Captive Annual Financial Statement

Captive Annual Financial Statement Requirements

Prior to March 1 of each year, each captive insurance company shall submit to the commissioner a report of its financial condition, verified by oath of two of its executive officers. Except as provided in Section 27-31B-6, each captive insurance company shall report using statutory accounting principles, unless the commissioner approves the use of generally accepted accounting principles, with any useful or necessary modifications or adaptations thereof required or approved or accepted by the commissioner for the type of insurance and kinds of insurers to be reported upon, and as supplemented by additional information required by the commissioner. Any pure captive insurance company or an industrial insured captive insurance company insuring the risks of industrial insured groups as defined in paragraph a. of subdivision (14) of Section 27-31B-2 may make written application for filing the required report on a fiscal year-end. If an alternative reporting date is granted, the annual report shall be due 60 days after the end of the fiscal year.

Captive Financial Statement Blanks


Association Captives		National Association of Insurance Commissioners Property and Casualty Annual Statement Blank

Industrial Insured captives insuring the risks of an industrial insured group defined in paragraph b. of subdivision (14) of Section 27-31B-2		National Association of Insurance Commissioners Property and Casualty Annual Statement Blank

Industrial Insured captives insuring the risks of an industrial insured group defined in paragraph a. of subdivision (14) of Section 27-31B-2		Captive Financial Statement- Pure or Industrial Insured

Pure Captives		Captive Financial Statement- Pure or Industrial Insured

Sponsored Captives		National Association of Insurance Commissioners Property and Casualty Protected Cell Annual Statement Blank

September 02, 2010