerto Rico (PR) . . . . . . . . . . . . . . . . . . . . U.S. Virgin Islands (VI) . . . . . . . . . . . . . Northern Mariana Islands (MP) . . . . Canada (CN) . . . . . . . . . . . . . . . . . . . . . . . . Aggregate other alien (OT) . . . . . . . . . Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Direct Premiums Written Direct Premiums Earned .................. .................. DETAILS OF WRITE-INS 5801. 5802. 5803. 5898. 5899. Summary of remaining write-ins for Line 58 from overflow page . . . . . TOTALS (Lines 5801 through 5803 plus 5898) (Line 58 above) . . QSupp5 Other Healthcare Facilities STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company 24619201036500103 2010 Document Code: 365 MEDICARE PART D COVERAGE SUPPLEMENT Net of Reinsurance For the Quarter Ended September 30, 2010 NAIC Group Code: 1. 2. 3. 4. 5. Individual Coverage 1 2 Insured Uninsured ..................... ...... X X X ...... ..................... ...... X X X ...... ..................... ...... X X X ...... ..................... ...... X X X ...... NAIC Company Code: 24619 Group Coverage 5 3 4 Total Insured Uninsured Cash ..................... ...... X X X ...... ..................... ..................... ...... X X X ...... ...... X X X ...... ..................... ...... X X X ...... ..................... ..................... ...... X X X ...... ...... X X X ...... Premiums Collected . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Earned Premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Claims Paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Claims Incurred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Reinsurance Coverage and Low Income Cost Sharing - Claims Paid Net of Reimbursements Applied (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . 6. Aggregate Policy Reserves - change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Expenses Paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Expenses Incurred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Underwriting Gain or Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Cash Flow Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X X X . . . . . . . . . . . . X X X . . . . . . . . . . . . X X X . . . . . . (a) Uninsured Receivable/Payable with CMS at End of Quarter: $...............0 due from CMS or $...............0 due to CMS QSupp6 ..................... ...... ...... ...... ...... ...... X X X ...... X X X ...... X X X ...... X X X ...... X X X ...... ..................... ...... X X X ...... ..................... ...... ...... X X X ...... X X X ...... ..................... STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company INDEX TO PROPERTY & CASUALTY QUARTERLY STATEMENT Accident and Health Insurance; Q3; Q12 Accounting Changes and Corrections of Errors; Q6, Note 2 Accounting Practices and Policies; Q6, Note 1 Admitted Assets; Q2; QSI01 Affiliated Transactions; Q2; Q3; Q7; Q7.1 Asbestos Losses and Loss Adjustment Expenses; Q6, Note 32 Bonds; Q2; Q5; Q7.1; Q7.2; QSI01; QSI02; QE04; QE05; QSupp2 Business Combinations and Goodwill; Q6, Note 3 Capital Gains (Losses); Q3; Q4; Q5 Capital Stock; Q3; Q4; Q6, Note 13 Capital Notes; Q3; Q5; Q6, Note 11 Caps; QE06 Cash; Q2; Q5; QE08; QSupp2 Cash Equivalents; Q2; Q5; QE09 Collars; QE07 Commissions; Q3; Q5 Common Stock; Q2; Q7.1; Q7.2; QSI01; QE04; QE05; QSupp2 Counterparty Exposure; Q6, Note 8; QE06; QE07 Contingencies; Q6, Note 14 Debt; Q6, Note 11 Deferred Compensation; Q6, Note 12 Derivative Instruments; Q6, Note 8; QSI04; QSI05; QE06; QE07 Discontinued