22-84131514-ITB Crime Insurance 2023 Attachment J Historical Loss Experience Report.pdf
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- Attached to
- Government Crime Insurance
- Solicitation number
- ITB-03255
- Issued by
- Leon County, Florida
About this file
This document is a loss experience report for the State of Florida Department of Management Services related to a government crime insurance contract. The report covers claims activity under five different policy numbers from 2018 to 2022, including details on the accident description, claim status, reserves, paid losses, and total incurred losses. The report indicates there was one open claim with $2,525 in total incurred losses during the 2021-2022 policy term, as well as one closed claim with $5,000 in paid losses during the 2018-2019 policy term.
The related state and local contract opportunity is for government crime insurance for the State of Florida Department of Management Services. The contract term and renewal options are not specified. Interested vendors must submit responses through the MyFloridaMarketPlace Ariba on Demand Sourcing event. The solicitation includes a price sheet that can be downloaded from the Ariba event. Protests regarding this procurement must be filed with the Agency Clerk within the time period prescribed by Florida statutes.
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ITB No. 22-84131514-ITB Government Crime Insurance
Attachment J Loss Experience Report
A loss experience report dated September 12, 2022 is provided on the following pages.
Page 1 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
Loss Detail Report
THE STATE OF FLORIDA DEPARTMENT OF MANAGEMENT SERVICES
| 4050 | Esplanade | Way, | #360 |
| Tallahassee, | FL | 32399 |
Account #: 1068294
| Report | Filters: | |||||||||
| Created | by: | Atul.Dagabaj@cfins.com | ||||||||
| Policy | #'s: | Crime | Commercial-626038626, | 626037986, | 626037436, | 626036876, | 626036402 | |||
| Claim | Status: | Open, | Closed, | Re-opened | ||||||
| Feature | Status: | Open, | Closed, | Re-opened | ||||||
| Note: | Feature | status | is | only | applicable | for | non | worker's | compensation | claims |
| Incurred | Range | From: | $0 | |||||||
| Incurred | Range | To: | $0 | |||||||
| Accident | Description | Type: | Defined | Description | ||||||
| Location: | All | |||||||||
| Department: | All | |||||||||
| State: | All | |||||||||
| Valuation | Date: | 9/12/2022 | ||||||||
| Show | Notification | Only | Claims: | N | ||||||
| Show | Billed | Deductible: | N |
Page 2 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Note: | Total | incurred | loss | includes | ALAE | minus | Subro | Recovery. |
| Accident | State: | FL | ||||||
| Accident | Description: | NOT | CLASSIFIED | |||||
| Claim | Status: | O | ||||||
| Date | Closed: | N/A |
Claimant Name Policy Number
Claim Number
Claim Type
Damage Type
Date of Loss
Date Reported
Loc/ Dept
Feature Status
OS
Reserve Paid ALAE
Total Incurred inc ALAE
The State Of Florida Department Of Management Services. 626038626 NJU00743114 INSI 8/20/2022 9/1/2022 O * $0 $0 *
Totals: * $0 $0 *
* Denotes undisclosed reserves
Policy Number: 626038626 1/1/2022 - 1/1/2023
Page 3 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Deductible: | $0 | ||
| Total | Claims: | 1 | |
| Report | Only | Features: | 0 |
| Claim | Type Average | Per | Claim Open | Claim | Features Total | Claim | Features Outstanding | Reserves Total |
| Paid | Loss ALAE Total | Incurred |
inc ALAE
Fidelity- Inside Premises * 1 1 * $0 $0 *
Totals 1 1 * $0 $0 *
* Denotes undisclosed reserves
Summary for Policy Number: 626038626 1/1/2022 - 1/1/2023
Page 4 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Note: | Total | incurred | loss | includes | ALAE | minus | Subro | Recovery. |
| Accident | State: | FL | ||||||
| Accident | Description: | FUNDS | TRANSFER | FRAUD | ||||
| Claim | Status: | C | ||||||
| Date | Closed:11/22/2021 |
Claimant Name Policy Number
Claim Number
Claim Type
Damage Type
Date of Loss
Date Reported
Loc/ Dept
Feature Status OS Reserve Paid ALAE Total Incurredinc ALAE
The State Of Florida Department Of Management Services 626037986 NJU00727280 INSI 7/21/2021 7/28/2021 C $0.00 $0 $0 $0.00
Totals: $0.00 $0 $0 $0.00
* Denotes undisclosed reserves
Policy Number: 626037986 1/1/2021 - 1/1/2022
Page 5 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Accident | State: | FL | ||
| Accident | Description: | BURGLARY | / | THEFT-DISAPPEARANCE |
| Claim | Status: | O | ||
| Date | Closed: | N/A |
Claimant Name Policy Number
Claim Number
Claim Type
Damage Type
Date of Loss
Date Reported
Loc/ Dept
Feature Status OS Reserve Paid ALAE Total Incurredinc ALAE
The State of Florida Department of Management Services 626037986 NJU00730298 INSI 2/10/2021 10/1/2021 O * $0$2,525 *
Totals: * $0$2,525 *
* Denotes undisclosed reserves
Page 6 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Deductible: | $0 | ||
| Total | Claims: | 2 | |
| Report | Only | Features: | 0 |
| Claim | Type Average | Per | Claim Open | Claim | Features Total | Claim | Features Outstanding | Reserves Total |
| Paid | Loss ALAE Total | Incurred |
inc ALAE
Fidelity- Inside Premises * 1 2 * $0 $2,525 *
Totals 1 2 * $0 $2,525 *
* Denotes undisclosed reserves
Summary for Policy Number: 626037986 1/1/2021 - 1/1/2022
Page 7 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Note: | Total | incurred | loss | includes | ALAE | minus | Subro | Recovery. |
| There | are | no | claims | for | this | policy. |
Policy Number: 626037436 1/1/2020 - 1/1/2021
Page 8 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Note: | Total | incurred | loss | includes | ALAE | minus | Subro | Recovery. |
| Accident | State: | FL | ||||||
| Accident | Description: | BURGLARY | / | THEFT-DISAPPEARANCE | ||||
| Claim | Status: | C | ||||||
| Date | Closed:9/26/2019 |
| Claimant | Name Policy | Number Claim | Number Claim | Type Damage | Type Date | of | Loss Date | Reported Loc/ | Dept FeatureStatus OS | Reserve Paid ALAE Total | Incurred |
| inc | ALAE |
Florida A&M - FL Department Of Management Services 626036876 NJU00687276 INSI 2/22/2019 3/13/2019 C $0.00 $0 $0 $0.00
Totals: $0.00 $0 $0 $0.00
* Denotes undisclosed reserves
Policy Number: 626036876 1/1/2019 - 1/1/2020
Page 9 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Accident | State: | FL | |
| Accident | Description: | NOT | CLASSIFIED |
| Claim | Status: | C | |
| Date | Closed:2/11/2020 |
| Claimant | Name Policy | Number Claim | Number Claim | Type Damage | Type Date | of | Loss Date | Reported Loc/ | Dept Feature |
| Status OS | Reserve Paid ALAE Total | Incurred |
inc ALAE
Dept of Children and Families 626036876 NJU00692439 OUTS 6/6/2019 6/11/2019 C $0.00 $0 $0 $0.00
Totals: $0.00 $0 $0 $0.00
* Denotes undisclosed reserves
Page 10 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Deductible: | $0 | ||
| Total | Claims: | 2 | |
| Report | Only | Features: | 0 |
| Claim | Type Average | Per | Claim Open | Claim | Features Total | Claim | Features Outstanding | Reserves Total |
| Paid | Loss ALAE Total | Incurred |
inc ALAE
Fidelity- Inside Premises $0.00 0 1 $0.00 $0 $0 $0.00
Fidelity- Outside Premises $0.00 0 1 $0.00 $0 $0 $0.00
Totals 0 2 $0.00 $0 $0 $0.00
* Denotes undisclosed reserves
Summary for Policy Number: 626036876 1/1/2019 - 1/1/2020
Page 11 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Note: | Total | incurred | loss | includes | ALAE | minus | Subro | Recovery. |
| Accident | State: | FL | ||||||
| Accident | Description: | EMPLOYEE | DISHONESTY | |||||
| Claim | Status: | C | ||||||
| Date | Closed:1/27/2022 |
| Claimant | Name Policy | Number Claim | Number Claim | Type Damage | Type Date | of | Loss Date | Reported Loc/ | Dept FeatureStatus OS | Reserve Paid ALAE Total | Incurred |
| inc | ALAE |
Department of Citrus/Matthew McDermott 626036402 NJU00665632 INSI 4/16/2018 4/17/2018 C $0.00 $17,922 $5,000 $0.00
Totals: $0.00 $17,922 $5,000 $0.00
* Denotes undisclosed reserves
Policy Number: 626036402 1/1/2018 - 1/1/2019
Page 12 of 12 Account #: 1068294 - Loss Detail Report Valuation Date: 9/12/2022
| Producer | Information | ||
| CRC | - | JERICHO | |
| 175 | Froehlich | Farm | Blvd |
| Woodbury, | NY | 117970000 |
| Crime | Commercial | ||||||||
| Insured | Name: | THE | STATE | OF | FLORIDA | DEPARTMENT | OF | MANAGEMENT | SERVICES |
| Deductible: | $0 | ||
| Total | Claims: | 1 | |
| Report | Only | Features: | 0 |
| Claim | Type Average | Per | Claim Open | Claim | Features Total | Claim | Features Outstanding | Reserves Total |
| Paid | Loss ALAE Total | Incurred |
inc ALAE
Fidelity- Inside Premises $0.00 0 1 $0.00 $17,922 $5,000 $0.00
Totals 0 1 $0.00 $17,922 $5,000 $0.00
* Denotes undisclosed reserves
Summary for Policy Number: 626036402 1/1/2018 - 1/1/2019
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