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MAINE STATE LEGISLATURE

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QUARTERLY COMPLIANCE REPORT

STATE OF MAINE WORKERS' COMPENSATION BOARD

Fourth Quarter 2005 Report

October 1, 2005 - December 31, 2005

Office of Monitoring, Audit & Enforcement

Paul R. Dionne Executive Director/Chair

Steven P. Minkowsky Deputy Director of Benefits Administration

27 State House Station Augusta, Maine 04333-0027

(207) 287-3751

JOHN ELIAS BALDACCI

GOVERNOR

STATE OF MAINE

WORKERS' COMPENSATION BOARD

DEERING BUILDING AMHI COMPLEX

27 STATE HOUSE STATION

AUGUSTA, MAINE

04333·0027

July 28, 2006

Senator Ethan K. Strimling, Chair Joint Standing Committee on Labor 3 State House Station Augusta, Maine 04333

Dear Senator Strimling:

PAUL R. DIONNE

EXECUTIVE DIRECTOR

Enclosed please find a copy of the Workers' Compensation Board Quarterly Compliance Report compiled for the fourth quarter of2005.

The Workers' Compensation Board has also initiated an audit program to review the activity of insurance carriers, self-insureds, and third-party administrators pursuant to P.L. 1997, Chapter 486. A seven-year audit cycle has been approved by the Board and audits are being conducted on a regular basis.

A new feature in this quarterly report is the inclusion of the number and timeliness of Notices of Controversy filed with the Board. This new section is based on the November 22, 2005 motion which was approved by majority vote by the Board of Directors.

The Monitoring, Audit and Enforcement (MAE) Program is having a significant impact on compliance in the State of Maine. Although much work remains to be done, the Board anticipates that this program will continue to improve compliance as envisioned by the Governor and the Legislature and as reflected in P.L. 1997, Chapter 486.

The Workers' Compensation Board is pleased with the results of the MAE Program, which is drawing national attention, and remains convinced that the program promises even better compliance in the future for Maine.

PRD/amp Enclosure

PHONE: (207) 287-3751

Sincerely,

~~(/ Paul R. Dionne Executive Director/Chair

PRINTED ON RECYCLED PAPER

TDD: (207) 287·6119

IV

FAX: (207) 287-7198

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State of Maine Workers' Compensation Board Quarterly Compliance Report

Fourth Quarter 2005

Table of Contents

Executive Summary Quarterly Compliance Summary First Reports of Occupational Injury or Disease Compliance Summary Payments of Initial Indemnity Benefit Summary Filing ofMemoranda of Payment Summary Filing of Notices of Controversy Summary

Table of Charts

First Reports of Occupational Injury or Disease Filing Distribution First Reports of Occupational Injury or Disease Quarterly Compliance First Reports of Occupational Injury or Disease Received Per Quarter Payments of Initial Indemnity Benefit Distribution Payments of Initial Indemnity Benefit Quarterly Compliance Payments of Initial Indemnity Benefit Compliance Trend Filing of Memoranda of Payment Distribution Filing of Memoranda of Payment Quarterly Compliance Filing ofMemoranda ofPayment Compliance Trend Filing of Notices of Controversy Distribution Filing ofNotices of Controversy Quarterly Compliance Filing of Notices of Controversy Compliance Trend

Pages 1-3

Page 5 Page 6 Page 7 Page 8

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Appendices

A. Insurance Group Compliance Pages Al-A9 Initial Filings Comparison

B. Insurance Group Compliance Pages Bl-B9 Initial Indemnity Payments and Memorandum ofPayment Filing

c. Insurance Group Compliance Pages Cl- C9 Notices of Controversy Filing

D. Insurance Group Compliance Pages Dl- D40 Quarterly Compliance Data

ii

Executive Summary

On July 11, 2006, the Maine Workers' Compensation Board unanimously approved the Fourth Quarter 2005 Compliance Report. This report represents the efforts of the Office of Monitoring, Audit and Enforcement (MAE Program) and the workers' compensation community.

The Reconcjliation Report was sent to one hundred forty four (144) entities on January 23, 2006. One hundred eighteen (118) responded timely. Sixteen (16) entities were not required to respond. Ten (10) entities failed to respond. The non-respondents were contacted to verify addresses and ensure future response.

I. COMPLIANCE OVERVIEW

A. Lost Time First Reports

• 3,446 Lost Time First Reports were received during the fourth quarter. 85.61% were received within 7 days and 90.75% were received within 10 days. The 7-day compliance (85.61 %) represents a slight increase (about 1.5%) from the previous quarter. This increase can be attributed to better implementation by insurance entities using the IAIABC Release III· format for electronic filing purposes. In the fourth quarter 95% of all First Reports oflnjury were filed electronically.

B. Payments of Initial Indemnity Benefit

• 88.68% oflnitial Indemnity Benefits were paid within 14 days. The Board's benchmark for this area is 80%. The insurance community exceeded this measure by nearly 9%. This is the highest ever compliance.

C. Filing of Initial Memoranda of Payment

• 86.96% oflnitial Memoranda of Payment were received by the Board within 17 days. The Board's benchmark for this area is 75%. The insurance community exceeded this mark by nearly 12%. This is also the highest ever compliance in this area.

D. Notices of Controversy

On November 22,2005, the Maine Workers' Compensation Board of Directors approved by majority vote the following motion:

MOVE to implement the reporting of the number, timeliness and the percent of initial indemnity claims denied (NOC's) in the quarterly and annual compliance reports.

• 90.82% ofthe Initial IndemnityNOCs filed within the fourth quarter of2005 were filed within 0-17 days.

1

* Appendix A: Initial Filings Comparison: Appendix A was generated at the request of the Board of Directors on August 24, 2004.

* Appendix C: provides NOC filing timeliness compliance information by insurance groups.

II. CAVEATS

A. General Caveats

• This Fourth Quarter 2005 Compliance Report represents static results based upon data received by February 27, 2006.

The Board's current benchmarks are as follows:

(1) Payments oflnitial Indemnity Benefit made within 0-14 days is 80%. (2) Memoranda ofPayment received within 0-17 days is 75%.

• Employer delays in reporting dates of injury and/or dates of incapacity lower insurance company and third-party administrator compliance.

• Question marks listed on this report indicate that the insurance company, the third-party administrator, or the self-administered employer did not provide the required data; therefore, the time line calculation could not be determined.

• The Reconciliation Report process identified internal and external errors and problems. These errors and problems were referred to the appropriate entities for correction.

B. NOC-Related Caveats

• The measurement ofthe Filing oflnitial Indemnity Notices of Controversy (NOCs) excludes the following types ofNOCs:

1. NOCs submitted for reasons of"Jurisdiction" and "Coverage". 2. NOCs submitted by entities that are not the carrier of record. 3. NOCs filed on "Medical Only" claims. 4. NOCs with subsequent incapacity dates after a Return to Work Date where a

claim for compensation could not be determined by the Board.

• The measurement of the filing of Initial Indemnity Notices of Controversy (NOCs) reflects the timeliness of initial indemnity NOCs.

• Initial Indemnity Notices of Controversy can be filed for a number of reasons including: Benefit Amount in Dispute, Legal Causation, Coverage, Notice of Injury, Extent of !ncapacity, Statute ofLimitations and Jurisdiction.

2

• The number oflnitial Indemnity NOCs filed by an insurer, contrasted with the number of Initial MOPs filed by the insurer, may be used as one of many claims administration indicators that result in an insurer being referred for audit for possible violations of the Act.

C. MOP-Related Caveats

• The timeliness of certain benefits such as salary continuation is currently impossible to track. Consequently, these are not measured for timeliness of payment, but are tracked for the timeliness ofthe form filing of the MOP.

• These MOPs are identified as "Alternate Benefits" within the appendices.

III. CORRECTIVE ACTION PLANS (CAPs)

A. Current CAPs The following insurance groups have had Corrective Action Plans (CAPs) in place for some period of time. Corrective Action Plans are implemented for insurers with chronic poor compliance and filing procedures. These plans have improved the performance of many of these carriers.

Market Share by Insurer Group Premium Written

A. Royal & Sunalliance 4.70%

B. St. Paul/Travelers Insurance 2.75%

c. Chubb & Son Insurance 0.35%

D. Ace/ESIS Insurance Group 0.01%

E. Gallagher Bassett Claims Services NA-TPA

F. Crawford & Company NA-TPA

G. Cambridge Integrated Services NA-TPA

H. Hartford/Specialty Risk Services Not Available

I. Georgia Pacific Not Available

Elements of the Corrective Action Plans are reviewed and updated each quarter to track compliance changes and ensure that the elements of the Corrective Action Plan are being met.

Compliance information on individual insurance carriers, third-party administrators, and self-administered employers for the fourth quarter of2005 is listed on the Board's website: www.maine.gov/wcb/

3

First Report Oflnjury Received within:

Initial Indemnity Payment Made Within 14 Days

Memoranda ofPayment Received Within 17 Days

Notice of Controversy Received Within 17 Days

First Report Of Injury Received within:

Initial Indemnity Payment Jyt:ade Within 14 Days

Memoranda of Payment Received Within 17 Days

Notice of Controversy Received Within 17 Days

Maine Workers' Compensation Board

7Days

86.02%

First Quarter

Quarterly Compliance Report 10/1/2005-12/31/2005

Second Quarter

Third Quarter

10'Days 7Days 10 Days 7Days 10 Days

89.76% 84.97% 89.56% 85.07% 89.81%

85.35% 85.38% 83.33%

82.55% 84.22% 80.62%

91.10% 91.56% 92.62%

7Days

87.50%

First Quarter

10 Days

91.23%

85.93%

83.03%

93.58%

7Days

86.51%

Second Quarter

10 Days

90.09%

86.08%

83.61%

90.98%

7Days

84.18%

I I

Third Quarter

10 Days

88.52%

85.66%

82.98%

91.91%

Fourth Quarter

7Days 10 Days

86.91% 90.82%

85.58%

82.70%

90.78%

Fourth Quarter

7Days 10 Days

85.61% 90.75%

88.68%

86.96%

90.82%

Char t 1

Chart 2

Chart 3

Fourth Quarter Compliance Report 10/112005 -12/31/2005

FIRST REPORTS OF OCCUPATIONAL INJURY OR DISEASE

11 - 14

I Filing Distribution I 15.21

22+ Days 4.27%

First Reports Received Within:

8- 10 Days 5.14%

5000

4500

91 .23%

1st Qtr 05

4000 3878

3500

3000

3rd Qtr 04

Quarterly Compliance

[a" 0-7 Days • 0-1 0 Days I 90.09% 88.52%

2nd Qtr 05 3rd Qtr 05

Lost Time First Reports Received Per Quarter

4th Qtr 04 1st Qtr 05 2nd Qtr 05

0 - 7 Days 2950 8 - 10 Days 177

11 - 14 Days 1 03 15 - 21 Days 69

22+ Da s 147 Total 3446

90.75%

4th Qtr 05

3868

3446

3rd Qtr 05 4th Qtr 05

85.61 % 5.14% 2.99% 2.00% 4.27% 100%

Maine Workers' Compensation Board 5

Chart 4

Chart 5

Chart 6

Fourth Quarter Compliance Report 10/01/2005 - 12/31/2005

PAYMENTS OF INITIAL INDEMNITY BENEFIT

22-28 Days 1.85%

I Payment Distribution I

15-21 Days

5.04%

"Indicates compliance could not be determined

1st Qtr 05

86%

83%~

Quarterly Compliance I • 0-14 Days I

86.08% 85.66%


Compliance Trend

8,% 86% •

Initial Payment Made Within:

0 - 14 Days 862 88.68% 15 - 21 Days 49 5.04% 22 - 28 Days 18 1.85%

29+ Days 35 3.60% ? Da s 8 0.82%

Total 972 100%

88.68%

4th Qtr OS

~89% 8% ---- --

-- ~--- -- -- ~- ~- ----

3rd Qtr 04 4th Qtr 04 1st Qtr 05 2nd Qtr 05 3rd Qtr 05 4th Qtr 05


Chart 7

Chart 8

Chart 9

27-34

Fourth Quarter Compliance Report l 0/0 l /2005 - 12131 /2005

MEMORANDA OF PAYMENT

35+ Days"""._ _____ __.

