Coverage description
An Insurance Services Office (ISO) standard form. It provides the extended reporting period for employee benefits liability coverage, with a separate aggregate limit for claims first received and recorded during that period, once the additional premium is paid.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 10 13Oct 2013Latest | 64 | 61 | 9 | Nov 2021 to Aug 2026 |
1 other edition date appears in one or two filings each, often carrier-specific versions: 11 20.
What the filings show
- Edition in use: in the past 12 months, 11 companies filed the 10 13 edition.
- CA 99 44 (Loss Payable Clause) is filed alongside it most often, in 64 of the same filings (98%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Aug 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include CA 25 67, out of 36 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Ambac Financial GroupEverspan Insurance Company | 4 | 2 | 10 13 | Apr 28, 2025 |
| Amtrust Financial Services Group5 group companies filed it, led by CorePointe Insurance Company and Milford Casualty Insurance Company | 4 | 1 | 10 13 | Apr 10, 2025 |
| Markel Corporation Group2 group companies filed it, led by State National Insurance Company, Inc. and Markel Insurance Company | 4 | 3 | 10 13 | Mar 9, 2023 |
| Core Specialty Insurance Holdings GroupStarStone National Insurance Company | 3 | 2 | 10 13 | Jul 29, 2024 |
| Great Plains Casualty, Inc. | 3 | 2 | 10 13 | May 2, 2023 |
| MS & AD Insurance Group2 group companies filed it, led by Mitsui Sumitomo Insurance Company of America and Transverse Insurance Company | 3 | 2 | 10 13 | Sep 4, 2025 |
| ACP Insurance Mgmt LLC GroupAccelerant National Insurance Company | 2 | 1 | 10 13 | Jan 6, 2025 |
| American Financial Group6 group companies filed it, led by Great American Alliance Insurance Company and Great American Assurance Company | 2 | 2 | 10 13 | Jan 7, 2026 |
| Arch Insurance Group3 group companies filed it, led by Arch Indemnity Insurance Company and Arch Insurance Company | 2 | 1 | 10 13 | Oct 5, 2023 |
| Ascot Insurance US Group4 group companies filed it, led by AmFed Advantage Insurance Company and AmFed Casualty Insurance Company | 2 | 1 | 10 13 | Sep 8, 2023 |
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States
Number of filings that include CA 25 67 in each state, Oct 2021 to Aug 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- CA 99 44Loss Payable Clause64 filings
- CA 20 48Designated Insured for Covered Autos Liability Coverage63 filings
- CA 04 44Waiver of Transfer of Rights of Recovery Against Others to Us (Waiver of Subrogation)62 filings
- CA 99 16Hired Autos Specified as Covered Autos You Own62 filings
- CA 25 39Silica or Silica- Related Dust Exclusion for General Liability Coverages61 filings
- CA 23 94Silica or Silica- Related Dust Exclusion for Covered Autos Exposure60 filings
- CA 25 36Auto Dealers Coverage Form - General Liability Coverages - Total Pollution Exclusion with a Building Heating, Cooling and Dehumidifying Equipment Exception and a Hostile Fire Exception60 filings
- CA 25 37Fungi or Bacteria Exclusion - General Liability Coverages60 filings
- CA 99 23Rental Reimbursement Coverage60 filings
- CA 99 47Employee as Lessor60 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Aug 28, 2026 | Jet Insurance Company | SC | 10 13 | MRTN-134878222 |
| Jun 18, 2026 | Atlantic Specialty Insurance Company | SC | 10 13 | BEAC-134983501 |
| Jun 11, 2026 | CopperPoint Casualty Insurance Companyand 1 more | SC | 10 13 | COPP-134982457 |
| Jun 5, 2026 | Incline Casualty Company | SC | 10 13 | MRTN-134969595 |
| May 21, 2026 | Jet Insurance Company | NM | 10 13 | MRTN-134878221 |
| Apr 30, 2026 | Trisura Insurance Company | CA | 10 13 | SHNF-134890981 |
| Jan 7, 2026 | Great American Security Insurance Companyand 1 more | SC | 10 13 | GACX-134791913 |
| Nov 10, 2025 | Chubb National Insurance Companyand 2 more | SC | 10 13 | ACEH-134735360 |
| Oct 28, 2025 | Incline Casualty Company | SC | 10 13 | MRTN-134696973 |
| Oct 1, 2025 | Lyndon Southern Insurance Company | SC | 10 13 | LFST-134691947 |
| Sep 4, 2025 | Mitsui Sumitomo Insurance Company of America | SC | 10 13 | REGU-134645279 |
| Aug 27, 2025 | Mitsui Sumitomo Insurance Company of America | IL | 10 13 | REGU-134638854 |
Most filed ISO CA forms
- CA DS 03 Business Auto Declarations
- CA DS 21 Motor Carrier Declarations
- CA 00 01 Business Auto Coverage Form
- CA 28 03 Abuse Or Molestation Exclusion For Covered Autos Liability Exposure
- CA 23 17 Truckers - Uniform Intermodal Interchange Endorsement Form UIIE - 1
- CA 04 43 Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic When Required By Written Contract Or Agreement
- CA 04 44 Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation)
- CA 04 49 Primary and Noncontributory - Other Insurance Condition
- CA 20 01 Lessor - Additional Insured And Loss Payee
- CA 20 48 Designated Insured For Covered Autos Liability Coverage
- CA 00 20 Motor Carrier Coverage Form
- CA 20 71 Auto Loan/Lease Gap Coverage
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