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American Modern Home Insurance

INDIANADEPARTMENTOFINSURANCE

311W.WashingtonSt.,Suite300

Indianapolis, IN46204-2787

Non-LIFE-STATEMENTOFCONDITION

Onthe31stdayofDecember, 2016

COMPANYNAME:American Modern Home Insurance Company

ADDRESS:PO Box 5323

CITY, STATEZIPCODE:Cincinnati, OH 45201

ORGANIZEDUNDERSTATEOFOhio FEIN: 31-0715697 NAIC CODE: 23469

CONTACTPERSON: Michael Haines  PHONE: (513) 947-5698

EMAIL: MHaines@amig.com

ASSETS OF COMPANY

(Nearest dollar)

Bonds (Schedule D)............................................................ $255,983,051

Stocks Schedule D)............................................................. $195,421,924

Mortgage Loans on Real Estate (Schedule B)...................................... $0

Real Estate (Schedule A)...................................................... $57,543,914

Cash & Short Term Investments (Schedule DA & E).............. $-1,700,496

Agents Balances or Uncollected Premiums........................ $142,974,001

Other assets....................................................................... $464,925,003

                                TOTAL ASSETS.................................. $1,115,147,397

LIABILITIES, SURPLUS AND OTHER FUNDS

Reserve for Losses................................................................ $73,137,674

Reserve for Loss Adjustment Expenses.................................. $6,894,029

Reserve for Unearned Premiums........................................ $153,166,941

Reserve for Taxes................................................................. $11,490,382

All Other Liabilities............................................................. $463,563,539

                                TOTAL LIABILITIES............................... $708,252,565

Special Surplus Funds................................................... $0

Capital Stock................................................... $5,000,000

Gross Paid in and Contributed Surplus....... $103,771,315

Unassigned Surplus.................................... $298,123,517

                Surplus as regards Policyholders........................ $406,894,832

                                TOTAL LIABILITIES AND SURPLUS...... $1,115,147,397

                      Andreas Kleiner                        Charles S. Griffith III

                       (Print Name)                             (Print Name)

                            CEO                                    Secretary

State Form 1143 (R/10-87)

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