4.99%

Initial Filing Received Within:

Days 0 - 17 5.27% 18 -26

27-34 35+

? Total

"' Indicates comoliance could not be determined

1st Qtr 05

Quarterly Compliance I • 0-17 oaYiJ

83.61% 82.98%


Compliance Trend

Days 907 86.96% Days 55 5.27% Days 21 2.01% Days 52 4.99% Da s 8 0 .77%

1,043 100"/o

4th Qtr 05

• 83..o/o • • 83o/~87%

• 81% . 84% 83% ---

3rd Qtr 04 4th Qtr 04 1st Qtr 05 2nd Qtr 05 3rd Qtr 05 4th Qtr 05


Cbart 10

27-34

Fourth Quarter Compliance Report 10/01/2005- 12/31/2005

NOTICES OF CONTROVERSY

j Filing Distribution I ?* Days

.56%

18 -26 Days 2.92%

Initial F iling Received W ithin:

0 - 17 Days 18 - 26 Days 27 - 34 Days

35+ Days ? Da s

Total

* Indicates filing time could not be determined

Cbart 11

93.58%

1st Qtr 05

Cbart 12 93%

• 1-

3rd Qtr 04


91%

•

Quarterly Compliance I • 0-17 Daiij


Compliance Trend 94%

• 91% • ~

92% • -- -- -- -~ ~- --

4th Qtr 04 1st Qtr 05 2nd Qtr 05 3rd Qtr 05

653 90.82% 21 2.92%

6 0.83% 35 4.87% 4 0.56%

719 100%

4th Qtr 05

91%

•

4th Qtr 05

8

Appendix A

Insurance Group Compliance Initial Filings Comparison

Fourth Quarter 2005 10/1/2005 -12/31/2005


INSURANCE GROUP COMPLIANCE -INITIAL FILINGS COMPARISON Fourth Quarter 2005 10/1/2005-12/31/2005

*Indicates no claims activity this quarter "No filings" indicates no MOP and/or NOC activity this quarter

~-----~~~~~~~~-~~~----~---~~----~~~

A1


INSURANCE GROUP COMPLIANCE ·INITIAL FILINGS COMPARISON Fourth Quarter 2005 10/1/2005-12/31/2005

•Indicates no claims activity this quarter "No filings" indicates no MOP and/or NOC activity this quarter

A2




A3



*Indicates no claims activity this quarter "No filings" indi~tes no MOP and/or NOC activity this quarter

A4


INSURANCE GROUP COMPLIANCE ·INITIAL FILINGS COMPARISON Fourth Quarter 2005 1 0/1/2005-12/31/2005

.. ,,, .. , ..... ,, " .... , .., l)'. ': ",l<,\').•1 .. ,' :}'\l\l, ,, ....... ·•[,).',~

:~~~ Total Initial

Total Number of Indemnity NOCs

NCCI INSURANCE GROUP Initial MOPs Filed Filed IF .! '"c,[;i!' i ',':"Ci'i!\,:>S·i >" ''·"'' li)i ,,, !i!'' .. ,,, ./'(

HANOVER INSURANCE GROUP Total Total !' 11002 CITIZENS INSURANCE CO OF AMERiCA . . ii 13633 HANOVER INSURANCE CO No filings No filings !' CA202 HANOVER INSURANCE CO 11 I

[t;;j ···::, 10006 MASSACHUSEITS BAY INS CO . . Group Total 11 I

':'!!· ?!\ .. l., <,,,'.<! ,;e· '·'Co' ;J.;i,i\'1.'(' .. \::!;i; .••. ,! .. ! 'lC "''''!: . ,(y .. F .. !;;. '!:0. !'((!'/!',,,,, '". {!'!J'Ji! 1i! ~,;:

,, ' HARLEYSVILLE WORCESTER INS. CO. Total Total 16926 HARLEYSVILLE MUTUAL INSURANCE CO. . .

,•' 21644 HARLEYSVILLE WORCESTER INSURANCE CO. . . ! ;,: Group Total . .

ki'i'il .,,. .. ;,;)', !i;!Ji''l'li);,i·! . "".":.!. F:A!',!Y< ','''""'"'"'''"'''''iii !!'+' !!•.il)il!!'t J/ i!i'

,,,·,!· HARTFORD Total Total

l;,,:c CA1()5 F.A. RiCHARD No filings No filings

CA203 HARTFORD ACCIDENT & INDEMNITY I 3

iO 14397 HARTFORD CASUALTY INSURANCE CO. No filings No filings

1,, ... · 13269 HARTFORD FIRE INSURANCE COMPANY . . ~:r

20005 HARTFORD INS. CO. OF THE MIDWEST No filings I 10456 HARTFORD UNDERWRiTERS INS. CO. I No filings

CA315 SPECIALTY RJSK SERVICES INC 7 4

I. CA310 THE HARTFORD 7 2 10448 THE HARTFORD . .

}.' 14974 TIVIN CITY FIRE INS CO 8 I Group Total 24 11

['ji~ ·'''.'''''· .. · ... ·':C.!·• .. '''k .. '!T ,.,, .. ''·'''r"'.?'Cf"'ll'(

BRH CLAIMS MANAGEMENT (Formerly DUNLAP) Total

!;,, 001 Group Total

'"'''·'"'"'' :::.; LIBERTY MUTUAL GROUP Total Total :;;;. 15555 EMPLOYERS INSURANCE OF WAUSAU No filings No filings ':;;,, 27359 FIRST LIBERTY INSURANCE CORP No filings No filings

••••

S321 HELMSMAN MANAGEMENT SERVICE • . CA210 LIBERTY MUTUAL INSURANCE 14 20

,: .. ,~;, 21814 LIBERTY INSURANCE CORP. 18 8 ,,,,,,. 16586 LIBERTY MUTUAL FIRE INSURANCE 4 5 15628 LIBERTY MUTUAL INSURANCE CO. No filings 2

·· c::i; 27243 LIBERTY MUTUAL INSURANCE CORP. . . 1/;i/1: 27332 WAUSAU BUSINESS INS. CO. 1 1 . t· 18996 WAUSAU UNDERWRITERS INS CO 2 I

':" Group Total 39 37

If:~··. >::·c;;;,; ,: .• ~·· '.::; . . >··:\)t,;:'\2:

MAINE ADJUSTMENT Total Total CA255 MEADOWBROOK INSURANCE 2 I

1~1 31771 SAVERS PROPERTY & CASUALTY INS CO . . 24562 STAR INSURANCE I No filings

>:·• CA375 UNITED STATES FIRE INSURANCE CO I No filings

;:;.'12m UNITED STATES FIRE INSURANCE CO 1 No filings

Group Total s 1 ,:: .:h\' i\'·''C :'J'•>:: .. ,,. ·,;o:;·,['::, /:,::;, ·>


A5




AS


INSURANCE GROUP COMPLIANCE -INITIAL FILINGS COMPARISON Fourth Quarter 2005 10/1/2005-12/31/2 005


A7


INSURANCE GROUP COMPLIANCE -INITIAL FILINGS COMPARISON Fourth Quarter 2005 10/112005-12/3112005

"Indicates no claims activity this quarter "No filings" indicates no MOP and/or NOC activity this quarter

AS



''" ,;, ,

,' '·"·" ,(':':'!;" ,, ·''· ,,·' >~ .;,;;;,,)c,>;> ;

''" Total Initial .

...• ' ... ·· Total Number of Indemnity NOCs II / .. NCCI INSURANCE GROUP lniti•l MOPs Filed Filed ,· , .. ·, Jq•",· '.,>,; '<),j;t:<.;''c;,,;;c<;', '{';'..J!ji'':it;,; '.!"' ''""''"' .,,, ;' ,,

.. I XL SPECIALTY INSURANCE COMPANY Total Toto) ~,':' u'.·l27944 Group Total . • T.!

'',•'!'. (X ,:;;;;.,,;,,-,,,,.,; "'"' ': ,.,·. -:,< '/,)! .. , ; ;,:t;c::.i:c , ,'''

' ZURICH INSURANCE GROUP Total Total 1: ..

11452 AMERICAN GUARANTY & LIABILITY . . ! f, 17965 AMERICAN ZURICH No filings I I,, !', 12173 ASSURANCE CO OF AMERICA . . l~ic,

CA080 CHESTERFIELD SERVICES No filings Nofi1ings rA 12963 MAINE BONDING & CASUALTY . . 10545 MARYLAND CASUALTY CO . • h 13765 NORTHERN INSURANCE CO OF NEW YORK . .

r: .. ',~ 12297 UNIVERSAL UNDERWRITERS INS. CO. . . , CA400 ZURICH AMERICAN INS CO 4 4

., !0863 ZURICH AMERICAN INS CO No filings I I,::'· Group Total 4 6 ,,·,·' -:< i; ;,,,,,, i, ,,,,,,;.., ;:,';"<!<,'', .• ,, 'b,-';i/!i',;:;:::.,;;;t;,


A9

Appendix B

Insurance Group Compliance Initial Indemnity Payments and MOP Filing

Fourth Quarter 2005 10/1/2005- 12/31/2005

INSURANCE GROUP COMPLIANCE

NCCI INSURANCE GROUP ;)<:',;: -;-_ .. ">::·.::.· .:·:,.:: <·:,-:;:: . .::: .. <,: '<··:·

ACADIA CAOIO ACADIA INSURANCE CO. 3339I ACADIA INSURANCE CO, 30260 ACADIA INSURANCE CO, 30252 CADILLAC MOUNT A!N INSURANCE CO I I053 CONTINENTAL WESTERN INSURANCE CO 27723 FIREMAN'S INS CO OF WASHINGTON

ALTERNATE BENEFITS Group Total

ACE!ESIS 23035 ACE AMERICAN INSURANCE CO 12165 ACE AMERICAN INSURANCE CO 12254 ACE PROPERTY & CASUALTY 15431 ACE FIRE UNDERWRITERS INS S370 ESIS INC S364 ESIS INC CA160 ESISINC CA175 FUTURE COMP 25437 INDEMNITY INSURANCE OF NORTH AMERICA 33790 MOUNTAIN VALLEY INDEMNITY COMPANY 10677 S0022

PACIFIC EMPLOYERS INS CO SDWARREN

AIG

Group Total ··.":

S328 AIG CLAIMS (AMERICAN INTERNATIONAL) CA015 AIG CLAIMS SERVICES 14354 AliJ INSURANCE 13781 AMERICAN ROME ASSURANCE CAl 00 CLAIMS MANAGEMENT INC (W AL-MARn 15172 COMMERCE & INDUSTRY INS. CO. 13102 GRANITE STATE INSURANCE COMPANY 13889 INS. CO. OF STATE OF PENNSYLVANIA 13072 NATIONAL UNION FIRE INS. CO. 13080 NEW HAMPSHIRE INS COMPANY


Fourth Quarter 2005 10/1/2005- 12/31/2005

First Indemnity Payments >.::·:r;:·<·<: ::< '-'< ·:,y:•··::·: ,.,

Psvments l\fade Tunely Payments Compliance Percenta2e 17 16 94% I I 100% . . . .

No filings Nofilini!S Nofilin~s

3 3 100*/. 2 NIA N/A 23 20 95%

.. •;iS>•:'i': ':::i:;i;G': ·';':''·:(: · .. · •. '::: ··> :··:e>;:;:;cy:: , ;.·-.. . •":¥·:::>· ,. >·. ·: Pll)'lllentsMade Timelv Pavments Compliance Percenta2e

Nofilini!S No filings No filings

11 II 100% 100%

0 0%

13 12 92%

Pavments 1\iade Timelv Pavments Compliance Percentaee Nofilini!S Nofilines Nofilines

18 10 56%

2 50% 100%

2 0 0%

0 0%

0 0%

P•yments 1\iade Timely Payments . . Payments Made Timely Payments . . Payments Made Timelv Pavments . . Payments 1\iade Timely Payments . .

