3/4/2003 Bureau of Workers & Unemployment Compensation Page 1 Insurance Company Listing

Transcription

1 3/4/2003 Bureau of Workers & Unemployment Compensation Page 1 A.I.U. Insurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: Acceptance Insurance Company 535 W. Broadway P.O. Box 1574 Council Bluffs, IA NAIC Number: Accident Fund Insurance Co. of America P.O. Box Lansing, MI NAIC Number: Ace American Insurance Company NAIC Number: Ace Fire Underwriters Insurance Company NAIC Number: Ace Property & Casualty Insurance Company NAIC Number: Acuity, A Mutual Insurance Company 2800 S. Taylor Drive P.O. Box 58 Sheboygan, WI NAIC Number: Affiliated F M Insurance Company Allendale Park P.O. Box 7500 Johnston, RI NAIC Number: Alea North America Insurance Company 55 Capital Blvd. Rocky Hill, CT NAIC Number: All America Insurance Company 800 S. Washington Street Vanwert, OH NAIC Number: Alliance Assurance Company, Ltd. c/o Royal Insurance Co NAIC Number: Allianz Insurance Company c/o GAB Business Services, Inc Telegraph Rd., Ste Bingham Farms, MI NAIC Number: Allied Insurance Company NAIC Number: Allied Property & Casualty Insurance Company 1000 Nationwide Drive P.O. Box Harrisburg, PA NAIC Number: Allstate Indemnity Company 3075 Sanders Road, Suite H1A Northbrook, IL NAIC Number: Allstate Insurance Company 3075 Sanders Road, Suite H1A Northbrook, IL NAIC Number: Amco Insurance Company One Nationwide Plaza Columbus, OH NAIC Number: American & Foreign Insurance Company c/o Royal Insurance Company NAIC Number: American Alternative Insurance Company American RE Plaza 555 College Road East Princeton, NJ NAIC Number: American Automobile Insurance Company Attn: Elly O'Donnell P.O. Box 7911 Chicago, IL NAIC Number: American Casualty Company of Reading, PA NAIC Number: American Commercial Liability Insurance Co. NAIC Number:

2 3/4/2003 Bureau of Workers & Unemployment Compensation Page 2 American Compensation Insurance Company 8500 Normandale Lake Blvd. Ste Bloomington, MN NAIC Number: American Continental Insurance Company Road NAIC Number: American Country Insurance Company 222 N. Lasalle Street Room 1600 Chicago, IL NAIC Number: American Druggists Insurance Company 1366 Dublin Road 2nd Floor Columbus, OH NAIC Number: American Economy Insurance Company P.O. Box St. Louis, MO NAIC Number: American Employers Insurance Company Attn: W.C. Claims NAIC Number: American Fire & Casualty Company 136 N. 3rd Street Hamilton, OH NAIC Number: American Guarantee & Liability Insurance Co. P.O. Box 1880 Pittsburgh, PA NAIC Number: American Hardware Mutual Insurance Company P.O. Box Indianapolis, IN NAIC Number: American Home Assurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: American Insurance Company Attn: Elly O'Donnell P.O. Box 7911 Chicago, IL NAIC Number: American Interstate Insurance Company 2301 Highway 190 West Deridder, LA NAIC Number: American Manufacturers Mutual Insurance Co. P.O. Box Livonia, MI NAIC Number: American Motorists Insurance Company P.O. Box Livonia, MI NAIC Number: American Mutual Insurance Company of Boston P.O. Box 1620 Burlington, MA NAIC Number: American Mutual Liability Insurance Company P.O. Box 1620 Burlington, MA NAIC Number: American Physicians Assurance Corporation 1301 N. Hagadorn P.O. Box 1471 East Lansing, MI NAIC Number: American Policyholders Insurance Co. P.O. Box 1620 Burlington, MA NAIC Number: American Protection Insurance Company P.O. Box Livonia, MI NAIC Number: American Risk Funding Insurance Company Merit Drive Suite 1660 Dallas, TX NAIC Number: American Safety Casualty Insurance Company 1845 The Exchange, Suite 200 Atlanta, GA NAIC Number: American States Insurance Company P.O. Box St. Louis, MO NAIC Number: American Universal Insurance Company NAIC Number:

