Attachment J - 2023 Commonwealth of KY Loss Runs - RFB 758 2300000826.pdf

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Attached to
Master Aviation Insurance
Solicitation number
RFB-758-2300000826-1
Issued by
Elliott County, Kentucky

About this file

This document is a loss run report for the Commonwealth of Kentucky's Various State Agencies, which details the loss experience under their insurance policy with Starr Companies. The policy covers the period from August 13, 2022, to August 13, 2023, with Starr providing 100% coverage. The report shows no losses for the 2022, 2021, and 2019-2020 policy years, but one loss event in the 2020-2021 policy year, with a total incurred amount of $117,076.11, including $110,000.00 in paid losses and $7,076.11 in paid expenses.

The report provides detailed information about the single loss event, including the claim number, date of loss, date reported, losses paid, expenses paid, loss reserve, expense reserve, and total incurred. The loss was related to a gear-up landing, resulting in damage to the propeller, belly, gear doors, and exhaust, with the engine also requiring inspection.

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Text version

*all numbers represent the Starr written line LOSS EXPERIENCE as of 5/11/2023 Commonwealth of Kentucky - VARIOUS STATE AGENCIES C/O STATE RISK & INSURANCE SERVICES DIVISION Policy #: 1000237730-05 Policy Year: 2022 Policy Period: 8/13/2022 - 8/13/2023 Starr Share: 100% *all numbers represent the Starr written line There are no Losses for this period

Commonwealth of Kentucky - VARIOUS STATE AGENCIES C/O STATE RISK & INSURANCE SERVICES DIVISION Policy #: 1000237730-04 Policy Year: 2021 Policy Period: 8/13/2021 - 8/13/2022 Starr Share: 100% *all numbers represent the Starr written line There are no Losses for this period

Commonwealth of Kentucky - VARIOUS STATE AGENCIES C/O STATE RISK & INSURANCE SERVICES DIVISION Policy #: 1000237730-03 Policy Year: 2020 Policy Period: 8/13/2020 - 8/13/2021 Starr Share: 100% *all numbers represent the Starr written line

Claimant Claim # Date of Loss Date

Reported Losses Paid

Expenses Paid

Total Paid

Loss Reserve

Expense Reserve

O/S Reserve

Total Incurred Summary Adjustor Status

N85A AVSIL0544849 5/14/2021 6/25/2021 $110,000.00 $7,076.11 $117,076.11 $0.00 $0.00 $0.00 $49,325.11Gear up landing. Damage is on the propeller, belly, gear doors and exhaust. Engine will need to be inspected as well.

Mueller, Warren

Closed

TOTALS8/13/2020 - 8/13/2021 $110,000.00 $7,076.11 $117,076.11 $0.00 $0.00 $0.00 $49,325.11

Commonwealth of Kentucky - VARIOUS STATE AGENCIES C/O STATE RISK & INSURANCE SERVICES DIVISION Policy #: 1000237730-02 Policy Year: 2019 Policy Period: 8/13/2019 - 8/13/2020 Starr Share: 100% *all numbers represent the Starr written line There are no Losses for this period

Commonwealth of Kentucky Policy #: 1000237730-01 Policy Year: 2018 Policy Period: 8/13/2018 - 8/13/2019 Starr Share: 100% *all numbers represent the Starr written line There are no Losses for this period

Losses Paid

Expenses Paid

Total Paid

Loss Reserve

Expense Reserve

O/S Reserve

Total Incurred

OVERALL TOTALS $110,000.00 $7,076.11 $117,076.11 $0.00 $0.00 $0.00 $49,325.11

File details come from the government source that posted it. Updated .