<·''./J•7··· ·:··~"<

*Indicates no claims activity this quarter

~~-----··-~- -------------

-Memoranda of Payment Filed (M:OP)

MOPs Filed MOPs Filed TIDleiv Compliance Percen~ I9 I7 89%

IOO%

Nofilini!S Nofilini!S Nofilinl!S 100%

23 21 91% . ·<:::Be(:?;::::· ". ,: '::·'J\f( ,,; /

MOPs Filed Timely Compliance Percentaee

No filines No filings Nofilines

11 11 100% 0%

0 0%

13 11 85%

MOPsFUed MOPs Filed Timelv Como!iance Percentaee Nofilines Nofilini!S Nofilines

18 44%

2 0% 7 7 100% 2

0%

0 0% 48%

Compliance Percentage



81



Fourth Quarter 2005 10/1/2005 -12/31/2005

1ndicates no claims actJvlty this quarter

82


NCCI INSURANCE GROUP

" , /;,: f')', <:,, ; '• oJ:h 'M ;: -' ', :.6 ::•: "-C.N.A. Payments Made

10030 AMERICAN CASUALTY CO. OF READING 2 12386 C N A CASUALTY OF CAUFORNIA • S382 C N A STANDARD LINE CLAIMS . S392 C N A STANDARD LINE CLAIMS . CA050 CONTINENTAL CASUALTY CO 5 10243' CONTINENTAL CASUALTY CO 1 15113 CONTINENTAL INSURANCE COMPANY . 12238 NATIONAL FIRE INSURANCE CO. OF HARTFORD 1 12688 TRANSCONTINENTAL INS. CO. No filings 12408 TRANSPORTATION INSURANCE CO. Nofilini!S 15032 VALLEY FORGE INSURANCE COMPANY 1

Group Total 10 ,,_, .. _ . .·:.· :,, :-'';':;:•:;::;:::•::,::;,;:::y::.:••:_ >' . -:r ;.;:,;:)':','.-: :; - v·•·::

CRAWFORD & CO P•vments !\lade 19968 ACCIDENT FUND INSURANCE COMPANY • 14095 ARGONAUT INSURANCE COMPANY 1 CA120 CRAWFORD & CO 11 S305 CRAWFORD & CO . 13188 GULF INSURANCE CO . 18376 LUMBERMEN'S UNDERWRITING ALLIANCE . 14788 PROTECTIVE INSURANCE No filings 17507 THE-FLORISTS' MUTUAL INSURANCE COMPANY . 18244 TRUCK INSURANCE EXCHANGE . 24023 VANLINER INSURANCE .

Group Total lZ

FAIRFIELD INSURANCE COMPANY Pavments Made 32530 Group Total No fdines

;-,,,:;'Cf\;,'~:.C·- ;'

I FEDERATED 1\fiJTUAL INSURANCE CO. Pavments Made 16446 Group Total . i;<•S!:,: .JJ"- " :;-,.; ' ''"' ·;. ·.·' _ ... ;:;.•:>' :(:>:;:;;,;'',;•,b;;' :::c '''::: ,;'' -~: ,-.. ,, ,., __ ,', ,::,\;','',''.;,;:;.·:

FlLENE'S DEPARTMENT STORE PaYments Made S338 Group Tots! .

''''f ;·;;<:•;::;:.;.c;,;·:•·):;; ;'' ,';:,:; :}:"'":,•',:_ ',A :>-:'.J·/',. ;,';( FIREMANS FUND PaY111_ents Made

10022 AMERICAN AUTOMOBILE INS CO . 12289 AMERICAN INS CO . 12416 FIREMANS FUND AMERICAN INS. CO. . CA170 FIREMANS FUND AMERICAN INS. CO. No filings 12866 NATIONAL SURETY .

Group Total No filings ,:·,;, \; :::,;


Fourth Quarter 2005 10/1/2005 -12/31/2005

First Indemnity Payments Ll ,-:,!:);'XC,: .:··,:{

Timely Payments Compliance PercenU.see 1 50% . . . . . • 5 100% 1 100% . . 1 100%

No filings No filings '· Nofilini!S Nofilini!S

1 100% I 9 90% r

;, ' · :,,/:LT, .,,.,: . Timelv Pavments Comoliance Percenta2:e . .

1 100% 8 73% . • . . . .

No filings No filini!S . . . . . . 9 75%

T'unelv Pa '11Jeuts Compliance Percenta2e No filin2s No filin~s

. •''·''' Timely Pavments I Compliance Percentaee . I .

-<>::;;;, "'': Timelv Pavments Comoliaua: Perceuta2e . .

;::;;:: ; >.:-" . . -'';,':,;,"_';'~ Timelv Pavments Comoliance Percenta2e . • . . . .

No filings Nofilini!S . . Nofilin2S No filings

',Y''C·<,<·"·'-·\ .. , ,,,_

"1ndlcates no claims activity this quarter

Memoranda of Payment Filed (MOP) . :;,·,,_ ',;;; ;:_:•;.:. ; '/:;::;::;;;_;; :::~. ";;•.v . :·· ' <::::: .••

MOPs Filed MOPs Filed Timely Compliance Percentaee 2 1 50% . . . . . . . • . 5 5 100% 1 1 1 000/o . . . 1 0 0%

Nofilini!S Nofilini!S Nofilini!S Nofilini!S Nofi1ini!S Nofilinl!S

1 1 100% 10 8 so•;.

::·:.;::~::·<..c:.: >::, uc;.:,;• :: :c: · • ·: . ;

MOPs Filed MOPs Filed Timely CompliancePercentaee . . . 1 0 0%

11 9 82% . • • . . . . . . Nofilines Nofilines Nofilines . . . . . .

• . . 12 9 75o/o

-,-,' ;;:, ·: ... ,.. •. .e MOPs Filed MOPs Filed Timely Compllllnce Percentaee

Nofilill2S No filings No f"iliugs ;;,-,;,:

MOPs Filed MOPs Filed Timely Compliance Percentage . . . ·;::. . >" ;:•:·::'',"'

MOPs Filed MOPs FHed Timely Compliance Percenta!:e . . . '_;,: :-.-, .. ,,· ,!;: ;; .. :· "''·"'"'' '''';,:,·•"?:<·:•::):

MOPsFUed MOPs Filed Timely Compliouce Perceota2e . . . . . . . • . Nofilines NofilinltS NofilinltS . . . No filines Nofilines No f"iliues

.:·;.• ;;>;,,,:

83


NCCI INSURANCE GROUP

Fourth Quarter 2005 10/1/2005 -12/31/2005

First Indemnity Payments I "J ', "'::-;' " . ,;,;,_: ·; • .. } ....... :·: .... ;. >,_ '< ->"- .,-:;:",·"- -·>··c-<::"L'':>,.·\;,:.;y< :···-: ... <A+ci<··::"; ,>-··+''"'!"

GAB ROBBINS l'"!lllents Made Timely Pa}ments Compliance Percenta,. CAI80 GAB ROBBINS 2 I 50% TPA2 GAB ROBBINS . . 5355 GENERAL ADJUSTMENT BUREAU . . 11126 PETROLEUM CASUALTY COMPANY . .

Group Total 1 50o/o ,L ,: '·'"''''';{ ,c:,Y;.•:C•i:•:.·7L: •.

GALLAGHER BASSETT Pavmeuts Made Timely P~ents Compliance Percentage CAI90 GALLAGHER BASSETT SERVICES INC. 13 8 62% S304 GALLAGHER-BASSETT SERVICES. INC. • . 20737 MANUFACTURERS ALLIANCE INSURANCE CO. • . 24147 NORTH AMERICAN SPECIALTY INSURANCE . . 11916 PENNSYL V AN1A MFG. ASSOC. INSURANCE CO. . . 21288 PENNSYL V AN1A MFG. INDEMNITY CO • . S350 RYDER CLAIMS SERVICE CORP . . 16349 SAFETYNATIONALCASUALTYCORP . .

Group Total 13 8 62% j

GATES MACDONALD Payments Made Timely Pa}ments Compliance Percentage CA200 GATES MACDONALD 10 10 1000/o S743 GATES MACDONALD . . 11509 OLD REPUBLIC INSURANCE 0% S377 UNlVERSITY OF MAINE SYSTEM Nofi1in~ Nofilin~ Nofilin~

10

GREAT AMERICAN INSURANCE CO Pa,ments Made Timelv Pavments Comoliance Percenta2e 14028 GREAT AMERICAN ALLIANCE INS. CO 14176 GREAT AMERICAN INSURANCE CO 24287 SEVEN HILLS INSURANCE COMPANY

GronpTotal

GREAT WEST CASUALTY P"!lllentsMade TimelyPayments Compliance Percentage 11371 GronpTotal No fillngs No filings No filings

GUARD GROUP Payments Made Timely Payments Compliance PerceotaJ!:e 21873 AMGUARD INSURANCE COMPANY 0 33936 EASTGUARD INSURANCE COMPANY CA205 INTERGUARD LTD. 11 10 91% 25844 NOR GUARD INSURANCE COMPANY No filin•s Nofilin~ Nofilin~

Group Toul 83%

HALLMARK MANAGEMENT Pavments Made

Memoranda of Payment Filed (MOP) · .. _;:._,<.;•-: "';:::•.">" :< x·,· :.-: . :/:Y_ •,

MOPs Filed MOPs Filed Timely Compliance Percentaee 2 0 0"/o . . . . -. .

0 0% ,.,>·

MOPs Filed MOPs Filed runely Compliance Percentaee 13 6 46% . . . . . . . . . . . . . . 13 6 46%

,:,:;;:;.); MOPs Filed MOPs FDed Timely Compliance Percentae:e

10 10 100% . . 0 0"/o

Nofi1in~ Nofilin~ Nofilin~

10 91"/.

MOPs Filed MOPs Filed Timelv Comoliance Percentaee . . . . . . . . :;;;:.; :.(["

MOPs Filed MOPs Filed Timelv Co111]1_liance Percen~e No filings No flllitgs No filings

MOPs Filed MOPs Filed Timely Compliance Percentaee 0 0% . .

11 10 91% Nofilin~ Nofilin•s Nofilin~

12 10 83%

~ MOPs Filed Time! · Comoliance Percentue . . MOPs Filed Time! · Complianre Percentage

S381 Group Total 17 16 94% !iii 17 16 94%

-,n<llcates no claims adlvlty this quarter

Maine Workers' Compensation Board B4


Fourth Quarter 2005 10/1/2005- 12/31/2005

NCCI INSURANCE GROUP I First Indemnity P•vments I Memorlindo of P•vment Filed IMOPl ;,,,''\,i ·''>l;•v '7;,

•···· < "';;;:.·>· .: ... " ':'o': .:.;.;; "''" :·. , ••.•• ,, >' ::····< •;·:, ,:·· .••.•• , ···!'•.•:•: .':'; ;•·.~· ,;:; .. ,:;:i·;;; ...