3 3/4/2003 Bureau of Workers & Unemployment Compensation Page 3 American Zurich Insurance Company P.O. Box 1880 Pittsburgh, PA NAIC Number: Amerisure Insurance Company Halsted Road P.O. Box 2060 Farmington Hills, MI NAIC Number: Amerisure Mutual Insurance Company Halsted Road P.O. Box 2060 Farmington Hills, MI NAIC Number: AmGuard Insurance Company P.O. Box A-H Wilkes-Barre, PA NAIC Number: Ansur American Insurance Company One Mutual Avenue Frankenmuth, MI NAIC Number: Argonaut Great Central Insurance Company Presidents Plaza III 8750 W. Bryn Mawr, Suite 600 Chicago, IL NAIC Number: Argonaut Insurance Company Presidents Plaza III 8750 W. Bryn Mawr, Suite 600 Chicago, IL NAIC Number: Argonaut Midwest Insurance Company Presidents Plaza III 8750 W. Bryn Mawr, Ste. 600 Chicago, IL NAIC Number: Associated Indemnity Corporation Attn: Elly O'Donnell P.O. Box 7911 Chicago, IL NAIC Number: Assurance Company of America 1400 American Lane Schaumburg, IL NAIC Number: Athena Assurance Company NAIC Number: Atlantic Mutual Insurance Company 3000 Town Center, Suite 1850 Southfield, MI NAIC Number: Auto Owners Insurance Company Michigan Workers' Comp. Claims P.O. Box Lansing, MI NAIC Number: Automobile Insurance Company of Hartford, CT Evergreen Road Suite 1410 NAIC Number: Axa Corporate Solutions Insurance Company One Seaport Plaza 199 Water Street New York, NY NAIC Number: Balboa Insurance Company 3349 Michelson Drive Irvine, CA NAIC Number: Bancinsure, Inc N. Lincoln Blvd. Oklahoma City, OK NAIC Number: Bankers Standard Insurance Company NAIC Number: Birmingham Fire Insurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: Bituminous Casualty Corporation N. Laurel Park Drive, Suite 254 Southfield, MI NAIC Number: Bituminous Fire & Marine Insurance Company N. Laurel Park Drive, Suite 254 Southfield, MI NAIC Number: Boston Insurance Company 1717 E. 9th Street Cleveland, OH NAIC Number:

4 3/4/2003 Bureau of Workers & Unemployment Compensation Page 4 Boston Old Colony Insurance Company P.O. Box 5041 NAIC Number: Brotherhood Mutual Insurance Company P.O. Box 2227 Fort Wayne, IN NAIC Number: Buckeye Union Insurance Company NAIC Number: Camden Fire Insurance Association Co. of NJ Attn: W.C. Claims NAIC Number: Carolina Casualty Insurance Company P.O. Box 2575 Jacksonville, FL NAIC Number: Carriers Insurance Company NAIC Number: Casualty Reciprocal Exchange P.O. Box Kansas City, MO NAIC Number: Celina Mutual Insurance Company 1 Insurance Square Celina, OH NAIC Number: Centennial Insurance Company 3000 Town Center, Suite 1850 Southfield, MI NAIC Number: Central Mutual Insurance Company 800 S. Washington Street Vanwert, OH NAIC Number: Central National Insurance Co. Of Omaha 105 S. 17th Street Omaha, NE NAIC Number: Century Indemnity Company NAIC Number: Charter Oak Fire Insurance Company Evergreen Suite 1410 NAIC Number: Cherokee Insurance Company Mound Road Sterling Heights, MI NAIC Number: Chrysler Insurance Company Franklin Road P.O. Box 5168 NAIC Number: Chubb Indemnity Company 5440 Corporate Drive Ste 300 P.O. Box NAIC Number: Church Mutual Insurance Company 3000 Schuster Lane P.O. Box 357 Merrill, WI NAIC Number: Cincinnati Casualty Company P.O. Box 273 Ada, MI NAIC Number: Cincinnati Indemnity Company P.O. Box 273 Ada, MI NAIC Number: Cincinnati Insurance Company P.O. Box 273 Ada, MI NAIC Number: Citizens Insurance Company of America Attn: Mark Breen 645 W. Grand River Howell, MI NAIC Number: Citizens Insurance Company of Ohio Attn: Mark Breen 645 W. Grand River Howell, MI NAIC Number:

5 3/4/2003 Bureau of Workers & Unemployment Compensation Page 5 Citizens Insurance Company of the Midwest Attn: Mark Breen 645 W. Grand River Howell, MI NAIC Number: City Insurance Company c/o Risk Enterprise Management P.O. Box 1618 Waukesha, WI NAIC Number: Clarendon National Insurance Company 1177 Avenue of the Americas #44-45 FL New York, NY NAIC Number: Colonial American Casualty & Surety Company P.O. Box 1880 Pittsburgh, PA NAIC Number: Colonial Penn Insurance Company P.O. Box 1998 Valley Forge, PA NAIC Number: Combined Specialty Insurance Company c/o AON Corporation 200 E. Randolph St. Ste Chicago, IL NAIC Number: Commerce & Industry Insurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: Commercial Insurance Company of Newark NAIC Number: Compass Insurance Company 709 Curtis Street Middletown, OH NAIC Number: Connecticut Indemnity Company c/o Royal Insurance Company NAIC Number: Consolidated American Insurance Company P.O. Box 1 Columbia, SC NAIC Number: Consolidated Insurance Company 3333 Warrenville Road, 4th Floor P.O. Box 5211 NAIC Number: Consolidated Underwriters NAIC Number: WC Continental Casualty Company NAIC Number: Continental Insurance Company NAIC Number: Continental National American Casualty Co. NAIC Number: Continental National Indemnity Co. NAIC Number: Coregis Insurance Company P.O. Box 2979 Overland Park, KS NAIC Number: Crum & Forster Indemnity Company 400 N. Executive Drive, Suite 401 Brookfield, WI NAIC Number: CUMIS Insurance Society, Inc. Workers' Compensation Claims P.O. Box 1221 Madison, WI NAIC Number: Discover Property & Casualty Insurance Co. NAIC Number:

6 3/4/2003 Bureau of Workers & Unemployment Compensation Page 6 Dorinco Reinsurance Company Sun Oil Building Suite Waldo Road Midland, MI NAIC Number: Eagle Pacific Insurance Company P.O. Box Livonia, MI NAIC Number: Eagle Star Insurance Company 111 John Street New York, NY NAIC Number: Edison Insurance Company 222 Merchandise Mart Plaza Ste Chicago, IL NAIC Number: Electric Insurance Company 260 Washington Avenue P.O. Box Albany, NY NAIC Number: Electric Mutual Liability Insurance Company 4 Corporate Plz #425 Albany, NY NAIC Number: Emcasco Insurance Company P.O. Box Lansing, MI NAIC Number: Employers Casualty Company 512 E. Riverside Drive Austin, TX NAIC Number: Employers Fire Insurance Company Attn: W.C. Claims NAIC Number: Employers Insurance of Wausau P.O. Box 1187 Indianapolis, IN NAIC Number: Employers Mutual Casualty Company P.O. Box Lansing, MI NAIC Number: Everest National Insurance Company P.O. Box 830 Liberty Corner, NJ NAIC Number: Evergreen National Indemnity Company 6515 E. 82nd Street Suite 115 Indianapolis, IN NAIC Number: Fairfield Insurance Company 695 E. Main Street P.O. Box Stamford, CT NAIC Number: Fairmont Insurance Company 5205 N. O'Connor P.O. Box Irving, TX NAIC Number: Farm Bureau General Insurance Company Medical Maintenance Unit P.O. Box Lansing, MI NAIC Number: Farm Bureau Mutual Insurance Company Medical Maintenance Unit P.O. Box Lansing, MI NAIC Number: Farmers Insurance Exchange Workers Compensation Claims P.O. Box 190 North Aurora, IL NAIC Number: Farmington Casualty Company Evergreen Road, Suite 1410 NAIC Number: Farmland Mutual Insurance Company 1963 Bell Avenue Des Moines, IA NAIC Number: Federal Insurance Company 5440 Corporate Drive Ste 300 P.O. Box NAIC Number: Federal Kemper Insurance Company One Kemper Drive Long Grove, IL NAIC Number:

7 3/4/2003 Bureau of Workers & Unemployment Compensation Page 7 Federated Mutual Insurance Company 8060 Knue Road P.O. Box Indianapolis, IN NAIC Number: Federated Rural Electric Insurance Corp. P.O. Box Lenexa, KS NAIC Number: Federated Service Insurance Company 8060 Knue Road P.O. Box Indianapolis, IN NAIC Number: Fidelity & Casualty Company of New York NAIC Number: Fidelity & Deposit Company of Maryland P.O. Box 1880 Pittsburgh, PA NAIC Number: Fidelity & Guaranty Insurance Company NAIC Number: Fidelity & Guaranty Insurance Underwriters NAIC Number: Fire & Casualty Insurance Company of Ct c/o Royal Insurance Company NAIC Number: Firemans Fund Insurance Company Attn: Elly O'Donnell P.O. Box 7911 Chicago, IL NAIC Number: Firemans Fund Insurance Company of Wisconsin Attn: Elly O'Donnell P.O. Box 7911 Chicago, IL NAIC Number: Firemens Insurance Company of Newark, N.J. NAIC Number: First American Insurance Company 100 First Stamford Place Stamford, CT NAIC Number: First Liberty Insurance Corporation P.O. Box 9191 Farmington Hills, MI NAIC Number: First National Insurance Company of America P.O. Box St. Louis, MO NAIC Number: Florists Mutual Insurance Company 1 Horticultural Lane Edwardsville, IL NAIC Number: Frankenmuth Mutual Insurance Company One Mutual Avenue Frankenmuth, MI NAIC Number: Fremont Casualty Insurance Company 9200 Keystone Crossing, Ste. 320 Indianapolis, IN NAIC Number: Fremont Compensation Insurance Company 9200 Keystone Crossing, Ste. 320 Indianapolis, IN NAIC Number: Fremont Indemnity Company 9200 Keystone Crossing, Ste. 320 Indianapolis, IN NAIC Number: Fremont Mutual Insurance Company 933 E. Main Street Fremont, MI NAIC Number: Frontier Insurance Company 195 Lake Louise Marie Rd. Rock Hill, NY NAIC Number: General Casualty Company of Wisconsin 8500 Keystone Crossing, Suite 200 Indianapolis, IN NAIC Number:

8 3/4/2003 Bureau of Workers & Unemployment Compensation Page 8 General Insurance Company of America P.O. Box 7209 Indianapolis, IN NAIC Number: Genesis Insurance Company 695 E. Main Street P.O. Box Stamford, CT NAIC Number: Glens Falls Insurance Company NAIC Number: Globe Indemnity Company c/o Royal Insurance Company NAIC Number: Grange Insurance Company of Michigan Victor Parkway, Suite NAIC Number: Granite State Insurance Company 2nd Floor Suite 200 East Lansing, MI NAIC Number: Great American Alliance Insurance Company 580 Walnut Street Cincinnati, OH NAIC Number: Great American Assurance Company 580 Walnut Street Cincinnati, OH NAIC Number: Great American Insurance Co of NY 580 Walnut Street Cincinnati, OH NAIC Number: Great American Insurance Company 580 Walnut Street Cincinnati, OH NAIC Number: Great American Security Insurance Company 580 Walnut Street Cincinnati, OH NAIC Number: Great American Spirit Insurance Company 580 Walnut Street Cincinnati, OH NAIC Number: Great Midwest Insurance Company P.O. Box 1788 Grand Rapids, MI NAIC Number: Great Northern Insurance Company 5440 Corporate Drive Ste 300 P.O. Box NAIC Number: Great West Casualty Company P.O. Box 277 S. Sioux City, NE NAIC Number: Greater New York Mutual Insurance Company 200 Madison Avenue New York, NY NAIC Number: Greenwich Insurance Company of NY 70 Seaview Avenue Stamford, CT NAIC Number: Grocers Insurance Company P.O. Box Portland, OR NAIC Number: Guideone Mutual Insurance Company 1025 Ashworth Road, Suite 101 West DesMoines, IA NAIC Number: Gulf Insurance Company P.O. Box Dallas, TX NAIC Number: Hamilton Mutual Insurance Company John Keller, Asst. VP 1520 Madison Road Cincinnati, OH NAIC Number: Hanover Insurance Company Attn: Mark Breen 645 W. Grand River Howell, MI NAIC Number:

9 3/4/2003 Bureau of Workers & Unemployment Compensation Page 9 Harco National Insurance Company P.O. Box Schaumburg, IL NAIC Number: Harleysville Insurance Company P.O. Box 1233 Minneapolis, MN NAIC Number: Harleysville Lake States Insurance Company Midwest Claims Service Center P.O. Box 1167 Minneapolis, MN NAIC Number: Hartford Accident & Indemnity Company 5445 Corporate Drive P.O. Box 3001 NAIC Number: Hartford Casualty Insurance Company 5445 Corporate Drive P.O. Box 3001 NAIC Number: Hartford Fire Insurance Company 5445 Corporate Drive P.O. Box 3001 NAIC Number: Hartford Insurance Company of the Midwest 5445 Corporate Drive P.O. Box 3001 NAIC Number: Hartford Underwriters Insurance Company 5445 Corporate Drive P.O. Box 3001 NAIC Number: Hastings Mutual Insurance Company Morrie Ozinga 404 E. Woodlawn Avenue Hastings, MI NAIC Number: Hawkeye Security Insurance Company P.O. Box 1848 Des Moines, IA NAIC Number: Highlands Insurance Company c/o Crawford & Company P.O. Box 5154 NAIC Number: HIH America Compensation & Liability Ins. Co. NAIC Number: Home Indemnity Company c/o Risk Enterprise Management P.O. Box 1618 Waukesha, WI NAIC Number: Home Insurance Company c/o Risk Enterprise Management P.O. Box 1618 Waukesha, WI NAIC Number: Home Owners Insurance Company Michigan Workers Comp. Claims P.O. Box Lansing, MI NAIC Number: Houston General Insurance Company Attn: W.C. Claims NAIC Number: Huron Insurance Company P.O. Box 352 Traverse City, MI NAIC Number: Ideal Mutual Insurance Company NAIC Number: Illinois National Insurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: Indemnity Insurance Company of North America NAIC Number:

10 3/4/2003 Bureau of Workers & Unemployment Compensation Page 10 Indiana Insurance Company 3333 Warrenville Road, 4th Floor P.O. Box 5211 NAIC Number: Indiana Lumbermens Mutual Insurance Company 3600 Woodview Trace P.O. Box Indianapolis, IN NAIC Number: Insurance Co. Of the State of Pennsylvania 2nd Floor, Suite 200 East Lansing, MI NAIC Number: Insurance Company of North America NAIC Number: Insurance Corporation of America 1301 N. Hagadorn P.O. Box 1471 East Lansing, MI NAIC Number: Intercontinental Insurance Company NAIC Number: International Business & Merchantile Reins W. 29th Street P.O. Box 277 Nebraska City, NE NAIC Number: International Insurance Company 400 N. Executive Drive, Suite 401 Brookfield, WI NAIC Number: Kansas City Fire & Marine Insurance Company NAIC Number: Kemper Employers Insurance Company P.O. Box Livonia, MI NAIC Number: Legion Insurance Company Attn: Dean Bender P.O. Box Philadelphia, PA NAIC Number: Liberty Insurance Corporation P.O. Box 9191 Farmington Hills, MI NAIC Number: Liberty Mutual Fire Insurance Company P.O. Box 9191 Farmington Hills, MI NAIC Number: Liberty Mutual Insurance Company P.O. Box 9191 Farmington Hills, MI NAIC Number: LM Insurance Corporation P.O. Box 9191 Farmington Hills, MI NAIC Number: LMI Insurance Company P.O. Box Raleigh, NC NAIC Number: London Guarantee & Accident Company of NY 25 Independence Boulevard Warren, NJ NAIC Number: Lumber Mutual Insurance Company P.O. Box 9165 Framingham, MA NAIC Number: Lumbermens Mutual Casualty Company P.O. Box Livonia, MI NAIC Number: Lumbermens Underwriting Alliance 7401 Metro Blvd., Suite 250 Minneapolis, MN NAIC Number: M L B A Mutual Insurance Company P.O. Box 4067 East Lansing, MI NAIC Number: Manufacturers & Merchants Mutual Insurance Co P.O. Box 514 Concord, NH NAIC Number:

11 3/4/2003 Bureau of Workers & Unemployment Compensation Page 11 Markel Insurance Company Shand Morahan Plaza Evanston, IL NAIC Number: Maryland Casualty Company 1400 American Lane Schaumburg, IL NAIC Number: Massachusetts Bay Insurance Company Attn: Mark Breen 645 W. Grand River Howell, MI NAIC Number: Massachusetts Bonding & Insurance Company 10 Post Office Square Boston, MA NAIC Number: Wc Medallion Insurance Company NAIC Number: Meridian Citizens Mutual Insurance Co. P.O. Box 1980 Indianapolis, IN NAIC Number: Meridian Mutual Insurance Company 2955 N. Meridian Street P.O. Box 7183 Indianapolis, IN NAIC Number: Meridian Security Insurance Company 2955 N. Meridian Street P.O. Box 7183 Indianapolis, IN NAIC Number: MHA Insurance Company 6215 W. St. Joseph Hwy. Lansing, MI NAIC Number: MIC Property & Casualty Insurance Company Corporate Compliance Dept W. Grand Blvd. 482?1x3301 Detroit, MI NAIC Number: Michigan Construction Industry Mutual Ins. Co W. Michigan Avenue P.O. Box Lansing, MI NAIC Number: Michigan Insurance Company P.O. Box Grand Rapids, MI NAIC Number: Michigan Millers Mutual Insurance Company Claims Department P.O. Box Lansing, MI NAIC Number: Mid-Century Insurance Company Commercial Claims Office P.O. Box 190 North Aurora, IL NAIC Number: Middlesex Insurance Company P.O. Box 8032 Stevens Point, WI NAIC Number: Midland Insurance Company NAIC Number: Midland National Insurance Company 173 W. Madison Street Chicago, IL NAIC Number: Wc Midwest Employers Casualty Company W. 12 Mile Road, Suite 351 Farmington Hills, MI NAIC Number: Millers Mutual Insurance Association 111 E. Fourth Street P.O. Box 9006 Alton, IL NAIC Number: Millers National Insurance Company 850 Warrenville Road 3rd Floor NAIC Number: Mission Insurance Company NAIC Number: Monroe Guaranty Insurance Company N. Meridian Street, Ste. 100 Carmel, IN NAIC Number:

12 3/4/2003 Bureau of Workers & Unemployment Compensation Page 12 Motorists Mutual Insurance Company 471 E. Broad Columbus, OH NAIC Number: Mutual Service Casualty Insurance Company P.O. Box St. Paul, Mn NAIC Number: N N Insurance Company c/o Vik Brothers Ins.? Claims 1000 Lenox Dr. P.O. Box 6396 Lawrenceville, NJ NAIC Number: National American Insurance Company 1006 Manval Avenue P.O. Box Drawer 9 Chandler, OK NAIC Number: National Ben Franklin Insurance Company NAIC Number: National Continental Insurance Company P.O. Box 5070 Cleveland, OH NAIC Number: National Farmers Union Property & Casualty Attn: WC Claims NAIC Number: National Farmers Union Standard Insurance Co E. Cornell Avenue Aurora, CO NAIC Number: National Fire Insurance Company of Hartford NAIC Number: National General Insurance Company Corporate Compliance Dept 3044 W. Grand Blvd x3301 Detroit, MI NAIC Number: National Grange Mutual Insurance Company P.O. Box 4828 Syracuse, NY NAIC Number: National Indemnity Company 4016 Farnam Street Omaha, NE NAIC Number: National Liability & Fire, Inc Harney Street Omaha, NE NAIC Number: National Mutual Insurance Company One Insurance Square Celina, OH NAIC Number: National Reinsurance Corporation 695 E. Main Street P.O. Box Stamford, CT NAIC Number: National Surety Corporation Attn: Elly O'Donnell P.O. Box 7911 Chicago, IL NAIC Number: National Union Fire Insurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: Nationwide Agribusiness Insurance Company 1963 Bell Avenue Des Moines, IA NAIC Number: Nationwide Mutual Fire Insurance Company 1000 Nationwide Drive P.O. Box Harrisburg, PA NAIC Number: Nationwide Mutual Insurance Company 1000 Nationwide Drive P.O. Box Harrisburg, PA NAIC Number: Netherlands Insurance Company 3333 Warrenville Road, 4th Floor P.O. Box 5211 NAIC Number: New Hampshire Indemnity Company, Inc. 2nd Floor, Suite 200 East Lansing, MI NAIC Number:

13 3/4/2003 Bureau of Workers & Unemployment Compensation Page 13 New Hampshire Insurance Company 2nd Floor, Suite 200 East Lansing, MI NAIC Number: New York Underwriters Insurance Company 5445 Corporate Drive P.O. Box 3001 Troy, M I NAIC Number: Newark Insurance Company c/o Royal Insurance Company NAIC Number: Niagara Fire Insurance Company NAIC Number: Nipponkoa Insurance Company, LTD 14 Wall Street, Suite 812 New York, NY NAIC Number: NLC Mutual Insurance Company 1301 Pennsylvania Avenue, NW Washington, DC NAIC Number: Nordia Insurance Company P.O. Box 886 Shelton, CT NAIC Number: NorGuard Insurance Company P.O. Box A-H Wilkes-Barre, PA NAIC Number: North American Specialty Insurance Company 650 Elm Street, Suite 600 Manchester, NH NAIC Number: North Pointe Insurance Company P.O. Box 2223 Southfield, MI NAIC Number: North River Insurance Company 400 N. Executive Drive, Suite 401 Brookfield, WI NAIC Number: Northbrook Indemnity Company NAIC Number: Northbrook Property & Casualty Company NAIC Number: Northern Assurance Company of America Attn: W.C. Claims NAIC Number: Northern Insurance Company of New York c/o Maryland Casualty 1400 American Lane Schaumburg, IL NAIC Number: Northwestern National Casualty Company c/o Vik Brothers Ins. - Claims 1000 Lenox Dr. P.O. Box 6396 Lawrenceville, NJ NAIC Number: Northwestern National Insurance Company 709 Curtis Street Middletown, OH NAIC Number: Occidental Fire & Casualty Company of NC John Mininger 702 Oberlin Road, Box Raleigh, NC NAIC Number: Ohio Casualty Insurance Company 136 N. 3rd Street Hamilton, OH NAIC Number: Ohio Farmers Insurance Company Mile Road, Suite 255 NAIC Number: Ohio Security Insurance Company 136 N. 3rd Street Hamilton, OH NAIC Number: Old Republic Insurance Company P.O. Box 2200 Greensburg, PA NAIC Number:

14 3/4/2003 Bureau of Workers & Unemployment Compensation Page 14 OneBeacon America Insurance Company Attn: W.C. Claims NAIC Number: OneBeacon Insurance Company Attn: W.C. Claims NAIC Number: Pacific Employers Insurance Company NAIC Number: Pacific Indemnity Company 5440 Corporate Drive Ste 300 P.O. Box NAIC Number: Partners Mutual Insurance Company Swenson Waukesha, WI NAIC Number: Patriot General Insurance Company P.O. Box 8032 Stevens Point, WI NAIC Number: Peerless Insurance Company 3333 Warrenville Road, 4th Floor P.O. Box 5211 NAIC Number: Pennsylvania General Insurance Company Attn: W.C. Claims NAIC Number: Pennsylvania Lumbermens Mutual Insurance 170 S. Independence Square Ste 200E Philadelphia, PA NAIC Number: Pennsylvania Manufacturers Assn. Insurance Co 380 Sentry Parkway Blue Bell, PA NAIC Number: Pennsylvania National Mutual Casualty Ins. P.O. Box 2361 Harrisburg, PA NAIC Number: Petroleum Casualty Company P.O. Box 3342 Houston, TX NAIC Number: Pharmacists Mutual Insurance Company 808 Hwy. 18 West P.O. Box 370 Algona, IA NAIC Number: Phico Insurance Company 5875 Castle Creek Pkwy N Dr. Ste. 300 P.O. Box Indianapolis, IN NAIC Number: Phoenix Assurance Company of New York 255 E. 5th Street, Suite 2100 Cincinnati, OH NAIC Number: Phoenix Insurance Company Evergreen Suite 1410 NAIC Number: Pioneer State Mutual Insurance Company 1510 N. Elms Road Flint, MI NAIC Number: Potomac Insurance Company of Illinois Attn: W.C. Claims NAIC Number: Preferred Physicians Insurance Co. P.O. Box Omaha, NE NAIC Number: Princeton Insurance Company 746 Alexander Road Princeton, NJ NAIC Number: Progressive Casualty Insurance Company P.O. Box 5070 Cleveland, OH NAIC Number: Protective Insurance Company 1099 N. Meridian Street Indianapolis, IN NAIC Number:

15 3/4/2003 Bureau of Workers & Unemployment Compensation Page 15 Providence Washington Insurance Company 19 Mansfield Avenue, Suite B P.O. Box 5069 Shelby, OH NAIC Number: Prudential Commercial Insurance Company P.O. Box 6426 Lawrenceville, NJ NAIC Number: Rampart Insurance Company 20 Exchange Place, 11th Floor New York, NY NAIC Number: Ranger Insurance Company P.O. Box 2807 Houston, TX NAIC Number: Regent Insurance Company 8500 Keystone Crossing, Suite 200 Indianapolis, IN NAIC Number: Reliance Insurance Company NAIC Number: Reliance National Indemnity Company NAIC Number: Reliance National Insurance Company NAIC Number: Republic Western Insurance Company 2721 N. Central Avenue Phoenix, AZ NAIC Number: Republic-Franklin Insurance Company P.O. Box 530 Utica, NY NAIC Number: Royal Indemnity Company c/o Royal Insurance Company NAIC Number: Royal Insurance Company NAIC Number: Sable Insurance Company 433 California Street, 11th Floor San Francisco, CA NAIC Number: Safeco Insurance Company 500 N. Meridian P.O. Box 7209 Indianapolis, IN NAIC Number: Safeguard Insurance Company c/o Royal Insurance Company NAIC Number: Safety First Insurance Company 2043 Woodland Parkway, Suite 200 St. Louis, MO NAIC Number: Safety National Casualty Corporation 2043 Woodland Parkway, Suite 200 St. Louis, MO NAIC Number: Secura Insurance Company P.O. Box 819 Appleton, WI NAIC Number: Security Casualty Company 222 S. Riverside Plaza Chicago, IL NAIC Number: Security Insurance Company of Hartford c/o Royal Insurance Company NAIC Number: Select Insurance Company National Workers' Compensation P.O. Box 1771 Dallas, TX NAIC Number: Selective Insurance Co of South Carolina 40 Wantage Avenue Branchville, NJ NAIC Number:

16 3/4/2003 Bureau of Workers & Unemployment Compensation Page 16 Selective Insurance Co of the Southeast 40 Wantage Avenue Branchville, NJ NAIC Number: Selective Way Insurance Company 40 Wantage Avenue Branchville, NJ NAIC Number: Seneca Insurance Company 7310 E. Arapahoe Road, Suite 200 Englewood, CO NAIC Number: Sentry Insurance a Mutual Company P.O. Box 8032 Stevens Point, WI NAIC Number: Sentry Select Insurance Company P.O. Box 8032 Stevens Point, WI NAIC Number: Shelby Insurance Company Central Service Center 175 Mansfield Avenue Shelby, OH NAIC Number: Sompo Japan Insurance Company 225 W. Wacker Drive, Suite 2140 Chicago, IL NAIC Number: South Carolina Insurance Company P.O. Box 1 Columbia, SC NAIC Number: St. Paul Fire & Marine Insurance Company NAIC Number: St. Paul Guardian Insurance Company NAIC Number: St. Paul Medical Liability Insurance Co. NAIC Number: St. Paul Mercury Insurance Company NAIC Number: St. Paul Property & Casualty Insurance Co. NAIC Number: Standard Fire Insurance Company Evergreen Road, Suite 1410 NAIC Number: Star Insurance Company c/o Meadowbrook Claims Service Telegraph Rd., Box 2054 Southfield, MI NAIC Number: State Auto Property & Casualty Insurance Company N Laurel Park Drive, Suite 167 NAIC Number: State Automobile Mutual Insurance Company N. Laurel Park Drive, Suite 167 NAIC Number: State Farm Fire & Casualty Company Workers' Comp. Claim Dept. P.O. Box 4072 Kalamazoo, MI NAIC Number: State Farm General Insurance Company Workers' Comp. Claim Dept. P.O. Box 4072 Kalamazoo, MI NAIC Number: State Mutual Insurance Company P.O. Box 280 Lapeer, MI NAIC Number: Sumitomo Marine & Fire Insurance Company c/o Sumitomo Marine Management Chagrin Blvd. Suite 250 Cleveland, OH NAIC Number: Sun Insurance Office, Ltd Corporate Drive Ste 300 P.O. Box 7078 NAIC Number:

