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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 2)*
Medical Assurance, Inc.
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(Name of Issuer)
Common Stock, $1.00 par value per share
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(Title of Class of Securities)
58449U 10.0
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(CUSIP Number)
Check the following box if a fee is being paid with this statement [ ]. (A fee
is not required only if the filing person: (1) has a previous statement on file
reporting beneficial ownership of more than five percent of the class of
securities described in Item I; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7).
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other promotions of the Act (however, see the
Notes).
Page 1 of 8 pages
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CUSIP NO. 58449 U 10 O 13G PAGE 2 OF 5 PAGES
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(1) NAMES OF REPORTING PERSON
I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
A. Derrill Crowe
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(2) CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ]
(b) [ ]
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(3) SEC USE ONLY
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(4) CITIZENSHIP OR PLACE OR ORGANIZATION
United States
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(5) SOLE VOTING POWER
NUMBER OF 2,404,452
SHARES --------------------------------------------------------
BENEFICIALLY (6) SHARED VOTING POWER
OWNED BY
EACH --------------------------------------------------------
REPORTING (7) SOLE DISPOSITIVE POWER
PERSON WITH 2,404,452
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(8) SHARED DISPOSITIVE POWER
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(9) AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
2,404,452
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(10) CHECK BOX IF AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES*
See Item 4
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(11) PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
9.7%
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(12) TYPE OF REPORTING PERSON*
IN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
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AMENDMENT NO. 2
SCHEDULE 13G
FILED WITH THE
SECURITIES AND EXCHANGE COMMISSION
ON BEHALF OF
A. DERRILL CROWE, M.D.
Item 1(a) Name of Issuer:
Medical Assurance, Inc. (Formerly MAIC Holdings, Inc.)
The reporting person originally filed a Schedule 13G with respect to Mutual
Assurance, Inc. (Cusip No. 62823T 10 1) on February 14, 1992, as amended
February 15, 1994. On August 31, 1995, MAIC Holdings, Inc. became the successor
registrant to Mutual Assurance, Inc. Pursuant to Rule 12g-3 of the SEC. On
September 23, 1996, MAIC Holdings, Inc. registered its common stock under
Section 12(b) of the Securities Exchange Act of 1934 upon listing its common
stock on the New York Stock Exchange (CUSIP No. 55261 V 10 9). Effective
June 1, 1997, MAIC Holdings changed its name to Medical Assurance, Inc.
(CUSIP No. 59449 U 10 0).
Item 1(b) Address of Issuer's Principal Executive Offices:
100 Brookwood Place
Birmingham, AL 35209
Item 2(a) Name of Person Filing:
A. Derrill Crowe, M.D.
Item 2(b) Address of Principal Business Office:
Medical Assurance, Inc.
100 Brookwood Place
Birmingham, AL 35209
Item 2(c) Citizenship
United States of America
Item 2(d) Title of Class of Securities:
Common Stock, $1.00 par value per share
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Item 2(e) CUSP NUMBER
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58449U 10 0
Item 3
Not Applicable
Item 4 Ownership:
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(a) Amount Beneficially Owned:*
2,404,452 shares
(b) Percent of Class:*
9.7%
(c) Number of Shares as to which such Person has:*
(i) Sole power to vote or to direct the vote:
2,404,452 shares
(ii) Shared power to vote or to direct the vote:
None
(iii) Sole power to dispose or to direct the disposition of:
2,404,452 shares
(iv) Shared power to dispose or to direct the disposition of
None
*Includes shares distributed as a result of stock dividends declared in 1993,
1994, 1995, 1996, 1997 and 1998, and the two-for-one-stock split in 1997. Also
includes stock dividend declared in 1999 for distribution in February, 2000.
Does not include 11,183 shares held for the account of Dr. Crowe in the Medical
Assurance, Inc. Pension Plan and 1,224 shares owned of record by his spouse.
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Item 5 Ownership of Five Percent or Less of a Class
Not applicable
Item 6 Ownership of More Than Five Percent on Behalf of Another Person
Not applicable
Item 7 Identification and Classification of the Subsidiary Which Acquired
the Securities Being Reported On By the Parent Holding Company
Not applicable
Item 8 Identification and Classification of Members of the Group
Not applicable
Item 9 Notice of Dissolution Group
Not applicable
Item 10 Certification
Not applicable
SIGNATURES
After reasonable inquiry and to the best of my knowledge and belief,
I certify that the information set forth in this statement is true, complete
and correct.
February 11, 2000
/s/ A. Derrill Crowe
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A. Derrill Crowe
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