HANOVER INSURANCE GROUP Payments Made Timel · Pa ~ents Comuliance Percentat!e MOPs Filed MOPs Filed Timelv Comnliance Percentaee 11002 OTIZENS INSURANCE CO OF AMERICA . . . . . . 13633 HANOVER INSURANCE CO NofilinRS No filings No filings NofilinRS Nofilin~s Nofilin"" CA202 HANOVER INSURANCE CO 11 11 100%

,. 11 11 100%

10006 MASSACHUSETTS BAY INS CO . . . . . . GrouoToW 11 11 100% 11 II 100% ,,, > :> .' 'Fi;' :';>: '': ' · :;:.·.;:.;::"'': .>'.' ;:. ::'(i >i:: •. ·.::, :";,;.!Aii'"'·'·•:L.·'' . "' .· ,;,!;( ;·,·.;/;;.,;;}J!•::•'::;;:;; .',.:•.·.·;·

HARLEYSVILLE WORCESTER INS. CO. Pavments Made Timelv Payments Compliance Percenta~e MOPs Filed MOPs Filed Timelv Comnliance Percenta~e 16926 HARLEYSVILLE MUTUAL INSURANCE CO. . . . . . . 21644 HARLEYSVILLE WORCESTER INS. CO. . • . . . .

Group Total . . . . . . :Cil':""' ''iJ::'·:''<·•:::'< ''''< .·."JY . ,';:;i;i; '', :.:· .{.· .... ••>•:;, ;'';: ,•iii •i.'• .. ''' .. tf· :C:'/·.;··.::,>:,:\'·,;;:. .. ;, i;',·;:;J,ii'< :: .

HARTFORD Pavments Made Timelv Pavments Compliance Percenta2e MOPs Filed MOPs Filed Timelv Comnliance PercentaP"e CAJ65 F. A. RICHARD No filings No filinRS NofilinRS Nofi1in~ Nofilini!S Nofilini!S CA203 HARTFORD ACODENT & INDEMNITY I 0 0% 1 0 O"lo 14397 HARTFORD CASUALTY INSURANCE CO. Nofilini!S Nofilin2S Nofilin25 Nofilin2S Nofilin'"' NofilinC. 13269 HARTFORD FIRE INSURANCE COMPANY . • . . . . 20605 HARTFORD INS. CO. OF THE MIDWEST No filinRS Nofi1inRS Nofi1in~s NofilinRS Nofilinl!S Nofilinos 10456 HARTFORD UNDERWRITERS INS. CO. 1 1 100% 1 1 100% CA315 SPECIALTY RISK SERVICES INC 7 3 43% 7 3 43% CA310 THE HARTFORD 7 7 100% 7 7 100% 10448 THE HARTFORD . • . • . . 14974 TIVIN CITY FIRE INS CO 8 5 63% 8 7 88%

Grouo Total 24 16 67% 24 18 7So/o ·,,., .. , . i'l'i''C\ .. '.; X : \.;;< ::': c.u .. x 'i ;'' •. · . ':oc/J ... •> :>·i ,. ,, •• ,, .. ··::·;·rc,·; ,;;'•if';;:,;,•·:::•:•:.;;;:;:::: •::'> "'"'::u.·,·:·,,,, :z :r;;,.•:;t,·'··' :'.;·:'~'T:·'-'

BRH CLAIMS MANAGEMENT (formerlv DUNLAP) P•yments Made Timely Pavments Compliance Percentage MOPs Filed MOPs Filed Timelv Comnliance Percenta~e CA001 HRH NORTHERN NEW ENGLAND 58 48 83% 62 54 &7%

ALTERNATE BENEFITS 4 NIA N/A GrouoTotal 62 48 83% 62 54 87%

1\""''<t:'>i :::.: ·, <>,;;.' "J·; /.:':''·\!.>. ;j,,:; ·.·, ','>IE,?. LIBERTY MUTUAL GROUP Payments 1\bde Timeb· Pavments CompliancePercenta~e MOPs Filed MOPs Filed Timelv Comoliance Percenta~e

15555 EMPLOYERS INSURANCE OF WAUSAU Nofi1in2.< Nofilini!S Nofi1inRS Nofilini!S Nofilin"" Nofi1inP< 27359 FIRST LffiERTY INSURANCE CORP No filinRS No filinRS Nofi1inRS NofilinRS Nofilinos Nofilinos S321 HELMSMAN MANAGEMENT SERVICE . . . . • . CA210 LffiERTY MUTUAL INSURANCE COMPANY 13 13 100% 14 14 100% 21814 LffiERTY INSURANCE CORP. 17 16 94% 18 17 94% 16586 LffiERTY MUTUAL FIRE INSURANCE 4 3 75% 4 3 75% 15628 LIBERTY MUTUAL INSURANCE CO. Nofi1ini!S No filinl>S Nofilinl>S Nofilinl>S Nofi1ini!S Nofi1inos 27243 LffiERTY MUTUAL INSURANCE CORP. . . . . . . 27332 WAUSAU BUSINESS INS. CO. 1 1 100% 1 l 100% 18996 WAUSAU UNDERWRITERS INS CO 2 1 50"/o 2 0 0%

ALTERNATE BENEffiS 2 NIA N/A GrouoTotal 39 34 92% 39 35 90%

!.,;•:· ·; ',;,,;,:.,:;;:..;.',<!·, ;;\:;,,,. .•;., ';,,;;c.i.;:

MAINE ADJUSTMENT Pavments 1\bde Timelv Pa,"Dlents Comnliance Percentage MOPs Filed MOPs FUed Timelv Comnlianee Percenta~e CA255 MEADOWBROOK INSURANCE 2 2 100% 2 2 100% 31771 SAVERS PROPERTY & CASUALTY INS CO . . • . . . 24562 STAR INSURANCE 1 1 100% 1 0 0"/o CA375 UNITED STATES FIRE INSURANCE CO 1 1 100% 1 1 100% 12777 UNITED STATES FIRE INSURANCE CO 1 I 100% I 1 100%

GrounTotal 5 5 100% 5 4 80o/o F''D,::. y:.;: .. :+:;;•:;:,.:'•:·•· "; i: ··>Ji;(> •·,: ; ,,, 'i:··T•u;,;:::;:;;y '··"·:· "·S >·:•




Fourth Quarter 2005 10/1/2005-12/31/2005

NCCI ! INSURANCE GROUP First Indemnity Payments ll Memonmda ofPaY1Jient Filed (MOP) ,,,, ,.x.···;::. :::LL· ,,, <.' ·: .. ,, .. ,:c. ::'.::,,;,.·.:· .. : .•. ,,.. :·:: <·.:::o <:>•,'>,::: ;,;: .:· ': """'"'"·:' :,.·' ,;;;:,: ',.,, .. ,. .:•.::::>',,,,., .<<<AXJh'< :;;.<: ;;::'!\;;,\·'·'

MAINE AUTOMOBILE DEALERS Payments Made Timelv Payments Compliance Percentage MOPs Filed MOPs Filed Timely Compliance Percent2ge S803 MAINE AUTOMOBILE DEALERS 5 4 80% 5 5 IOO"A. CA220 MAINE AUTOMOBILE DEALERS 7 7 100% 7 7 100%

Group ToW 12 11 92% 12 12 too•to . ', t''\': ,·.::,.;, '.:::: ::: > :::· ·", 'i..:;.''''t'Z ,,,, ' ' ,,·::::.y,:, :·,;/ ""'"'" ;,:·; ··. :(. :•:, 'cc.: .·/'" ·: .,.,,,,· '·:

"' .. :::··!'<'

MAINE EMPLOYERS MUTUAL INSURANCE Pavments Made Time! · P&vments Compliance Percenta2e MOPs Filed MOPs Filed Timely Comvliance Percentaee 30449 MAINE EMPLOYERS MUTUAL INSURANCE 349 325 93% 381 350 92% TPA28 MAINE EMPLOYERS MUTUAL INSURANCE • . . . . .

ALTERNATE BENEFITS 32 NIA NIA Group Total 381 325 93% 381 350 92%

I .,,, :;';'';.: ,;:;'1:;'::<•: ;, ... '· ', ,,,, .... · ...... <'::r,·:: .. ··::: .. ,::: .. ·.,·:,.;:>'·: ... ( ., >.:·;,, .,,;,:,·::.···;•:' :::·:t,,., >:.::· .:.;:,;;:.:p·':: ;,:.•;:;,<·>.:: ' 'y~ :: ·,:·.

MAINE HEALTH CARE ASSOCIATION Pnments M&de Timely Pavments Compliance Percenta2e MOPs Filed MOPs Filed Timely Compliance Percenta2e S387 Group Total 5 5 100~/a 5 5 100'% :·:::.:·:::.:;'::·; 'i'i .,;-:,;,::::'..:: ·:·>'""': '. ·"·' y: ;,•:•·

i '• .• . ,;:"/ ,;( ,)::'/ ·. ,y;.;i/i' .:.;; ',i/· ·':"< MAINE MOTOR TRANSPORT ASSOCIATION Pavments M&de Timely Pavments Compliance Percent21!e MOPs Filed MOPs Filed runelv Compliance Percentaee

S385 Group Total 13 13 100% 13 12 92% ·:·,;:'\. ;·::y:;''i ·.:':F.>.,. /';.,N:;,i:':';i'i};'.·:. '. '>'. ·; .. ,.; i:''' .:·''.' .',\''""·' ;: ·,·,,;50'';;:;.:<: > ;;C)::;':Ci:•'')i'', . '''>L'.· ·,;.';;<)i:;0<''':" . /J"hi01'' ·;; · .. :/ ;'Z::~i'' ':::'.'·

MAINE MUNICIPAL ASSOCIATION Payments Made Timely Payments Compliance Percen~e MOPs Filed MOPs Filed runely Compliance Percentage S801 MAINE MUNICIPAL ASSOCIATION 48 42 88% 48 42 88% S733 PORTLAND CITY OF 6 4 67% 6 4 67%

Group Total 54 46 85% 54 46 85% .}'·;,: i:::; : . . :i . ::'" '·" \},:)•:' :; ; ·:.:;•:f;::{A: .. :i\ ':;:;:.,: """' '.it)· ... ; ')i)>:.· . ,.,,.,,,,", .,;;

MAINE SCHOOL MANAGEJ1,1ENT ASSOC. Pavments Made TimelY Pavments Comoliance Percenta2e !;;! MOPs Filed MOPs Filed Timely Compliance Percentaee S374 Group Total 29 29

~~~ 29

100% "' ··." ::;.:::·:;:\'· ··•· :,;,.:.:::;.,:<·.:,:·:···· . ·, ;,: :·: .:, .. /" ... ·/."', ·:· ·; :.,.: ;:··.,..: : .: ... .,,,i?Jt\Cii · .• ,. ,'":·;''"''

MITSID SUMITOl\:10 INS CO OF AMERICA Pavments Made TimelY Pavments MOPs Filed Time! • Compliance Percenta2e 19089 I * * . *

:;:::.,:;· ;.');"•'•: ·:C:· .. <:~il:'X"i'''>> .. ''.' .·.':'">·i ;:; ,':··:·Y ,.:/::";: . .,;;:,, .. >>:'::'\': ·: .• • i.)';>:.ji:i'<i> . ,,i,.i\':,;i :;, :·.:.\ :;.,.;::·;:;:'.·

NATIONAL GRANGE MUTUAL INSURANCE Payments Made Timelv Pa,ments Compliance Percenta2e MOPs Filed MOPs Filed Timely Compliance Percentae:e CA265 NATIONAL GRANGE MUTUAL INSURANCE I I 100% I l IOO"A, 16322 NATIONAL GRANGE MUTUAL INSURANCE . . . . . .

Group Total 1 1 100% I 1 100% ·':.··:·• .·,.·,····.'~c::'Y:~,··~J;/, .'}ii:C: ;:;i::,::r: .,,,, :.:::;,,,: i:i';i:'J:;ii/ "''''''"'/'.

1:•: ,. ::hi'''', e~:;:: i,;!' ,.,,: ,\;1 ''>:'!::'·

ONEBEACON Pavments M&de TimelY Pavments Comuliaoce Percenf!ge MOPs Filed MOPs Filed Timely Comuliance Percenta~e 10049 AMERICAN EMPLOYERS INSURANCE CO . • . . . . 12300 EMPLOYERS FIRE INS. CO. • • . . . . 14540 ONEBEACON AMERICA INSURANCE CO No filin25 Nofilin~s No filin2S Nofilin25 Nofilin25 Nofilin25 10359 ONEBEACON AMERICA INSURANCE CO . . . . • . 36501 YORK INSURANCE COMPANY OF MAINE . . . . . .

Group Total No filings No mings No filings No filings No filln_g» No filings ~'';•"'/ .. ''': ·A>!:. ;!'<;;;<::;:,,,;, :::. ''''.;: ,/'>).!!''.· .. ,.,..

PEERLESS INSURANCE GROUP PaY1J1ents Made Timely PaY1Jients Compliance Percentage MOPs Filed MOPs Filed rlDlely Compliance Percentage 10650 EXCELSIOR INSURANCE COMPANY . . . . • • 14184 NETHERLANDS INSURANCE COMPANY . . • . • . CA275 PEERLESS INS CO· 24 20 83% 25 22 88% 11355 PEERLESS INS CO Nofilin2S Nofilin25 Nofilin2S Nofilin25 Nofilin25 Nofilin25

ALTERNATE BENEFITS l N/A NIA GronpToW 25 20 83% 25 22 88o/o

l.''<'i ,.,,.,., .. ,,.,,.;,:,;, .. :.·:;.>:.: .• ''.':·.:,·;j<:::,:c .•:< ·'' :,:;;c;::::P:j>:

•tndlcates no claims activity this quarter



NCCI INSURANCE GROUP ', -::- ';":- :v -'" > _; -,_,

> _,,,;:<'',:' PUBLIC SERVICE MUTUAL Pavments Made

16152 Groun Total! 1 1 .• : ... ,,.;,.;.,·,;, , ••. ,,,,:,'; :; .,, ,:,:.>' ,,; :'' ,,;,;,:,,,,,: '''''''''·.:

ROYAL & SUN ALLIANCE INSURANCE GROUP Pavments Made· 14699 AMERICAN & FOREIGN INSURANCE CO. . 11762 CONNECTICUT INDEMNITY CO . 10731 FIRE & CASUALTY INS CO OF CONNECTICUT . 10391 GLOBE INDEMNITY CO Nofilin2s CA280 RISK ENTERPRISES MANAGEMENT No filin2s 13684 ROYAL & SUNALLIANCE No fi1in2S 10723 ROYAL INDEMNITY . 13986 SAFEGUARD INSURANCE CO . 12572 SECURITY INSURANCE OF HARTFORD . 15572 SECURITY INSURANCE OF HARTFORD .

Groun Total No filings ''

: ; ,,, ''',:,:;" ,,. ,,., ;o;,:. !,').,/;,;,-,,,,,',,.,; .. ,,,

SEDGWICK INSURANCE GROUP P•vments Made S336 CYRO INDUSTRIES . 12629 ELECTRIC INSURANCE CO I S0028 FEDERAL EXPRESS CORP . S716 GREAT NORTHERN NEKOOSA CORP . S394 NEW PAGEI'F;,nnerlv MEADIWESTV ACO Nofilin•s CA285 ROMAN CATHOLIC DIOCESE OF PORTLAND Nofilin•s CA300 SEDGWICK CLAIMS MANAGEMENT 62 S301 SEDGWICK OF MAINE INCISeru!wick Clms M21l1t. Svc • S7!4 SEDG'IVICK CLAIMS SERVICES/GEORGIA PACIFIC . S316 SHAW'S SUPERMARKETS INC Nofilin~

S729 VERIZON . Group Total 63

I :._, ,,, :'; ':. ,,::::.' <;:::: : ''"<" "-;-;-, ··-:-. ' ,::,:-- .. ,

SELECTIVE INSURANCE COMPANY Payments Made 11867 SELECTIVE INSURANCE COMPANY . 15741 SELECTIVE INS COMPANY OF NEW YORK .

GrouoTotal . :: ;' ';j':-I:;:;::F'<\:;1,::. >;.;,,:;,,; '(';;'<\ '/,::' ,":,:' ,'',:;' .:. ::,,' /'/;,' ;:;'':,'

SENTRY INSURANCE CO. P•vments Made 15571 SENTRY INSURANCE CO, 2 CA305 SENTRY INSURANCE CO. 8 13668 SENTRY SELECT INSURANCE CO No filings

Grouo Total 10 r::,• ~·;· "';''' •;•,'. ·!,,·•

SOMPO JAPAN INSURANCE CO P•vments Made 19321 Grono Tota!T .

:·c;c:;: ;;:,::;,: .. ;.::,';,'" ', ,; :. ,'' ,;• ,:: > STATE OF MAINE Pnvments Made

S369 STATE OF MAINE II ALTERNATE BENEFITS 30

GrounTotal 41 I<?<:',:, ,: > ,:~.: ,,,',

' ':'/'";: :·: ''\"

Maine Workers' Co~ensation Board

Fourth Quarter 2005 10/1/2005 - 12/31/2005

First Indemnitv Pavments II Memoranda ofPavment Filed li\io:P\ ' <--: ',,, ,' < ,;_,;,:.,; ;/; !,/:':-:: -;<- ' __ <:::<'''" ,,.,. ' :'>''f':''''-:< ,, ,j' ::'''. ,; } ,-,,:;:;: ' : ,;:':,;:;

Timely Payments I Compliance Percentn~e F:l MOPs Filed MOPs Filed Tunelv I Comnllimce Percental!e 0 0% ll 1 0 Oo/v

'; ,,,; ;: . '·' ': ,,;, '< : :'>, /i ;; ::.: ' :,;:. .<: /.: ,: ~'.< ,;:, ; ', . : ,·:: -::: Time( · Pavments Comoliance Percentage MOPs Filed MOPs Filed Timelv Coinoliance Percenta!!e . . . . . . . . . . . . . . .

Nofilin~ No filings Nofilin~ Nofilin2S Nofi!in2S Nofilin~ No filings No filings Nofilin2S Nofilin2S Nofilin2S No filin2S No filings Nofilin2S Nofi1in2S . . . . . . . . . . . . . . . . . . . . No filin2s No filings No filings No filin2s No filin•s

' '':-;"': ',: ::,,,:';·._,_' ;'i;f',;';:>:';:',: ,,.z,::;;c.:· \,',·;;;F' :

Timelv Payments Comoliance Percentage MOPs Filed MOPs Filed Timelv Comoliance Percentae:e . . . . . I 100% I I 100% . • . • . . . . • .

Nofi!in~ No filings No filings Nofilin2S No filings Nofilin~ No filings No filings Nofi1in"" No filin2S

53 85% 62 52 84% . . • . . . . . • . No filings No filings Nofilin~ Nofilin2< No filin2S

• • . . . 54 86% 63 53 84%

:,,, ;:,:->,-, '"' :;;:: '/, . •·•,:•::':>', •c':•,:_:xr ,·.;::c.;:,::-e; i : '':"'- -~

Timely Payments Compliance Percentage MOPs Filed MOPs Filed Timelv Comnliance Percentse:e . . . . . . • • . . . . . . . '";.·' :/:; .. ,/_;;;;/-:- '':""~;,;·;;::•: ',' <''''' ·······>•.:::.•·,;.::';;:;; ::;\:;:y ·•::-, '

Timely Pavments Compliance Percenta-ge MOPs Filed MOPs Filed Timelv Comnliance Percentae:e 2 100"/o 2 2 100"/o 8 100% 8 8 100%

Nofi!inl!S Nofilin~ Nofilin~ Nofilinl!S Nofilin .. 10 100% 10 10 100%

\;,-,,:';''; :,'-:,:>;'; ' .;:, -,,, ' ',.;: '"''iJ' .•>'• ,•.;: :' ·, ;,,-,,:·:,'•' :: Timel · Pa rments Compliance Percenta2:e , MOPs Filed MOPs Filed Timelv Comnliance Percenta~e . . . . .

;;· ,./, :->:;-• ,"· .. '/;'c '··'''\ ')\':'!:''>"':!>/ :--:-- -:~•, :;:::;y:: : :'C: Time! · Pavments Comoliance Percenta2e MOPs Filed MOPs Filed Timelv Comnliance Percentll~e

10 91% 41 33 80% N/A NIA 10 91% 41 27 66%

'.:\'::, :.: .:: '.''"":' :,:::' '';xc.:: "-- S','; ',,,

'"'Indicates no claims activity this quarter

B7


Fourth Quarter 2005 10/1/2005- 12/31/2005

NCCI I INSURANCE GROUP First lndemnitv Payments t~ Memonmda of Payment Filed (MOP) \;:: :,-,,_.,,,' : i::''''::::· <: ·'":; .,. \"'/,; .<h<"'P•':'\':-, ,,; ;_ •;.'':::: :,:. ><•.·.:·;': ,··•:>·· :;;.;.;,''···. ,;,; _, ,'';:j;':'·<,::c;:,-:/ ,C ·, ;,:·,:; ·,:;:;';':'.;;·::_·: ,,.,. ·:;\'; ;·:;,, :; ;,:;,; .. ;:)i\' ''(\i';;~:;:;:.g x::·:

STPAUL TRAVELERS INSURANCE GROUP Pavments Msde Timely Payments Compliance Percentage MOPs Filed MOPs Filed Timely Compliance Percentaee !53!8 CHARTER OAK FIRE INSURANCE CO. 4 3 75% 4 3 75% CA!!O CONSTITUTION STATE SERVICE 2 2 100% 2 2 100% TPA!l CONSTITUTION STATE SERVICE . . . . . . S327 CONSTITUTION STATE SERVICE • . . . . . 20702 DISCOVER PROPERTY & CASUALTY INC . . . • . . 10227 FIDELITY & GUARANTY INS. CO. 1 1 100% 1 I 100% 12610 PHOENIX INSURANCE No filings No filings No filings No filings No filings No filings 13706 ST. PAUL FIRE & MARINE INSURANCE CO. No filings No filings No filings No filings No filings No filings 14230 ST. PAUL GUARDIAN INS CO . • . . . . 12823 ST. PAUL INSURANCE COlv!PANY . . . . . . 13692 ST. PAUL MERCURY INSURANCE CO . . • . • . 11223 TRAVELERS CASUALTY & SURETY CO . . . . . . 13579 TRAVELERS PROPERTY CASUALTY CO. 1 1 100% 1 I 100% 13439 TRAVELERS INDElvlNITY COlv!PANY OF AMERICA No filings No filings No filings No filings No filings No filings CA350 TRAVELERS INS CO 9 8 89% 9 7 78% 10804 TRAVELERS INS CO No filings No filings No filings No filings No filings No filings 10847 USF & G INC/ST. PAUL FIRE INS. 1 1 100% 1 1 100%

Group Total 18 16 89% 18 15 83o/o .:: :·,.:· .: :' ;,:-: ':;:'( ··.: '":.'. ·~::,:: ;.-,,:;::,-, '-' ... f,:.:.,,,.,;;:·:· ;, i'?.'< ', ·,, '!''' ->:·:::·, ::;''•::"( :: '':,-"·:·:·;_""',;:; .-: _;,'/'~:,;;'; ,,:

SYNERNET Payments Made Time! · Pavments Compliance Percentage MOPs Filed MOPs Filed Tunelv Compliance Percentaee S0025 WJUNEHEALTH\VORKERS'COlv!PENSATION No filings No filings No filings No filings No filings No filings S0024 SISTERS OF CHARITY HEALTH SYSTEM . . . . . . S0023 SYNERNET WORKERS' COlv!PENSATION No filings No filings No filings No filings No filings No filings CA320 SYNERNET 35 33 94% 35 32 91%