17 3/4/2003 Bureau of Workers & Unemployment Compensation Page 17 T H E Insurance Company Gulf Blvd. Treasure Island, FL NAIC Number: TIG Insurance Company 5205 N. O'Connor P.O. Box Irving, TX NAIC Number: TIG Insurance Company of Michigan 5205 N. O'Connor P.O. Box Irving, TX NAIC Number: TIG Insurance Corporation of America 5205 N. O'Connor P.O. Box Irving, TX NAIC Number: TIG Premier Insurance Company 5205 N. O'Connor P.O. Box Irving, TX NAIC Number: Tokio Marine & Fire Insurance Company 444 N. Michigan Avenue, Suite 2980 Chicago, IL NAIC Number: Toyota Motor Insurance Company S. Western Ave., FS 21 Torrance, CA NAIC Number: Trans Pacific Insurance Company 101 Park Avenue New York, NY NAIC Number: Transcontinental Insurance Company NAIC Number: Transit Casualty Company NAIC Number: Transport Indemnity Company 2 Cross Roads of Commerce, Suite 700 Rolling Meadows, IL NAIC Number: Transport Insurance Company 4100 Harry Hines Blvd. Dallas, TX NAIC Number: Transportation Insurance Company NAIC Number: Travelers Casualty & Surety Co. Of America Evergreen Road, Suite 1410 NAIC Number: Travelers Casualty & Surety Co. Of Illinois Evergreen Road, Suite 1410 NAIC Number: Travelers Casualty Company Evergreen Road, Suite 1410 NAIC Number: Travelers Casualty Company of Connecticut Evergreen Road, Suite 1410 NAIC Number: Travelers Commercial Insurance Company One Tower Square Hartford, CT NAIC Number: Travelers Indemnity Co. Of Connecticut Evergreen, Suite 1410 NAIC Number: Travelers Indemnity Company Evergreen, Suite 1410 NAIC Number: Travelers Indemnity Company of America Evergreen, Suite 1410 NAIC Number: Travelers Indemnity Company of Illinois Evergreen, Suite 1410 NAIC Number: Travelers Insurance Company Evergreen, Suite 1410 NAIC Number:

18 3/4/2003 Bureau of Workers & Unemployment Compensation Page 18 Tri State Insurance Company of Minnesota One Roundwind Drive Luverne, MN NAIC Number: Truck Insurance Exchange Workers Compensation Claims P.O. Box 190 North Aurora, IL NAIC Number: Twin City Fire Insurance Company 5445 Corporate Drive P.O. Box 3001 NAIC Number: U S Specialty Insurance Company P.O. Box Montgomery, AL NAIC Number: Ulico Casualty Company Ramona Drive Chino, CA NAIC Number: Unigard Security Insurance Company N.E. 24 Street Bellevue, WA NAIC Number: United Pacific Insurance Company NAIC Number: United Security Insurance Company P.O. Box 1848 Des Moines, IA NAIC Number: United States Fidelity & Guaranty NAIC Number: United States Fire Insurance Company 400 N. Executive Drive, Suite 401 Brookfield, WI NAIC Number: United States Liability Insurance Company 190 S. Warner Road Wayne, PA NAIC Number: United Wisconsin Insurance Company W. Nation Avenue New Berlin, WI NAIC Number: Universal Underwriters Insurance Company P.O. Box Livonia, MI NAIC Number: Utica Mutual Insurance Company P.O. Box Columbus, OH NAIC Number: Valiant Insurance Company 1400 American Lane Schaumburg, IL NAIC Number: Valley Forge Insurance Company NAIC Number: Vanliner Insurance Company One United Drive P.O. Box Fenton, MO NAIC Number: Vigilant Insurance Company 5440 Corporate Drive Ste 300 P.O. Box 7078 NAIC Number: Wausau Business Insurance Company P.O. Box 1187 Indianapolis, IN NAIC Number: Wausau Underwriters Insurance Company P.O. Box 1187 Indianapolis, IN NAIC Number: West American Insurance Company 136 N. 3rd Street Hamilton, OH NAIC Number: West Bend Mutual Insurance Company 1900 S. 18th Avenue West Bend, WI NAIC Number:

19 3/4/2003 Bureau of Workers & Unemployment Compensation Page 19 Westchester Fire Insurance Company NAIC Number: Zurich Insurance Company P.O. Box 1880 Pittsburgh, PA NAIC Number: Western Casualty & Surety Company c/o American States Ins. Co. P.O. Box 154 Workers Comp Unit Grand Rapids, MI NAIC Number: Western Continental Insurance Company 20 Exchange Place, 11th Floor New York, NY NAIC Number: Western Employers Insurance Company 1400 N. Harbor Boulevard P.O. Box 5347 Fullerton, CA NAIC Number: Westfield Insurance Company Mile Road, Suite 255 NAIC Number: Westfield National Insurance Company Mile Road, Suite 255 NAIC Number: Westport Insurance Company P.O. Box 2979 Overland Park, KS NAIC Number: Williamsburg National Insurance Company c/o Meadowbrook Claims Service Telegraph Rd., Box 2054 Southfield, MI NAIC Number: X L Specialty Insurance Company 70 Seaview Avenue Stamford, Ct NAIC Number: Zenith Insurance Company 2105 W. White Oaks Drive Springfield, IL NAIC Number: Zurich American Insurance Company of Illinois P.O. Box 1880 Pittsburgh, PA NAIC Number: