FILING OF FINANCIAL STATEMENT BY LIFE, HEALTH, OR ACCIDENT INSURANCE COMPANY

A foreign or alien life insurance company, accident insurance company, life and accident insurance company, health and accident insurance company, or life, health, and accident insurance company that wants to engage in the business of insurance in this state shall provide to the department a written or printed statement, under the oath of the president or vice president or under the oath of the treasurer and secretary of the company, that shows: (1) the company's name and location; (2) the amount of the company's capital stock; (3) the amount of the company's paid up capital stock; (4) the company's assets, including in the following order: (A) the amount of cash on hand; (B) the amount of cash held by other persons and the names and residences of those persons; (C) unencumbered real estate, its location, and its value; (D) bonds the company owns, the manner in which the bonds are secured, and the rate of interest on the bonds; (E) debts due the company that are secured by mortgage, a description of the mortgaged property, and the property's market value; (F) debts due the company that are secured other than by mortgage and a statement of how they are secured; (G) debts due the company for premiums; and (H) all other money and securities; (5) the amount of the company's liabilities and the name of the person or corporation to whom each liability is owed; (6) losses adjusted and due; (7) losses adjusted and not due; (8) losses adjusted; (9) losses in suspense and the reason for the suspension; (10) all other claims against the company and a description of each claim; and (11) any additional facts required by the department to be shown.