Grouo Total 35 33 94% 35 32 91% f.:>',/, . '' .;,::;.\ :;;:., .. tY; v-t •';:;' ,;;::~·. ,.;

' ' ',; ';,'':, .;:!';!;'; [:''>::;,, ·7:·...-n::.•;,.:•: !i ::;,.:·'' .:·.: .;.-',;'•\ .'· ' .,,,.>~

TD BANKNORTH IFormerlv MORSE PAYSON & NOYES Pavments Made Timelv Pavments Comoliance Perc:enta2e MOPs Filed MOPs Filed Timelv Comoliance Percen~ CA316 TD BANKNORTH INS AGENCY TECH SERVICES 2 2 100% 2 2 100% S388 TD BANKNORTH INS AGENCY TECH SERVICES 11 9 82% 11 8 73%

Group Total 13 11 851% 13 10 77% :>}\ •\::Wi';:•'':;:,:;: ','i'' :>~-1': /'.':;•".::. i:;':?(.,' .. '':'!Cf::;•:. ,;".!.;''!'' ;: .·,:,·;;' . .. :+·>, •Y'i/' ,;, -;;,;;:;;-::·'> : , .,:,;c;.':s:

T.H.E. CASUALTY INS. COMP. I Payments Made I Timely Pavments Compliance Percentaee MOPs Filed MOPs Filed Timely Compliance Percentaee 40851 Group Total . I . I . . . . ""·, ·:·,· :; "i'>:, .;,,,,,, ;-;.;:·;,.;. :y;,::; .,;;::;::<,:;\:; !",,,; /,.f' ;:i/'';;:· !',;. ,; <'''".· :-:: :· ,,':,','' .::,';:: ::::;'<': ,, ,:;',;;i:'<:'< ···'''i'''''i:.'";'';c:,;' ?:;::·., .. ,;;•':,,;.,:;'':''"'':'''' -''"'' ,,; ,'L ';'!;

TOKIO MARINE & FIRE IND CO Payments Made Timely Pavments Compliance Percenta2e MOPs Filed MOPs Filed Timely Compliance Percentaee 14281 Group Total . . . . . .

/,;,' :·n .. ;.. .. ; ''''" ;:y:;:

\.',·. -:'.';.. , .:-·:v+: m:.:-";, •'f':':',J:t!. ;';" :; ',' .. ;::;;,;:,;;.' .> :\;.":"::;., ;.:>.c:.;,: ;:; •:,;; : /i':'·i':':<<< '<>'\!;;,. TRANSGUARD INSURANCE COMPANY Payments Made TIDlelv Payments Compliance Percenta2e t MOPs Filed MOPs FDed Timely Compliance Percentage

31097 GronpTotal . . . . . . i;7:L:: ."',;'.·:' :-::' ';'':"i'·i ·!i'f!'' ,c·,:/,!:':i;h('''i'i ;' . :,~. :,.-,;,;;

VIRGINlA SURETY COMPANY INC. Pavments Made Timelv Pavments Compliance Percenta2e MOPs Filed MOPs Filed Timelv Comoliance Percenta•e CA030 APPLIED RISK SERVICES 6 5 83% 6 4 67% 19879 VIRGINlA SURETY No filings No filings No filings No filings No filings No filings

Group Total 6 5 83% 6 4 67% : :.,,;:;..,.;,;. ·'? '.'\';;;(;':;Jf(<;:,i).';,, ·:· :\;:;, ~'t,:o.:;:·;'.f:'/; ·-cc:e ...... \ ;;/;;t:'.>'l':'.:, ,,,.

I WARD NORTH AMERICA P•vments M•de Timel · P.avments I Comoliance Percentage ~!;:! MOPs Filed MOPs Filed Timelv Comoliance Percen~ CT014 I Group Total * . . I': I . . . ; , , ., .,;-.:''i)T;,;;(•''> :·; :'·,;;:x· ,::n< •.:'•:' •;,, >;;;:';:::,,,,,"''"'' ',:\:: : ,y.:::•::';,<t\. ::: ; .. ;.;:·::nr-::'iv:;;. ~, .. ,;,;.:J.:::s>:sr:e:::y·. ;;: ·\,:.:,;,;,:-;:0:;;;,;··· •,v::;-:~:;-;;<iY::;y;;:y:<:c·::;,cJ.:

•tndlcates no claims activity this quarter



NCCI I INSURANCE GROUP I ,).'. ,,>····-,>. ., .;.c, . ;;.\, .<, ·.· '· ,; ' : ..•. :.•·•·::..:: .. "·

I XL SPECIALTY INSURANCE COMPANY I Pavments Made 27944 I Group Total I . . / ·:•;;·· · ... ,. <"''•'' .· •... ····: •:· ' .•

. • ·' ·''"' ·.· .;i'< ZURICH INSURANCE GROUP Pavments l\bde

11452 AMERICAN GUARANTY & LIABILITY . 17965 AMERICAN ZURICH No filings 12173 ASSURANCE CO OF AMERICA . CA080 CHESTERFIELD SERVICES Nofi1ings 12963 MAINE BONDING & CASUALTY . 10545 MARYLAND CASUALTY CO . 13765 NORTHERN INSURANCE CO OF NEW YORK . 12297 UNIVERSAL UNDERWRITERS INS. CO. . CA400 ZURICH AMERICAN INS CO 4 10863 ZURICH AMERICAN INS CO No filings

GrouoTotal 4 ·: ·. . " ·::.:.:c:.


Fourth Quarter 2005 10/112005 -12/3112005

First Indemnity Pa,'Dlents Ll .. <: . :.'·· .. ,.: : .. ::.)::.·•:··,··,. .···

Timelv Pavments Compliance Percenta2e I•.J I . . ll

Memoranda of Pavment Filed (MOP) ,,,··,··: <·>.:DVc>;.:•:.·,.; :,., ·"''"'':.'· ..... ·.,.;·,/:, '

MOPs Filed MOPs Filed Timely Compliance Percentaee . . . . :··:,s,,;::•:::<Q/:'··. . •,.·::··:·· . ·. ·.·( ,, . ,., : ·:•:: :.f!}il': ..•. :·, .. ..:···< .. ••/.' ..

Timely Pavments Comuliance Percenta2e MOPs Filed MOPs Filed Timely Compliance Percentaee

• . . . . No filings No filings No filings No fi1illgS. Nofilin2S . . . . • Nofi1ings No filings No filin2S Nofilin2S Nofilin2S . . . . . . . • . . . . . . . . . . . .

4 100% 4 4 100"/o No filings Nofi1ings Nofilin2S Nofi1in2S Nofi1in2S

4 100% 4 4 100% ,·.,; ':; ;.•:· ,: .. ..... · .. ·· : ···.t>< : ,· ........ ·: • :.·•>::·.·:·.: . ,.

•Indicates no claims activity this quarter

89

Appendix C

Insurance Group Compliance NOC Filing

Fourth Quarter 2005 10/1/2005 -12/31/2005


INSURANCE GROUP COMPLIANCE - NOC FILING Fourth Quarter 2005 10/1/2005-12/31/2005

*Indicates no claims activity this quarter "No filings" indicates no MOP andfor NOC activity this quarter




C2



.?:,::· . Total Initial Percentage oflnitial ,,c;,c,,c:;:, ,,,,,;,;::·: , •:J•c ', .;;c;' ,;0 : :J>:C''';<'j _;;;£:; ,,,;;l\{\'~J/'{F;';,';; ,:·.>,;;./:.;> '•; i .. !','/. ,;;<'.!>;{ :'·<·;,:::; ·, ~

.·~ .: .·• Indemnity NOCs Total Filed Indemnity NOCs Filed >::: NCCI INSURANCE GROUP Filed within 0-17 Days within 0-17 Days ·· ; ,;·· .,;; . · • ·• · ·,:::i.' · • '':if." :..o; :•ii:Y. ·',,i30';;,y·, ,;':!·;;., • / .. : ·:;· i·:·;;::;: :::::··c'!:;~ ;,· ;::);!.: >'P.$ :J;;y:; . ,' ':

· ·:Y C.N.A. Total Tunelv Timelv'Pereenta~e C: ,.;

.. :", S382 CNASTANDARDLINECLAIMS • • • ;:;,: S392 C N A STANDARD LINES CLAIMS • • • ·; ,: •. :>' .. ;'·F-CA~05~0~~C~O~NT=ThlliNT~~AL~~CA~S=U~AL~TY~C~O~---------------i~~N~o~fil~m-~.---+--~N~o-ffi:7m--~--r-----~N-o~fil~in--~----~~~:~~

:.·.. 10243 CONTINENTALCASUALTYCO Nofilings Nofilings Nofilin~ I :,;,', l'' :·;:;. 15113 CONTThmNTAL INSURANCE COMPANY • • • ·' : .. 1:'.'",'~12~23~8~-+.N~A~TI~ON~A~L~flRE~~IN~S~URAN~~CE~CO~.~O~F~HAR~~TF=O~RD~------b-~N7o~fi~li~n~--~~~N~o~ffi~m--~--+-----~N~o~fi~li-ngs------f.'>0· <. 12688 TRANSCONTINENTAL INS. CO. I I !00% . ~;

f;. \' 12408 TRANSPORTATION INSURANCE CO. No filings No filings No filings :·:;

;'}<' CRAWFORD & CO Total Timelv 19968 ACCIDENT FUND INSURANCE COMPANY • • 14095 ARGONAUT INSURANCE COMPANY 1 I

.• ,; CA120 CRAWFORD&CO 2 2 S305 CRAWFORD & CO •

.<\i' l3188 GULFINSURANCECO. ;';•i. 18376 LUMBERMEN'S UNDERWRITING ALLIANCE

17507 THE FLORISTS' MUTUAL INSURANCE COMPANY 8244 TRUCK INSURANCE EXCHANGE 4023 V ANLINER INSURANCE

Group Total 4 J:C):>:i,OJ:i;"' <. ,, '!;•.; ·'';

FAIRFIELD INSURANCE COMPANY Group Total

FIREll.fANS FUND Total )! 10022 AMERICAN AUTOMOBILE INS CO

AMERICAN INS CO flREMANS FUND AMERICAN INS. CO. FIREMANS FUND AMERICAN INS. CO. NATIONAL SURETY

Group Total '; ·;>·, c .//J.; •,;;.;);.,J•J•;·:·/Y•:•,:;,;':''c', :, ' J ;:';i·;J(!••"

No filings


0

Timely

Timely

Nofilml!S

"No filings" indicates no MOP and/or NOC activity this quarter

;;;••:';~;;· :',:{:;.:,:it''"' 'f.<'C Timelv Percental!e ff(cl, .

;~~ 100%

100% ;·;,< . ::', . . ::·' 0% ;c:. • '~,;j:} . . i;{;;','

75% lh:J! : .,;;:,;;"

TimelY No

Timelv Percen

Time!y_percen

TIDlelY. Percentaf(e

Nofilmgs

C3


INSURANCE GROUP COMPLIANCE- NOC FILING Fourth Quarter 2005 10/1/2005-12/31/2005


C4




C5


INSURANCE GROUP COMPLIANCE • NOC FILING Fourth Quarter 2005 10/1/2005-12/31/2005


C6




C7


INSURANCE GROUP COMPLIANCE - NOC FlUNG Fourth Quarter 2005 10/1/2005-12/31/2005


C8



Total Filed

within 0-17 Days

,,,;'"''"'' ,'' •' T"unely

* ,';

Timely . I .

No filings . . 13765 NORTHERN INSURANCE CO OF NEW YORK .

'/' 12297 UNNERSAL UNDERWRITERS INS. CO. : ,,,, CA400 ZURICH AMERICAN INS CO

~::J:,,:, 10863 ZURICH AMERICAN INS CO

i'Ti• .. :>,,,·;'" Group Total

4

I 6

'"·


. 3

I 5

'', .'."'

"No filings" indicates no MOP and/or NOC activity this quarter

. . . /''

r, 75%

100% 83% s.~

C9

Appendix D

Insurance Group Compliance Quarterly Compliance Data

Fourth Quarter 2005 10/1/2005 -12/31/2005

Compliance Report

ACADIA INSURANCE COMPANY Ncci - CA010

Indemnity Payment

0-14 Days 16 94 .12% 15-21 Days 1 5.88% 22-28 Days 0 0.00% 29+ Days 0 0.00% ? Days 0 0.00% Alt. Benefits 2

Total 19 100%

AIG CLAIM SERVICES INC Ncci - CA015

Indemnity Payment

0-14 Days 10 55.56% 15-21 Days 3 16.67% 22-28 Days 1 5.56% 29+ Days 3 16.67% ? Days 1 5.56% Alt. Benefits 0

Total 18 100%

APPLIED RISK SERVICES Ncci - CA030

Indemnity Payment

0-14 Days 5 83.33% 15-21 Days 1 16.67% 22-28 Days 0 0.00% 29+ . Days 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 6 100%

10/01/2005 - 12/31/2005

Memorandum of Payment Notice of Controversy

0-17 Days 17 89.47% 0-17 Days 14 82.35% 18-26 Days 1 5.26% 18-26 Days 1 5.88% 27-34 Days 0 0.00% 27-34 Days 1 5.88% 35+ Days 1 5.26% 35+ Days 1 5.88% ? Days 0 0.00% ? Days 0 0.00%

19 100% 17 100%



18 100% 9 100%



6 100% 0 100%

Dl

Compliance Report

BROADSPIRE Ncci - CA040

Indemnity Payment

0-14 Days 2 15-21 Days 0 22-28 Days 0 29+ Days 0 ? Days 0 Alt. Benefits 0

Total 2

100.00% 0.00% 0.00% 0.00% 0.00%

100%

CAMBRIDGE INTEGRATED SVCS GRP Ncci - CA060

Indemnity Payment

0-14 Days 0 0.00% 15-21 Days 1 100.00% 22-28 Days 0 0.00% 29+ Oays 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 1 100%

CANNON COCHRAN MANAGEMENT Ncci - CA070

Indemnity Payment


Total 27 100%

10/01/2005 - 12/31/2005



2 100% 6 100%



1 100% 1 100%



27 100% 21 100%

D2

Compliance Report

CHESTERFIELD SERVICES INC Ncci - CA080

Indemnity Payment


Total 0

CHUBB & SON, INC. Ncci - CA090

Indemnity Payment


Total 1

CLAIMS MANAGEMENT, Ncci - CA100

Indemnity Payment


Total 7

0.00% 0.00% 0.00% 0.00% 0.00%

100%

100.00% 0.00% 0.00% 0.00% 0.00%

100%

INC

100.00% 0.00% 0.00% 0.00% 0.00%

100%

10/01/2005 - 12/31/2005



0 100% 0 100%



1 100% 2 100%


0-17 Days 7 100.00% 0-17 Days 13 100.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 o .. 00% ? Days 0 0.00% ? Days 0 0.00%

7 100% 13 100%

D3

Compliance Report

CONSTITUTION STATE SERVICES, L Ncci - CA110

Indemnity Payment


Total 2 100%

CONTINENTAL CASUALTY COMPANY Ncci - CA050

Indemnity Payment


Total 5 100%

CRAWFORD & COMPANY Ncci - CA120

Indemnity Payment


Total 11 100%

10/01/2005 - 12/31/2005



2 100% 6 100%



5 100% 0 100%



11 100% 2 100%

D4

Compliance Report

ESIS, INC Ncci - CA160

Indemnity Payment


Total 11

F. A. RICHARD Ncci - CA165

Indemnity Payment


Total 0

100.00% 0.00% 0.00% 0.00% 0.00%

100%

0.00% 0.00% 0.00% 0.00% 0.00%

100%

FIREMAN'S FUND INSURANCE Ncci - CA170

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



11 100% 15 100%



0 100% 0 100%



0 100% 0 100%

D5

Compliance Report

FUTURE COMP Ncci - CA175

Indemnity Payment


Total 1

100.00% 0.00% 0.00% 0.00% 0.00%

100%

GAB ROBINS NORTH AMERICAN Ncci - CA180

Indemnity Payment


Total 2 100%

GALLAGHER BASSETT SERVICES Ncci - CA190

Indemnity Payment


Total 13 100%

INC

INC

10/01/2005 - 12/31/2005



1 100% 2 100%



2 100% 1 100%



13 100% 8 100%

D6

Compliance Report

GATES MCDONALD & COMPANY Ncci - CA200

Indemnity Payment


Total 10 100%

HANVOER CITIZENS INSURANCE Ncci - CA202

Indemnity Payment

0-14 Days 11 100.00% 15-21 Days 0 .0.00% 22-28 Days 0 0.00% 29+ Days 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 11 100%

HARTFORD ACCIDENT & INDEMNITY Ncci - CA203

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005



10 100% 11 100%



11 100% 1 100%

Memorandum of Payment .Notice of Controversy


1 100% 3 100%

D7

Compliance Report

HRH NORTHERN NEW ENGLAND Ncci - CAOOl

Indemnity Payment

0-14 Days 48 82.76% 15-21 Days 6 10.34% 22-28 Days 2 3.45% 29+ Days 2 . 3. 45% ? Days 0 0.00% Alt. Benefits 4

Total 62 100%

INTERGUARD, LTD. Ncci - CA205

Indemnity Payment


Total 11 100%

LIBERTY MUTUAL INSURANCE COMPA Ncci - CA210

Indemnity Payment


Total 14 100%

10/01/2005 - 12/31/2005



62 100% 51 100%



11 100% 6 100%


0-17 Days 14 100.00% 0-17 Days 19 95.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 1 5.00% ? Days 0 0.00% ? Days .0 0.00%

14 100% 20 100%

D8

Compliance Report

MAINE AUTOMOBILE DEALERS ASSOC Ncci - CA220

Indemnity Payment


Total 7 100%

MEADOWBROOK INSURANCE Ncci - CA255

Indemnity Payment


Total 2 100%

NGM INSURANCE co. Ncci - CA265

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005



7 100% 0 100%



2 100% 1 100%



1 100% 0 100%

D9

Compliance Report

PEERLESS INSURANCE Ncci - CA275

Indemnity Payment


Total 25

83.33% 8.33% 0.00% 4.17% 4.17%

100%

RISK ENTERPRISES MANAGEMENT Ncci - CA280

Indemnity Payment


Total 0 100%

ROMAN CATHOLIC DIOCESE OF PORT Ncci - CA285

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



25 100% 8 100%



0 100% 1 100%



0 100% 1 100%

DlO

Compliance Report

SEDGWICK CLAIMS MANAGEMENT SER Ncci - CA300

Indemnity Payment


Total 62 100%

SENTRY INSURANCE A MUTUAL COMP Ncci - CA305

Indemnity Payment


Total 8 100%

SPECIALTY RISK SERVICES Ncci - CA315

Indemnity Payment


Total 7 100%

10/01/2005 - 12/31/2005



62 100% 43 100%



8 100% 1 100%



7 100% 4 100%

Dll

Compliance Report

Synernet Ncci - CA320

Indemnity Payment


Total 35

94.29% 2.86% 0.00% 2.86% 0.00%

100%

TD BANKNORTH INS AGENCY TECH Ncci - CA316

Indemnity Payment


Total 2 100%

THE HARTFORD Ncci - CA310

Indemnity Payment


Total 7 100%

10/01/2005 - 12/31/2005


0-17 Days 32 91.43% 0-17 Days 21 100.00% 18-26 Days 2 5. 71% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 1 2.86% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

35 100% 21 100%



2 100% 0 100%



7 100% 2 100%

D12

Compliance Report

TRAVELERS INDEMNITY COMPANY Ncci - CA350

Indemnity Payment


Total 9 100%

UNITED STATES FIRE INSURANCE Ncci - CA375

Indemnity Payment


Total 1 100%

ZURICH AMERICAN INSURANCE COMP Ncci - CA400

Indemnity Payment


Total 4 100%

10/01/2005 - 12/31/2005



9 100% 6 100%



1 100% 0 100%



4 100% 4 100%

Dl3

Compliance Report

Ncci - ?

Indemnity Payment


Total 1 100%

A I G (American International Ncci - 8328

Indemnity Payment


Total 0

ACADIA INSURANCE CO Ncci - 33391

Indemnity Payment


Total 1

0.00% 0.00% 0.00% 0.00% 0.00%

100%

100.00% 0.00% 0.00% 0.00% 0.00%

100%

10/01/2005 - 12/31/2005



1 100% 3 100%



0 100% 0 100%



1 100% 2 100%

D14

Compliance Report

ACE AMERICAN INSURANCE COMPANY Ncci - 12165

Indemnity Payment


Total 0 100%

AMERICAN CASUALTY CO OF READIN Ncci - 10030

Indemnity Payment


Total 2 100%

AMERICAN HOME ASSURANCE CO Ncci - 13781

Indemnity Payment


Total 2 100%

10/01/2005 - 12/31/2005



0 100% 1 100%



2 100% 2 100%



2 100% 1 100%

D15

Compliance Report

AMERICAN ZURICH Ncci - 17965

Indemnity Payment


Total 0

AMGUARD INSURANCE Ncci - 21873

Indemnity Payment


Total 1

ARGONAUT INSURANCE Ncci - 14095

Indemnity Payment


Total 1

0.00% 0.00% 0.00% 0.00% 0.00%

100%

COMPANY

0.00% 100.00%

0.00% 0.00% 0.00%

100%

COMPANY

100.00% 0.00% 0.00% 0.00% 0.00%

100%

10/01/2005 - 12/31/2005


0-17 Days 0 0.00% 0-17 Days 1 100.00% 18-26 Days 0 0.00% 18-26 Days b 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

0 100% 1 100%



1 100% 0 100%



1 100% 1 100%

D16

Compliance Report

BANGOR, CITY OF Ncci - S705

Indemnity Payment


Total 3

BATH IRON WORKS Ncci - S347

Indemnity Payment

0-14 Days 12 15-21 Days 0 22-28 Days 0 .29+ Days 0 ? Days 0 Alt. Benefits 0

Total 12

100.00% 0.00% 0.00% 0.00% 0.00%

100%

100.00% 0.00% 0.00% 0.00% 0.00%

100%

CHARTER OAK FIRE INS Ncci - 15318

Indemnity Payment


Total 4 100%

10/01/2005 - 12/31/2005



3 100% 2 100%



12 100% 13 100%



4 100% 2 100%

D17

Compliance Report

CHURCH MUTUAL INSURANCE COMPAN Ncci - 16853

Indemnity Payment


Total 0 100%

CIANBRO CORP Ncci - S344

Indemnity Payment


Total 0 100%

COMMERCE & INDUSTRY INS CO Ncci - 15172

Indemnity Payment


Total 2 100%

10/01/2005 - 12/31/2005



0 100% 0 100%



0 100% 0 100%



2 100% 1 100%

D18

Compliance Report

CONTINENTAL CASUALTY CO Ncci - 10243

Indemnity Payment


Total 1 100%

CONTINENTAL WESTERN INS COMPAN Ncci - 11053

Indemnity Payment


Total 0 100%

ELECTRIC INSURANCE COMPANY Ncci - 12629

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005



1 100% 0 100%


o-17 Days 0 0.00% 0-17 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

0 100% 0 100%



1 100% 0 100%

D19

Compliance Report

EMPLOYERS INS COMPANY OF WAUSA Ncci - 15555

Indemnity Payment


Total 0 100%

FAIRFIELD INSURANCE COMPANY Ncci - 32530

Indemnity Payment


Total 0 100%

FEDERAL INSURANCE co Ncci - 12890

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



0 100% 0 100%



0 100% 0 100%


0-17 Days 0 0.00% 0-17 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00%

/ 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

0 100% 0 100%

D20

Compliance Report

FIDELITY & GUARANTY INSURANCE Ncci - 10227

Indemnity Payment


Total 1 100%

FIREMAN'S INS CO OF WASHINGTON Ncci - 27723

Indemnity Payment


Total 3 100%

First Liberty Insurance Corp Ncci - 27359

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005


0-17 Days 1 100.00% 0-17 Days 0 0.00% 18-26 Dars 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

1 100% 0 100%



3 100% 1 100%



0 100% 0 100%

D21

Compliance Report

GLOBE INDEMNITY CO Ncci - 10391

Indemnity Payment


Total 0

GREAT WEST CASUALTY Ncci - 11371

Indemnity Payment

0-14 Days· 0 15-21 Days 0 22-28 Days 0 29+ Days 0 ? Days 0 Alt. Benefits 0

Total 0

HANNAFORD BROTHERS Ncci - S381

Indemnity Payment


Total 17

0.00% 0.00% 0.00% 0.00% 0.00%

100%

0.00% 0.00% 0.00% 0.00% 0.00%

100%

94.12% 0.00% 5.88% 0.00% 0.00%

100%

10/01/2005 - 12/31/2005


0-17 Days 0 0.00% 0-17 Days 1 100.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days ,0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

0 100% 1 100%



0 100% 0 100%



17 100% 11 100%

D22

Compliance Report

HANOVER INSURANCE CO Ncci - 13633

Indemnity Payment


Total 0 100%

HARTFORD CASUALTY INS. co. Ncci - 14397

Indemnity Payment


Total 0 100%

HARTFORD INSURANCE CO OF THE M Ncci - 20605

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



0 100% 0 100%



0 100% 0 100%



0 100% 1 100%

D23

Compliance Report

HARTFORD UNDERWRITERS INS CO Ncci - 10456

Indemnity Payment


Total 1 100%

INDEMNITY INS CO OF NORTH AMER Ncci - 25437

Indemnity Payment


Total 1 100%

INS CO OF THE STATE OF PENNSYL Ncci - 13889

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005



1 100% 0 100%



1 100% 0 100%



1 100% 0 100%

D24

Compliance Report 10/01/2005 - 12/31/2005

LIBERTY INSURANCE CORP. Ncci - 21814

Indemnity Payment Memorandum of Payment Notice of Controversy

0-14 Days 16 94.12% 0-17 Days 17 94.44% 0-17 Days 8 100.00% 15-21 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 22-28 Days 0 0.00% 27-34 Days 1 5.56% 27-34 Days 0 0.00% 29+ Days 1 5.88% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00% Alt. Benefits 1

Total 18 100% 18 100% 8 100%

LIBERTY MUTUAL FIRE INSURANCE Ncci - 16586


0-14 Days 3 75.00% 0-17 Days 3 75.00% 0-17 Days 5 100.00% 15-21 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 22-28 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 29+ Days 1 25.00% 35+ Days 1 25.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 4 100% 4 100% 5 100%

LIBERTY MUTUAL INS CO Ncci - 15628


0-14 Days 0 0.00% o-·17 Days 0 0.00% 0-17 Days 2 100.00% 15-21 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 22-28 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 29+ Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 0 100% 0 100% 2 100%

D25

Compliance Report

MAINE AUTOMOBILE DEALERS Ncci - S803

Indemnity Payment


Total 5 100%

MAINE EMPLOYERS MUTUAL INSURAN Ncci - 30449

Indemnity Payment


Total 381 100%

MAINE MOTOR TRANSPORT W.C. TRU Ncci - S385

Indemnity Payment


Total 13 100%

10/01/2005 - 12/31/2005


0-17 Days 5 100.00% 0-17. Days 2 100.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

5 100% 2 100%



381 100% 230 100%



13 100% 12 100%

D26

Compliance Report

MAINE MUNICIPAL ASSOCIATION Ncci - S801

Indemnity Payment

0-14 Days 42 87.SO% 1S-21 Days 2 4.17% 22-28 Days 1 2.08% 29+ Days 2 4.17% ? Days 1 2.08% Alt. Benefits 0

Total 48 100%

MAINE SCHOOL MGNT ASSOC Ncci - S374

Indemnity Payment

0-14 Days 29 100.00% 1S-21 Days 0 0.00% 22-28 Days 0 0.00% 29+ Days 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 29 100%

MAINEHEALTH WORKERS' COMPENSAT Ncci - S002S

Indemnity Payment

0-14 Days 0 0.00% 1S-21 Days 0 0.00% 22-28 Days 0 0.00% 29+ Days 0 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 0 100%

10/01/200S - 12/31/200S


0-17 Days 42 87.SO% 0-17 Days so 100.00% 18-26 Days 1 2.08% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 3S+ Days 4 8.33% 3S+ Days 0 0.00% ? Days 1 2.08% ? Days 0 0.00%

48 100% so 100%


0-17 Days 29 100.00% 0-17 Days 9 100.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 3S+ Days 0 0.00% 3S+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

29 100% 9 100%


0-17 Days 0 0.00% 0-17 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 3S+ Days 0 0.00% 3S+ Days 0 0.00% ? Days 0 0.00% ? Days 0 0.00%

0 100% 0 100%

D27

Compliance Report

MHCA WORKERS' COMP FUND Ncci - S387

Indemnity Payment


Total 5 100%

NATIONAL FIRE INS CO OF HARTFO Ncci - 12238

Indemnity Payment


Total 1 100%

NEW HAMPSHIRE INS COMPANY Ncci - 13080

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005


0-17 Days 5 100.00% 0-17 Days 14 87.50% 18-26 Days 0 0.00% 18-26 Days 2 12.50% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 . 0. 00% ? Days 0 0.00% ? Days 0 0.00% •,

5 100% 16 100%



1 100% 0 100%



1 100% 0 100%

D28

Compliance Report

NEWPAGE CORP. Ncci - 8394

Indemnity Payment


Total 0

0.00% 0.00% 0.00% 0.00% 0.00%

100%

NO RECORDED COVERAGE Ncci - NONE

Indemnity Payment


Total 0 100%

NORGUARD INSURANCE COMPANY Ncci - 25844

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



0 100% 0 100%



0 100% 0 100%



0 100% 1 100%

D29

Compliance Report

OLD REPUBLIC INS CO Ncci - 11509

Indemnity Payment


Total 1

0.00% 0.00% 0.00% 0.00%

100.00%

100%

ONEBEACON AMERICA INSURANCE CO Ncci - 14540

Indemnity Payment


Total 0 100%

PEERLESS INS co Ncci - 11355

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



1 100% 1 100%



0 100% 1 100%



0 100% 0 100%

D30

Compliance Report

PHOENIX INSURANCE Ncci - 12610

Indemnity Payment


Total 0

PORTLAND, CITY OF Ncci - 8733

Indemnity Payment


Total 6

PROTECTIVE INS co Ncci - 14788

Indemnity Payment

0-14 Days 0 15-21 Days 0 22-28-Days 0 29+ Days 0 ? Days 0 Alt. Benefits 0

Total 0

0.00% 0.00% 0.00% 0.00% 0.00%

100%

66.67% 33.33%

0.00% 0.00% 0.00%

100%

0.00% 0.00% 0.00% 0.00% 0.00%

100%

10/01/2005 - 12/31/2005



0 100% 1 100%



6 100% 7 100%



0 100% 1 100%

D31

Compliance Report

PUBLIC SERVICE MUTUAL INS CO Ncci - 16152

Indemnity Payment


Total 1 100%

ROYAL & SUNALLIANCE Ncci - 13684

Indemnity Payment

0-14 Days 15-21 Days 22-28 Days 29+ Days ? Days Alt. Benefits

Total

SENTRY INSURANCE Ncci - 15571

0 0 0 0 0 0

0

Indemnity Payment


Total 2

0.00% 0.00% 0.00% 0.00% 0.00%

100%

100.00% 0.00% 0.00% 0.00% 0.00%

100%

10/01/2005 - 12/31/2005



1 100% 0 100%



0 100% 1 100%



2 100% 0 100%

D32

Compliance Report

SENTRY SELECT INSURANCE COMPAN Ncci - 13668

Indemnity Payment


Total 0 100%

SHAW'S SUPERMARKETS INC Ncci - S316

Indemnity Payment


Total 0 100%

ST PAUL FIRE & MARINE INSURANC Ncci - 13706

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



0 100% 0 100%



0 100% 0 100%


0-17 Days 0 0.00% 0-17 Days 0 0.00% 18-26 Days 0 0.00% 18-26 Days 0 0.00% 27-34 Days 0 0.00% 27-34 Days 0 0.00% 35+ Days 0 0.00% 35+ Days 0 0.00% ? ·Days 0 0.00% ? Days 0 0.00%

0 100% 0 100%

D33

Compliance Report

STAR INSURANCE CO Ncci - 24562

Indemnity Payment


Total 1

100.00% 0.00% 0.00% 0.00% 0.00%

100%

STATE OF MAINE WORKERS COMP DI Ncci - S369

Indemnity Payment


Total 41 100%

SYNERNET WORKERS' COMPENSATION Ncci - S0023

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



1 100% 0 100%



41 100% 24 100%



0 100% 1 100%

D34

Compliance Report

TD BANKNORTH INS AGENCY TECH S Ncci - S388

Indemnity Payment


Total 11 100%

TRANSCONTINENTAL INSURANCE COM Ncci - 12688

Indemnity Payment


Total 0 100%

TRANSPORTATION INSURANCE COMPA Ncci - 12408

Indemnity Payment

0-14 Days 0 0.00% 15-21 Days 0 0.00% 22-28 Days 0 0.00% 29+ Days -o 0.00% ? Days 0 0.00% Alt. Benefits 0

Total 0 100%

10/01/2005 - 12/31/2005



11 100% 9 100%



0 100% 1 100%



0 100% 0 100%

D35

Compliance Report

TRAVELERS INDEMNITY COMPANY OF Ncci - 13439

Indemnity Payment


Total 0 100%

TRAVELERS INS co Ncci - 10804

Indemnity Payment


Total 0 100%

TRAVELERS PROPERTY CASUALTY CO Ncci - 13579

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005



0 100% 0 100%



0 100% 1 100%



1 100% 1 100%

D36

Compliance Report

TWIN CITY FIRE INS CO Ncci - 14974

Indemnity Payment


Total 8 100%

UNITED STATES FIDELITY & GUARA Ncci - 10847

Indemnity Payment


Total 1 100%

UNITED STATES FIRE INSURANCE C Ncci - 12777

Indemnity Payment


Total 1 100%

10/01/2005 - 12/31/2005



8 100% 1 100%



1 100% 0 100%



1 100% 0 100%

D37

Compliance Report

UNIVERSITY OF MAINE SYSTEM Ncci - S377

Indemnity Payment


Total 0 100%

VALLEY FORGE INSURANCE COMPANY Ncci - 15032

Indemnity Payment


Total 1 100%

VIRGINIA SURETY COMPANY INC Ncci - 19879

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



0 100% 1 100%



1 100% 0 100%



0 100% 0 100%

D38

Compliance Report

WAUSAU BUSINESS INSURANCE CO Ncci - 27332

Indemnity Payment


Total 1 100%

WAUSAU UNDERWRITERS INS co Ncci - 18996

Indemnity Payment


Total 2 100%

ZURICH AMERICAN INSURANCE CO Ncci - 10863

Indemnity Payment


Total 0 100%

10/01/2005 - 12/31/2005



1 100% 1 100%



2 100% 1 100%



0 100% 1 100%

D39

Summary Compliance Report 10/01/2005 - 12/31/2005


0-14 Days 862 88.68% 0-17 Days 907 86.96% 0-17 Days 653 90.82% 15-21 Days 49 5.04% 18-26 Days 55 5.27% 18-26 Days 21 2.92% 22-28 Days 18 1.85% 27-34 Days 21 2.01% 27-34 Days 6 0. 83% 29+ Days 35 3.60% 35+ Days 52 4.99% 35+ Days 35 4.87% ? Days 8 0.82% ? Days 8 0. 77% ? Days 4 0.56% Alt. Benefits 71

Total 1043 100% 1043 100% 719 100%

D40

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