Operations; Q6, Note 4 Discounting of Liabilities; Q6, Note 31; Q8 Electronic Data Processing Equipment; Q2 Environmental Losses and Loss Adjustment Expenses; Q6, Note 32 Exchange or Counterparty; QE06 Expenses; Q3; Q4; Q5; Q8; QE01; QSupp3 Extinguishment of Liabilities; Q6, Note 17 Extraordinary Items; Q6, Note 20 Federal ID Number; Q9 Federal Reserve Board; Q7 Finance and Service Charge; Q4 Floors; QE06 Foreign Exchange; Q2; Q3; Q4; QSI01; QSI02; QSI03; QE04; QE05 Forwards; QE07 Futures Contracts; QE06; QE07 Guaranty Fund; Q2 Health Care Receivables; Q6, Note 27 Hedging Transactions; Q7.1; QE06; QE07 High Deductible Policies; Q6, Note 30 Holding Company; Q7; Q11 Income Generation Transactions; QE06 Income Taxes; Q2; Q3; Q4; Q5; Q6, Note 9 Intercompany Pooling; Q6, Note 25 Investment Income; Q2; Q4; Q5; Q6, Note 7; QSupp2 Investments; Q2; Q4; Q6, Note 5; Q7.1; Q7.2; QSI01; QSI03; QE03; QE04; QE05; QE09; QSupp2 Joint Venture; Q6, Note 6 Leases; Q6, Note 15 Licensing; Q3; Q7; Q10 Limited Liability Company (LLC); Q6, Note 6 Limited Partnership; Q6, Note 6 Lines of Business; Q8; Q12 Long-Term Invested Assets; QSI01; QE03 Loss Development; Q6 Losses; Q3; Q4; Q5; Q6, Note 24; Q8; Q10; Q12; Q13; QSupp1; QSupp3 Loss Adjustment Expenses; Q3; Q6, Note 25; Q8; Q13; QSupp3 Managing General Agents; Q6, Note 19; Q7 Medical Malpractice Insurance; Q12; Q14; QSupp5 Medicare Part D Coverage; QSupp6 Mortgage Loans; Q2; Q5; Q7.1; QSI01; QE02; QSupp2 Multiple Peril Crop Insurance; Q6, Note 34 Nonadmitted Assets; Q2; Q4; QSI01; QSI03 Non-Tabular Discount; Q6, Note 31 Off-Balance Sheet Risk; Q6, Note 16 Options; Q7.1; QE06 Organizational Chart; Q7; Q11 INDEX STATEMENT AS OF September 30, 2010 OF THE AequiCap Insurance Company INDEX TO PROPERTY & CASUALTY QUARTERLY STATEMENT Other Derivative Transactions; QE06; QE07 Parent, Subsidiaries and Affiliates; Q2; Q3; Q6, Note 10; Q7.1 Participating Policies; Q6, Note 28 Pharmaceutical Rebates; Q6, Note 27 Policyholder Dividends; Q3; Q4; Q5 Postemployment Benefits; Q6, Note 12 Postretirement Benefits; Q6, Note 12 Preferred Stock; Q2; Q7.1; Q7.2; QSI01; QSI02; QE04; QSupp2 Premium Deficiency Reserves; Q6, Note 29 Premium Notes; Q2; Q5 Premiums; Q3; Q5; Qsupp3 Accrued Retrospective; Q2 Advance; Q3 Direct; Q10; Q12 Earned; Q4; Q10; Q12; QSupp5 Earned but Unbilled; Q2 Unearned; Q3 Written; Q4; Q10; Q12; QSupp5 Quasi Reorganizations; Q6, Note 13 Real Estate; Q2; Q5; Q7.1; QSI01; QE01; QSupp2 Redetermination, Contract Subject to; Q6, Note 23 Reinsurance; Q6, Note 22 Assumed; Q12 Ceded; Q3; Q9; QSupp3 Commutation; Q6, Note 22 Funds Held; Q2; Q3 Losses; Q3; Q4; Q8; QSupp3 Payable; Q3; QSupp3 Premiums; Q3; QSupp3 Receivable; Q2; QSupp3 Unsecured; Q6, Note 22 Uncollectible; Q6, Note 22 Reserves Incurred but Not Reported (IBNR); Q8; Q13 Unpaid Loss Adjustment Expense (LAE); Q13 Retirement Plans; Q6, Note 12 Retrospectively Rated Contracts; Q6, Note 23 Salvage and Subrogation; Q10 Servicing of Financial Assets; Q6, Note 17 Short-Term Investments; Q2; Q5; Q7.1; QSI03; QSupp2 Special Deposits; QSupp2 Stockholder Dividends; Q3; Q4; Q5 Structured Settlements; Q6, Note 26 Subscriber Savings Accounts; Q6, Note 33 Subsequent Events; Q6, Note 21 Surplus; Q3; Q4; Q5; Q6, Note 13; Q13; Q14; QSupp1; QSupp2; QSupp3 Surplus Notes; Q3; Q4; Q5 Swaps; QE07 Synthetic Assets; QSI04; QSI05 Tabular Discount; Q6, Note 31 Third Party Administrator; Q6, Note 19; Q7 Treasury Stock; Q3; Q4; Q5 Underwriting Expenses; Q4 Uninsured Accident and Health; Q3; Q6, Note 18 Valuation Allowance; QSI01 Wash Sales; Q6, Note 17 INDEX.1
