MEDICAL DEFENSE HOLDING CO
10-Q, 1997-11-13
SURETY INSURANCE
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<PAGE>
 
________________________________________________________________________________

                                 UNITED STATES
                      SECURITIES AND EXCHANGE COMMISSION
                            WASHINGTON, D.C. 20549
                                   FORM 10-Q


     QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES
EXCHANGE ACT OF 1934.

               For the quarterly period ended September 30, 1997

                        Commission file number 0-28214

                          MEDICAL DEFENSE HOLDING CO.
            (Exact name of registrant as specified in its charter)


                 Missouri                                   43-1696112
       (State or other jurisdiction                      (I.R.S. Employer
    of incorporation or organization)                  Identification No.)


1311 East Woodhurst, Springfield, Missouri                    65804
 (Address of principal executive offices)                   (Zip Code)

      (Registrant's telephone number, including area code):  (417) 887-3120

                   __________________________________________

     Indicate by check mark whether the registrant (1) has filed all reports
required to be filed by Section 13 or 15 (d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the
registrant was required to file such reports), and (2) has been subject to such
filing requirements for the past 90 days.


                  X    Yes                                      No
              --------                                 --------

     As of November 10, 1997 there were 999,998 shares of the Registrant's Class
A Common Stock, $.50 par value outstanding and there were 33,230 shares
outstanding of the Registrant's Class B Common Stock, $.50 par value.


________________________________________________________________________________
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

                         Quarterly Report - Form 10-Q

                               Table of Contents


PART I - FINANCIAL INFORMATION

<TABLE>
<CAPTION>
                                                                                            Page
                                                                                            ----
<S>                                                                                         <C>
ITEM  1. Financial Statements

Medical Defense Holding Co. Consolidated Balance Sheets as of
 September 30, 1997 and December 31, 1996 (Unaudited)                                       3, 4
Medical Defense Holding Co. Consolidated Statements of Operations
 for the quarter and nine months ended September 30, 1997 and 1996 (Unaudited)                 5
Medical Defense Holding Co. Consolidated Statements of Cash Flow
 for the nine months ended September 30, 1997 and 1996 (Unaudited)                             6
Medical Defense Holding Co. Notes to Consolidated Financial Statements
 (Unaudited)                                                                                7-17

ITEM  2.  Management's Discussion and Analysis of Financial
                Condition and Results of Operations                                        18-20



PART II - OTHER INFORMATION


ITEM  1.  Legal Proceedings                                                                   21

ITEM  2.  Changes in Securities                                                               21

ITEM  3.  Defaults Upon Senior Securities                                                     21

ITEM  4.  Submission of Matters to a Vote of Security Holders                                 21

ITEM  5.  Other Information                                                                   21

ITEM  6.  Exhibits and Reports on Form 8-K                                                    21


SIGNATURES                                                                                    22
</TABLE>

                                       2
<PAGE>

                        PART I - FINANCIAL INFORMATION

ITEM 1.  FINANCIAL STATEMENTS


                          MEDICAL DEFENSE HOLDING CO.

                          CONSOLIDATED BALANCE SHEETS
                   September 30, 1997 and December 31, 1996

                                  (Unaudited)
                                   _________


<TABLE>
<CAPTION>
                                                  September 30,      December 31,
                              ASSETS                  1997               1996
                                                  -------------      ------------
<S>                                               <C>                <C>
                                    
Investments:
  Fixed maturity investments, at market value
    (amortized cost of $76,528,599 and
    $79,151,698, respectively)                      $76,794,619       $78,789,906
  Short-term investments, at cost                     8,537,084         4,508,740
                                                    -----------       -----------
     Total investments                               85,331,703        83,298,646

Other assets:
  Cash and cash equivalents                           3,030,678         3,514,854
  Accrued investment income                             910,014         1,054,327
  Premium receivable                                  2,334,752         1,895,965
  Deferred policy acquisition costs                     113,098

  Reinsurance recoverable on loss
    and loss expenses:
    Paid claims                                                             2,798
    Unpaid claims                                     1,411,000         1,951,000

  Property and equipment, net of accumulated
    depreciation of $1,233,939 and
    $1,163,536, respectively                          1,056,516         1,117,542

  Federal income tax:
    Current                                             202,027         2,401,224
    Deferred                                          1,296,000         1,204,000

  Other assets                                          417,774           338,138
                                                    -----------       -----------

     Total assets                                   $96,103,562       $96,778,494
                                                    ===========       ===========

</TABLE>



                  The accompanying notes are an integral part
                   of the consolidated financial statements.

                                       3
<PAGE>

                          MEDICAL DEFENSE HOLDING CO.

                    CONSOLIDATED BALANCE SHEETS, CONTINUED
                   September 30, 1997 and December 31, 1996

                                  (Unaudited)
                                   _________

<TABLE>
<CAPTION>
                           LIABILITIES &                      September 30,     December 31,
                       STOCKHOLDERS' EQUITY                       1997              1996
                                                              -------------     ------------
<S>                                                           <C>               <C>

Liabilities:
  Claims and policy liabilities:
    Unpaid losses and loss adjustment expenses                  $61,541,266      $63,205,000
    Unearned premiums                                             6,703,996        7,571,534
                                                                -----------      -----------

    Total claims and policy liabilities                          68,245,262       70,776,534

Other liabilities:
  Retrospective premium due reinsurers                            1,970,047        1,970,047
  Amounts withheld or retained by Company
    for account of others                                           223,985          273,679
  Other liabilities                                               2,521,931        1,922,744
                                                                -----------      -----------

    Total liabilities                                            72,961,225       74,943,004
                                                                -----------      -----------

Stockholders' equity:
  Preferred stock, par value $1.00 per share;
    12,000,000 shares authorized; 9,202,038 and
    9,208,851 shares issued and outstanding, respectively         9,202,038        9,208,851
  Class A common stock, $0.50 per share;
    2,000,000 shares authorized; 999,998 shares
    issued and outstanding                                          499,999          499,999
  Class B common stock, $0.50 per share;
    48,000,000 shares authorized; 33,230 and 19,604
    shares issued and outstanding, respectively                      16,615            9,802
  Additional paid-in capital                                      1,668,803        1,668,803
  Unrealized gains (losses) on investments
    (net of recoverable deferred income taxes (provision)
    of $(90,881) and $122,565, respectively                         176,417         (237,920)
  Retained earnings                                              11,578,465       10,685,955
                                                                -----------      -----------

    Total stockholders' equity                                   23,142,337       21,835,490
                                                                -----------      -----------

         Total liabilities, redeemable preferred
           stock, and stockholders' equity                      $96,103,562      $96,778,494
                                                                ===========      ===========
</TABLE>


                 The accompanying notes are an integral part of
                     the consolidated financial statements.

                                       4

<PAGE>

                          MEDICAL DEFENSE HOLDING CO.

                     CONSOLIDATED STATEMENTS OF OPERATIONS

                                  (Unaudited)
                                    ________

<TABLE>
<CAPTION>
                                                                 Quarter Ended                          Nine Months Ended
                                                                 September 30,                            September 30,
                                                           1997                 1996                1997                 1996
                                                    -------------------  ------------------  -------------------  ------------------

<S>                                                 <C>                  <C>                 <C>                  <C>
Revenues:
  Premiums earned                                          $ 2,783,336         $ 3,270,672          $ 8,688,523         $ 9,704,034
  Investment income                                          1,340,868           1,366,854            3,987,970           4,223,119
  Net realized investment gains (losses)                        22,797              (3,586)              29,740              68,543
  Other income                                                      71                  96                  536                 401
                                                           -----------         -----------          -----------         -----------

     Total revenues                                          4,147,072           4,634,036           12,706,769          13,996,097
                                                           -----------         -----------          -----------         -----------

Expenses:
  Losses and loss adjustment expenses,
     net of reinsurance recoveries of $(40,000),
     $436,000, $540,000 and $436,000, respectively           3,766,912           5,774,132           10,194,156          15,219,500
  Amortization of policy acquisition costs                       6,592              65,044                6,592             182,116
  Other underwriting and insurance
     expenses                                                  446,479             510,677            1,508,060           1,633,296
  Investment expenses                                           59,017              59,105              179,968             197,182
  Other operating expenses                                      39,125              37,396              138,929              83,952
                                                           -----------         -----------          -----------         -----------

     Total expenses                                          4,318,125           6,446,354           12,027,705          17,316,046
                                                           -----------         -----------          -----------         -----------

        Income/(Loss) before provision
             for federal income taxes                         (171,053)         (1,812,318)             679,064          (3,319,949)

                                                           -----------         -----------          -----------         -----------

Provision for federal income taxes:
   Current                                                     (22,000)           (400,000)              92,000          (1,090,000)

   Deferred                                                   (191,446)            (75,298)            (305,446)            625,658
                                                           -----------         -----------          -----------         -----------

       Total tax provision/(benefit)                          (213,446)           (475,298)            (213,446)           (464,342)

                                                           -----------         -----------          -----------         -----------

            Net Income/(Loss)                              $    42,393         $(1,337,020)         $   892,510         $(2,855,607)

                                                           ===========         ===========          ===========         ===========

Earnings per common share and common
  equivalent share (Note 9):
Primary-Weighted average shares                             19,437,304          24,999,980           19,437,304          24,999,980
                                                           ===========         ===========          ===========         ===========

Net income/(loss) per common share                               $0.00              $(0.05)               $0.05              $(0.11)

                                                           ===========         ===========          ===========         ===========


</TABLE>


                 The accompanying notes are an integral part of
                     the consolidated financial statements.

                                       5
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

                      CONSOLIDATED STATEMENTS OF CASH FLOW

             for the nine months ended September 30, 1997 and 1996

                                  (Unaudited)

                                   ---------

<TABLE>
<CAPTION>
                                                                                   September 30,   September 30,                
                                                                                            1997            1996                    
                                                                                   -------------   -------------
<S>                                                                                <C>             <C>                          
Operating activities:                                                                                                           
  Net income/(loss)                                                                 $    892,510    $ (2,855,607)               
                                                                                                                                
  Adjustments to reconcile net income to net cash provided                                                                      
       by operating activities:                                                                                                 
    Realized investment gains                                                            (29,740)        (68,543)               
    Depreciation and amortization of deferred policy                                                                            
         acquisition costs                                                                86,633         246,068                
    Provision (benefit) for deferred income tax                                         (305,446)        625,658                
                                                                                                                                
  Change in assets and liabilities:                                                                                             
    Accrual and amortization of investment income                                         66,196         106,283                
    Premiums receivable from policyholders                                              (438,787)       (400,384)               
    Deferral of policy acquisition costs                                                (119,689)       (202,633)               
    Reinsurance recoverable on loss & loss expenses:                                                                            
      Paid claims                                                                          2,798         (69,355)               
      Unpaid claims                                                                      540,000         436,000                
    Unpaid losses & loss adjustment expenses                                          (1,663,734)       (350,620)               
    Unearned premiums                                                                   (867,538)        244,076                
    Amounts withheld or retained by Company on account                                                                          
         of others                                                                       (49,694)        (78,671)               
    Income tax                                                                         2,199,197      (2,140,000)               
    Other assets                                                                         (79,636)        209,581                
    Other liabilities                                                                    599,187         687,756                
                                                                                    ------------    ------------                
                                                                                                                                
        Net cash provided (used) by operating activities                                 832,257      (3,610,391)               
                                                                                    ------------    ------------                
                                                                                                                                
Investing activities:                                                                                                           
  Proceeds from:                                                                                                                
    Fixed maturity investments - Sales                                                 4,563,750       5,572,813                
    Fixed maturity investments - Maturities                                            6,733,977       4,785,684                
    Short-term investments                                                            12,050,000      16,890,844                
                                                                                                                                
  Purchase of investments:                                                                                                      
    Fixed maturity investments                                                        (8,795,898)     (7,026,093)               
    Short-term investments                                                           (15,849,247)    (16,221,208)               
    Purchases of property and equipment (net)                                            (19,015)       (137,462)               
                                                                                    ------------    ------------                
                                                                                                                                
      Net cash (used) provided by investing activities                                (1,316,433)      3,864,578                
                                                                                    ------------    ------------                
                                                                                                                                
      Net (decrease) increase in cash and cash equivalents                              (484,176)        254,187                
                                                                                                                                
Cash and cash equivalents, beginning of period                                         3,514,854       4,952,745                
                                                                                    ------------    ------------                
                                                                                                                                
Cash and cash equivalents, end of period                                            $  3,030,678    $  5,206,932                
                                                                                    ============    ============                
                                                                                                                                
Federal income taxes (refunded) paid                                                $ (2,107,197)   $  1,050,000                
                                                                                    ============    ============                 
 
 
 
 
</TABLE>
                The accompanying notes are an integral part of
                     the accompanying financial statements.


                                       6

<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

                  NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

                                  (Unaudited)

                                    --------


1.   Organization and Related Matters:
     -------------------------------- 

     Medical Defense Holding Co. (the "Company") is a Missouri general business
     corporation formed on November 28, 1994, for the purpose of facilitating
     the consummation of a series of transactions whereby Medical Defense
     Associates ("MDA") converted from a mutual assessment insurance
     organization under Chapter 383 RSMo to a wholly-owned stock insurance
     company subsidiary of the Holding Company. MDA's conversion was completed
     on June 26, 1995 in accordance with an agreement and plan of conversion
     dated November 29, 1994. The agreement and plan of conversion was approved
     by eligible policyholders at a special meeting on April 3, 1995.

     MDA was organized in 1976 as a mutual assessment insurance organization for
     the purpose of providing protection against loss from medical professional
     liability claims for Missouri health care professionals. MDA's wholly-owned
     subsidiary, Medical Defense Services Corp. ("MDS") provides management
     services primarily to MDA. Medical Defense Services Corp.'s wholly-owned
     subsidiary, Medical Defense Insurance Company ("MDIC"), is a stock
     insurance company organized under Chapter 379 RSMo for the purpose of
     providing protection against loss from medical professional liability
     claims. MDIC is licensed to operate in Missouri and Kansas but only wrote
     business in Kansas from its inception in 1982 until September 1, 1988 when
     it ceased writing business. In June of 1994, MDIC again began writing
     policies in Kansas.


2.   Basis of Presentation:
     --------------------- 

     All September 30, 1997 and 1996 information contained in the following
     footnotes is unaudited. It is management's opinion that the financial
     statements as of September 30, 1997 and 1996 and for the nine months then
     ended reflect all adjustments which are necessary to present a fair
     statement of results for the interim periods presented. The financial
     statements of MDA and its subsidiaries as of September 30, 1997 and 1996,
     have been consolidated with the Company in a manner similar to a pooling of
     interests to reflect the conversion of MDA to a wholly-owned stock
     subsidiary of the Company, effective on June 26, 1995. All significant
     intercompany transactions have been eliminated. All other adjustments made
     are of a normal recurring nature.

3.   Summary of Significant Accounting Policies:
     ------------------------------------------ 

     The following is a description of the significant accounting policies under
     generally accepted accounting principles followed by the Company in the
     preparation of the accompanying consolidated financial statements:

     A.   Pervasiveness of Estimates:
          -------------------------- 

          The preparation of consolidated financial statements in conformity
          with generally accepted accounting principles requires management to
          make estimates and assumptions that affect the reported amounts of
          assets and liabilities at the date of the consolidated financial
          statements and the reported amounts of revenues and expenses during
          the reporting period. Actual results could differ from those
          estimates.

                                       7

<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                   ---------

     B.   Recently Issued Accounting Standards:
          ------------------------------------ 

          In February 1997, the Financial Accounting Standards Board issued
          Statement of Financial Accounting Standards No. 128, "Earnings Per
          Share" ("SFAS 128"). SFAS No. 128 specifies revised computational
          guidelines, presentation and disclosure requirements for earnings per
          share and supersedes Accounting Principal Board Opinion No. 15. SFAS
          No. 128 is effective for financial statements issued for periods
          ending after December 15, 1997, including interim periods. Earlier
          application is not permitted, however, upon adoption SFAS No. 128
          requires restatement of all prior periods earnings per share
          information. The Company has not yet determined the impact SFAS No.
          128 would have on earnings per share.

          In June 1997, the Financial Accounting Standards Board issued
          Statement of Financial Accounting Standards No. 130, Reporting
          Comprehensive Income ("SFAS 130"), which is effective for fiscal years
          beginning after December 31, 1997. SFAS 130 establishes standards for
          reporting and display of comprehensive income and its components
          (revenues, expenses, gains, and losses) in a full set of general-
          purpose financial statements. The Company has not yet determined the
          effect SFAS 130 will have on the financial statements.

     C.   Investments:
          ----------- 

          Held-to-maturity debt securities that the Company has the positive
          intent and ability to hold to maturity are reported at amortized cost.
          Debt and equity securities that are bought and held principally for
          the purpose of selling them in the near term are classified as trading
          securities and are to be reported at fair value, with unrealized gains
          and losses included in earnings. Debt and equity securities not
          classified in the other two categories are classified as available-
          for-sale securities and reported at fair value, with unrealized gains
          and losses excluded from earnings and reported as a separate component
          of surplus as regards policyholders.

          The accompanying consolidated GAAP financial statements of the Company
          for the nine months ended September 30, 1997 and the year ended
          December 31, 1996 have been prepared in accordance with SFAS 115, and
          the Company has classified all investments in fixed maturities as
          available for sale. Should the Company experience declines in market
          value that are other than temporary, the difference between amortized
          cost and market would be recognized through current earnings.

          Fair value is defined as market value based on third-party quoted
          market prices or, when unavailable, on similar investments.

          Investment income includes amortization of premium and accretion of
          discount relating to fixed maturities acquired at other than par
          value.

     D.   Reinsurance:
          ----------- 

          The Company accounts for reinsurance receivables and prepaid
          reinsurance premiums as assets.

                                       8

<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                    ________


     E.     Income Taxes:
            ------------ 

        The Company recognizes deferred tax liabilities and assets based on the
        expected future tax effect of events that have been included in the
        financial statements or tax returns.

4.     Capital Stock:
       ------------- 

      The Company has issued shares of $1.00 par value redeemable convertible
      preferred stock to the eligible policyholders of MDA in exchange for their
      mutual policyholders' rights in MDA. Each share of preferred stock is
      convertible into two shares of Medical Defense Holding Co. Class B Common
      Stock, at the holder's option, and may be converted at any time prior to
      redemption. Each share of preferred stock is redeemable, at the Company's
      option, after three years from the date of issuance at a price per share
      of $1.00. The preferred stock does not provide a stated dividend and no
      dividends may be paid on any Company common stock while there are
      preferred stock shares outstanding. Subsequent to the conversion of MDA to
      a stock company, 16,615 shares of preferred stock were converted to 33,230
      shares of Class B common stock.

      The Company has issued shares of $0.50 par value Class A common stock in
      accordance with an agreement and plan of conversion dated November 29,
      1994, in exchange for cash.

5.    Investments:
      ----------- 

      The following information summarizes the difference between amortized cost
      and market value of fixed maturities investments:

<TABLE>
<CAPTION>
                                                                       Gross       Gross    Estimated
                                                       Amortized  Unrealized  Unrealized       Market
                                                            Cost       Gains      Losses        Value
                                                     -----------  ----------  ----------  -----------
<S>                                                  <C>          <C>         <C>         <C>
              September 30, 1997
- ---------------------------------------------
U.S. Treasury debt securities and obligations
     of U.S. Government corporations and
     agencies                                        $38,458,804    $300,301    $164,739  $38,594,366
Corporate debt securities                              6,145,805      71,969      13,787    6,203,987
Mortgage-backed securities                            27,902,580     247,986     184,938   27,965,628
Other debt securities                                  4,021,410      33,246      24,018    4,030,638
                                                     -----------    --------    --------  -----------

                                                     $76,528,599    $653,502    $387,482  $76,794,619
                                                     ===========    ========    ========  ===========

              December 31, 1996
- ---------------------------------------------
U.S. Treasury debt securities and obligations
     of U.S. Government corporations and
     agencies                                        $40,130,465    $207,149    $336,604  $40,001,010
Corporate debt securities                              6,371,525      78,063      37,161    6,412,427
Mortgage-backed securities                            29,829,606     188,864     434,881   29,583,589
Other debt securities                                  2,820,102      13,306      40,528    2,792,880
                                                     -----------    --------    --------  -----------

                                                     $79,151,698    $487,382    $849,174  $78,789,906
                                                     ===========    ========    ========  ===========
</TABLE>

                                       9


<PAGE>

                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                    ________


5.  Investments, continued:
    ----------------------

    The change in net unrealized holding gain or loss on available for sale
    securities, net of deferred taxes, for the nine months ended September 30,
    1997 and the year ended December 31, 1996, is as follows:

<TABLE>
<CAPTION>
                                                September 30,              December 31,
                                                         1997                      1996
<S>                                             <C>                        <C>
                                                -------------              ------------

                                                    $ 414,337              $(1,108,031)
                                                    =========              ============
</TABLE>

  The amortized cost and estimated market value of debt securities by
  contractual maturity are shown as follows:


<TABLE>
<CAPTION>
                                                                                                                  Estimated
                                                                                        Amortized                    Market
                                                                                             Cost                     Value
                                                                                      -----------               -----------
<S>                                                                                   <C>                       <C>
          September 30, 1997
- --------------------------------------

Due in one year or less                                                               $ 9,421,189               $ 9,420,738
Due after one year through five years                                                  38,972,335                39,053,617
Due after five years through ten years                                                 21,896,582                22,054,862
Due after ten years                                                                     6,238,493                 6,265,402
                                                                                      -----------               -----------

                                                                                      $76,528,599               $76,794,619
                                                                                      ===========               ===========
</TABLE>


  For purposes of the above, bonds without prepayment characteristics have been
  included at their stated maturity date.  Bonds with prepayment features are
  included at their estimated maturity date as supplied by the Company's
  investment adviser.

  Accrued investment income at September 30, 1997 and December 31, 1996, is as
  follows:

<TABLE>
<CAPTION>
                                                                                    September 30,              December 31,
                                                                                             1997                      1996
                                                                                    -------------              ------------
                                                                                    <C>                        <C>
<S>
U.S. Treasury securities                                                                 $616,229                $  726,630
Corporate bonds                                                                            91,412                   140,595
Mortgage-backed securities                                                                182,712                   174,860
Other debt securities                                                                      19,661                    12,242
                                                                                         --------                ----------

                                                                                         $910,014                $1,054,327
                                                                                         ========                ==========
</TABLE>


                                       10
<PAGE>

                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                    ________


5.  Investments, continued:
    -----------


          Securities on Deposit With Statutory Authorities:
          ------------------------------------------------

          To comply with the Missouri Department of Insurance, MDA had a U.S.
          Treasury Note with a par value of $1,400,000 as of September 30, 1997
          and December 31, 1996 on deposit with the State of Missouri. In
          addition, to comply with a special agreement with the Missouri
          Department of Insurance related to the conversion of MDA to a Chapter
          379 stock insurance company and the release of MDA members from
          potential future assessment liability, MDA had U.S. Treasury Notes
          with a total par value of $5,000,000, on deposit with the State of
          Missouri at September 30, 1997 and December 31, 1996.

          To comply with the Missouri Department of Insurance, MDIC had a U.S.
          Treasury Note with a par value of $850,000 as of September 30, 1997
          and December 31, 1996, on deposit with the State of Missouri.

          Escrow Funds:
          ------------

          Pursuant to the settlement agreement for a specific claim, MDA has
          deposited $400,000 in escrow to guarantee future annuity payments. The
          Company receives all earnings on the escrowed funds. At September 30,
          1997 and December 31, 1996, the escrowed funds were invested in a
          $400,000 par value U.S. Treasury Note with a fair value of $403,564
          and $400,876, respectively, which is included with investments on the
          balance sheet. This U.S. Treasury Note matures April 30, 2001.


    Net investment income by source was as follows for the nine months ended
    September 30, 1997 and 1996:

<TABLE>
<CAPTION>
                                                                              September 30,             September 30,
                                                                                       1997                      1996
                                                                              -------------             -------------
<S>                                                                           <C>                        <C>
    Investment income:
       Fixed maturity investments                                                $3,667,168                $3,867,877
       Short-term investments                                                       320,802                   355,242
                                                                                 ----------                ----------

         Total investment income                                                  3,987,970                 4,223,119

    Less investment expenses                                                        179,968                   197,182
                                                                                 ----------                ----------

         Net investment income                                                   $3,808,002                $4,025,937
                                                                                 ==========                ==========
</TABLE>


                                       11
<PAGE>

                          MEDICAL DEFENSE HOLDING CO.

                    NOTES TO FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                  ___________


5.   Investments, continued:
     -----------

     Realized gains on investments reflected in the results of operations for
     the nine months ended September 30, 1997 and 1996, are as follows:

<TABLE>
<CAPTION>
                                                                               September 30,     September 30,
                                                                                        1997              1996
                                                                               -------------     -------------
<S>                                                                            <C>               <C>
Sale of fixed maturity investments:
  Realized gains                                                                     $38,253           $74,849
  Realized losses                                                                     (8,513)           (6,306)
                                                                                     -------           -------

     Net realized gains                                                              $29,740           $68,543
                                                                                     =======           =======
</TABLE>

6.   Statutory Disclosures:
     ---------------------

     Net income and surplus reported by MDA separately in its reports filed or
     to be filed with the Missouri Department of Insurance utilizing statutory
     accounting principles and practices prescribed or permitted by the Missouri
     Department of Insurance are as follows:

<TABLE>
<CAPTION>
                                                                               September 30,     September 30,
                                                                                        1997              1996
                                                                               -------------     -------------
<S>                                                                            <C>               <C>
Net income/(loss) for nine months ended September 30                             $   319,691       $(2,432,703)
                                                                                 ===========       ===========
Surplus (including equity in MDS and
     MDIC), September 30                                                         $18,962,189       $21,467,433
                                                                                 ===========       ===========
</TABLE>

     Net income and surplus reported by MDIC separately in its reports filed or
     to be filed with the Missouri Department of Insurance utilizing statutory
     accounting principles and practices prescribed or permitted by the Missouri
     Department of Insurance are as follows:


<TABLE>
<CAPTION>
                                                                               September 30,     September 30,
                                                                                        1997              1996
                                                                               -------------     -------------
<S>                                                                            <C>               <C>
Net income for nine months ended September 30                                     $   44,044        $   19,242
                                                                                  ==========        ==========

Surplus, September 30                                                             $4,376,742        $4,424,799
                                                                                  ==========        ==========
</TABLE>



                                       12
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                   ________


7. Federal Income Tax:
   ------------------ 

   The Company files a consolidated federal income tax return. MDA and MDIC are
   statutorily exempt from state income taxes. State income taxes relating to
   the Company and MDS are included in other operating expenses in the
   consolidated statement of income. None of the Company's income tax filings
   are currently under examination.

   The following table accounts for the differences between the total actual tax
   provision and the amounts obtained by applying the statutory U.S. federal
   income tax rate to income before income taxes:

<TABLE>
<CAPTION>
                                                        Nine Months Ended                  Nine Months Ended
                                                       September 30, 1997                 September 30, 1996
                                                      ---------------------              ---------------------
                                                       Income     Effective                  Income  Effective
                                                        Taxes      Tax Rate                   Taxes   Tax Rate
                                                      -------     ---------               ---------  ---------
<S>                                                <C>           <C>                    <C>         <C>
Pre-tax income calculated at
  statutory tax rates                               $ 230,882         34.00%            $(1,128,783)    (34.00)%
Nondeductible expenses                                 11,674          1.72                  19,319       0.58
Other permanent differences                           (16,142)        (2.38)                 (7,608)     (0.23)
Change in valuation allowance                        (439,860)       (64.77)                652,730      19.66
                                                    ---------        ------             -----------     ------
Provision for income taxes                          $(213,446)       (31.43)%           $  (464,342)    (13.99)%
                                                    =========        ======             ===========     ======
</TABLE>

  The components of the net deferred tax asset at September 30, 1997 and
  December 31, 1996, are as follows:


<TABLE>
<CAPTION>
                                                             September 30, 1997                     December 31, 1996
                                                             ------------------                     -----------------
                                                          Deferred         Deferred              Deferred           Deferred
                                                         Tax Asset    Tax Liability             Tax Asset      Tax Liability
                                                         ---------    -------------            ----------      -------------
<S>                                                   <C>             <C>                    <C>              <C>
Tax discounting of loss reserves                       $ 4,008,245                            $ 4,069,721
Tax acceleration of unearned premium                       455,872                                514,864
Deferred policy acquisition costs                                          $ 13,946
Unrealized gain/loss                                                         90,881               122,565
                                                       -----------         --------           -----------        -----------
                                                       $ 4,464,117         $104,827           $ 4,707,150        $         -
                                                       ===========         ========           ===========        =========== 

Net deferred federal income tax asset                  $ 4,359,290                            $ 4,707,150

Valuation allowance                                     (3,063,290)                            (3,503,150)
                                                       -----------                            -----------

Net realized deferred tax asset                        $ 1,296,000                            $ 1,204,000
                                                       ===========                            ===========
</TABLE>

                
                                      13
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                    ________


7.  Federal Income Tax, continued:
    ------------------


    The valuation allowance represents the difference between the total deferred
    tax asset related to loss reserve discounting required by the Internal
    Revenue Service and the amount that is more likely than not to be realized.
    Medical malpractice is a long tail line of business. MDA's payout pattern as
    well as the industry payout pattern for this line of business is expected to
    be 15 years or longer.

    Management evaluates the payout pattern based on advice from its outside
    actuary concerning trends in claim frequencies and severities and needed
    changes in future premium rates, industry trends and experience of direct
    Missouri competitors in these matters.

    Projection of future income is inherently uncertain and the achievability of
    any projection is made more difficult by the length of the discount period.
    Historical losses cannot be adjusted precisely to future cost levels and the
    impacts of future emergence of new classes of losses or types of losses
    which may not be represented sufficiently in MDA's data base or which are
    not yet quantifiable, cannot be precisely anticipated. Utilizing an outside
    actuary, management believes that it can reasonably estimate the amount of
    the loss reserves which will likely settle in the next two years. Based on
    this estimate, management determines how much of the discount will likely
    reverse and could be recovered, if necessary, from taxes paid in the two-
    year carryback period.

    Management does not believe it can reasonably determine the amount of loss
    reserve deferred tax benefit which can be recovered from future taxable
    income arising more than three years in the future, using a more likely than
    not standard.

    The change in the valuation allowance is as follows:

<TABLE>
<CAPTION>

                                       September 30,            September 30,
                                                1997                     1996
                                       -------------            -------------
<S>                                    <C>                      <C>

                                           $(439,860)                $652,730
                                           =========                 ========
</TABLE>

                                       14
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                    ________



8.  Unpaid Losses and Loss Adjustment Expenses:
    ------------------------------------------ 


    The Company's reserves for loss and loss adjustment expenses represent the
    estimated ultimate cost of all losses and loss adjustment expenses which are
    unpaid at the balance sheet date, on a consolidated basis, for both MDA and
    MDIC.

    The reserves include estimates of future trends in claim frequency, severity
    and cash flow, which could vary as the losses are ultimately settled; thus,
    the ultimate liability may be in excess of, or less than, the amounts
    provided in the accompanying financial statement.

    Company management believes the reserves are reasonably stated to cover the
    ultimate cost of losses and related loss adjustment expenses which are
    unpaid at September 30, 1997 and December 31, 1996, respectively; however,
    as the reserves are based on estimates, there can be no assurance that the
    ultimate liability will not differ from such estimates.

    MDIC's reserves for loss and loss adjustment expenses have not been
    actuarially reviewed due to the few number of claims outstanding. MDIC's
    reserves represent less than 1% of total reserves for the periods
    represented by the financial statements.

                                       15
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                    ________



8.  Unpaid Losses and Loss Adjustment Expenses, continued:
    ------------------------------------------            

    Activity in the liability for unpaid losses and loss adjustment expenses is
    summarized as follows:


<TABLE>
<CAPTION>
                                                           September 30,       December 31,
                                                                    1997               1996
                                                           -------------       ------------
<S>                                                        <C>                 <C>
Balance at January 1                                        $63,205,000         $65,660,000
Less reinsurance recoverables                                 1,951,000           2,383,000
                                                            -----------         -----------

Net balance at January 1                                     61,254,000          63,277,000
                                                            -----------         -----------

Incurred related to:
  Current year                                               10,804,112          15,802,388
  Prior years                                                  (609,956)          4,576,958
                                                            -----------         -----------

     Total incurred                                          10,194,156          20,379,346
                                                            -----------         -----------

Paid related to:
  Current year                                                  471,188             749,388
  Prior years                                                10,846,702          21,652,958
                                                            -----------         -----------

     Total paid                                              11,317,890          22,402,346
                                                            -----------         -----------

Net balance at end of period                                 60,130,266          61,254,000
Plus reinsurance recoverables                                 1,411,000           1,951,000
                                                            -----------         -----------

Balance at end of period                                    $61,541,266         $63,205,000
                                                            ===========         ===========
</TABLE>

9.  Net Income Per Common Share:
    --------------------------- 

    Net income per common share is computed using net income divided by the
    weighted average number of common shares and common share equivalents
    outstanding. All of the Company's outstanding shares of preferred stock are
    convertible to common stock at a ratio of two shares of common stock for
    each one share of preferred stock. Since the Company's preferred stock has
    no stated dividend rate, and thus, no effective yield, these securities are
    considered common stock equivalents for the purpose of computing net income
    per common share.

                                       16
<PAGE>
 
                          MEDICAL DEFENSE HOLDING CO.

             NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, Continued

                                  (Unaudited)
                                   _________



9.  Net Income Per Common Share:
    --------------------------- 

    Other than the preferred stock discussed above, the Company does not have
    any other potentially dilutive stocks. Therefore, the computations for fully
    dilutive net income per common share are not presented since the results do
    not differ from primary net income per common share.

    Following are the net income per common share computations for the nine
    months ended September 30, 1997 and 1996:


<TABLE>
<CAPTION>
                                                                Nine Months Ended        Nine Months Ended
                                                                September 30, 1997      September 30, 1996
                                                                ------------------      ------------------
<S>                                                             <C>                     <C>
Net income (loss)                                                      $   892,510             $(2,855,607)
                                                                       ===========             ===========


Weighted average common shares outstanding                               1,033,228               1,019,602
Weighted average common stock options expressed
     as common stock equivalents                                        18,404,076              23,980,378
                                                                       -----------             -----------
Weighted average common and equivalent
     shares outstanding                                                 19,437,304              24,999,980
                                                                       ===========             ===========


Net income (loss) per common share                                     $      0.05             $     (0.11)
                                                                       ===========             ===========
</TABLE>



10.  Commitments and Contingencies:
     -----------------------------

The Company is party to a number of insurance claims arising in the normal
course of business.  While the results of litigation cannot be predicted with
certainty, management, based upon the advice of Company's counsel, believes
that the final outcome of such litigation will not have a material adverse
effect on the consolidated financial position or results of operations of the
Company.

                                       17
<PAGE>
 
               ITEM 2.  MANAGEMENT'S DISCUSSION AND ANALYSIS OF
                 FINANCIAL CONDITION AND RESULTS OF OPERATIONS
                                        
General

Medical Defense Holding Co. ("MDHC") is a Missouri general business corporation
formed for the purpose of facilitating the conversion of Medical Defense
Associates ("MDA") from a mutual insurance association to a stock insurance
company.  On June 26, 1995, the conversion was completed with the exchange of
the policyholders' rights in MDA, the mutual insurance association, for shares
of convertible Preferred Stock in MDHC, the parent holding company.  MDHC owns
all of the outstanding shares of MDA.

The accompanying consolidated financial statements and related discussion
include the accounts of MDHC and its wholly-owned insurance subsidiary, MDA, and
have been consolidated with MDHC in a manner similar to a pooling of interests
to reflect the conversion of MDA to a wholly-owned stock subsidiary of MDHC.
MDHC does not have any significant revenue producing operations of its own other
than through its ownership of MDA.  Cash flow within MDHC consists of investment
income and operating expenses.  Also included in the accompanying consolidated
financial statements are MDA's wholly-owned subsidiaries, Medical Defense
Services Corp. ("MDS") and Medical Defense Insurance Company ("MDIC").  MDS is a
wholly-owned subsidiary of MDA and provides management services primarily to
MDA.  MDIC is a wholly-owned subsidiary of MDS and is a stock insurance company
organized under Chapter 379 RSMo for the purpose of providing protection against
loss from medical professional liability claims.  During the past nine months,
MDIC has written a small amount of premium, less than $75,000, entirely in the
state of Kansas.

On August 8, 1997, MDHC initiated a tender offer for up to 5,000,000 shares of
its Preferred Stock, $1.00 par value.  The purpose of this offer was to respond
to the desires of certain shareholders for a source to liquidate all or a
portion of their securities holdings in the Company, as no public market has
developed for the Preferred Stock and MDHC does not anticipate that such a
market will develop.  This tender offer was conducted in a method commonly
referred to as a "Dutch auction".  Under a Dutch auction method, shareholders
tender the shares they wish to sell at a price within a pre-selected range and
at the close of the tender offer the company selects the lowest purchase price
which will permit it to acquire up to the pre-announced number of shares.  After
the purchase price has been selected, all tendering shares purchased by the
company are purchased at the same price, regardless of the price at which the
tendering shareholder tendered the shares.  This tender offer by MDHC, which
concluded on October 3, 1997, had a pre-selected purchase price range of not
less than $.30 or in excess of $.40 per Preferred Share in cash, subject to the
terms and conditions of the offer.  The tender offer concluded with 1,721,445
shares of Preferred Stock being accepted for purchase at a price of $.40 per
share.

Results of Operations

MDHC recorded a 10.5% decrease in total revenues in the third quarter of 1997
and a 9.2% decrease for the nine months ended September 30, 1997, compared with
the same periods in the prior year.  The decrease in total revenues during the
quarter and the nine month period ended September 30, 1997, was primarily due to
a decrease in premium revenue.  This decrease in premiums earned, which occurred
although MDA instituted a 15% overall rate increase effective January 1, 1997,
was due to a decline in premiums written during the first nine months of 1997 of
approximately $2,070,000 or 21.5% compared to the same time frame in 1996.  This
decrease in premiums written was the result of a 15.8% decline in total
policyholders which was concentrated in the higher premium surgical
classifications.  Management believes that the decline in policyholders is the
result of insureds becoming employees of health care systems that self-insure
their professional liability coverage and aggressive pricing used by some
competitors.  There can be no assurance that this trend will not continue.  The
remaining decreases were the result of various other changes in the Company's
book of business which primarily relate to specialty classifications and
discounts which policyholders are eligible to receive.

                                       18
<PAGE>
 
               ITEM 2.  MANAGEMENT'S DISCUSSION AND ANALYSIS OF
            FINANCIAL CONDITION AND RESULTS OF OPERATIONS, Continued
                                        
Results of Operations, continued

Investment income decreased less than 2% for the quarter ended September 30,
1997, and decreased by 5.6% for the nine months ended September 30, 1997,
compared to the same periods in 1996.  This variation was primarily the result
of fluctuations in market interest rates during the first nine months of 1997,
compared with the same period in 1996.  The company had realized investment
gains of $22,797 in the quarter and realized investment gains of $29,740 for the
nine month period ended September 30, 1997, compared to realized investment
losses of $3,586 and $68,543 in the same prior year periods, respectively.  The
realized investment losses for the quarter ended September 30, 1996, were the
result of pre-payments on fixed-income investments.

MDHC's total expenses for the quarter and nine month periods ended September 30,
1997, represented approximately 104% and 95% of total revenues, respectively,
compared to 139% and 124% during the same periods in 1996.  The decrease in
expenses during the first nine months of 1997, compared to the same period in
1996, is almost entirely the result of decreased claim losses and claim loss
adjustment expenses which decreased 35% for the quarter and 33% for the nine
months prior.  As the result of an increase in claims paid late in the first
quarter and during the second quarter of 1996, the Company's management retained
its independent actuary to prepare an interim reserve study as of June 30, 1996.
Based on that study and an additional study performed by another actuary, the
Company determined to strengthen its reserve for losses and loss adjustment
expenses by approximately $2.4 million as of June 30, 1996.  At September 30,
1996, as in prior years, the Company had its actuary perform an updated reserve
study and based on this study the Company recorded an additional approximate
$2.2 million increase in reserves for claim losses and claim loss adjustment
expenses.  This reserve strengthening in 1996 related primarily to total
expected ultimate losses for 1993 through 1996. Actuarial studies performed
during 1997 do not indicate additional reserve strengthening is necessary at
this time, as was the case in the prior year.  The Company will continue to
monitor the level of claim severity, and to seek input from actuaries as
appropriate.  There can be no assurance that the estimates of the actuaries will
prove to be accurate, or that the Company's reserve for loss and loss adjustment
expense is at the appropriate level.  In the event that claim severity increases
in the future, current reserve amounts may not prove to be adequate and may be
increased.  However, if claim severity decreases in the future, current reserve
amounts may prove to be adequate or redundant.

Other underwriting and insurance expenses for the quarter and nine months ended
September 30, 1997, decreased approximately 13% and 8%, respectively, compared
to the same periods in 1996.  This decrease is the result of a slight decrease
in salaries and benefits due to a small decline in the number of employees and
also, a decline in premium tax expense resulting from the decrease in written
premiums discussed earlier.  Investment expenses for the quarter and nine months
ended September 30, 1997, remained relatively stable compared to the prior
periods.

Financial Condition

MDHC's total consolidated assets were $96,103,562 as of September 30, 1997
consisting primarily of cash and investments which comprised approximately 92%
of total assets.  Approximately 81% of MDHC's total assets consisted of either
cash, U.S. Treasury bonds, U.S. government agency bonds, or other investments
either collateralized or guaranteed by U.S. government agencies or securities.
MDHC's total assets declined $674,932 or less than 1% during the nine months
ended September 30, 1997.  MDHC does not hold, either directly or indirectly,
any real estate owned for investment purposes or any fixed maturity investments
rated below AA by nationally recognized rating agencies.  MDHC's total
investment composition is not anticipated to change substantially in the near
future.

                                       19
<PAGE>
 
                ITEM 2.  MANAGEMENT'S DISCUSSION AND ANALYSIS OF
            FINANCIAL CONDITION AND RESULTS OF OPERATIONS, Continued
                                        
Financial Condition, continued

MDHC's total consolidated liabilities as of September 30, 1997, were
$72,961,225, a decline of less than 3% from December 31, 1996.  Approximately
84% of MDHC's consolidated total liabilities at September 30, 1997, relate to
unpaid loss and loss adjustment expenses which, due to loss payments exceeding
losses incurred by approximately $1,120,000, have declined 2.6% from the prior
year end.  In addition, unearned premiums declined approximately $865,000 or
11.5% from the prior year end which is the result of the decrease in premiums
written discussed earlier.

Stockholders' equity increased 6% as of September 30, 1997, compared with the
prior year-end due to an increase in the net unrealized gains on investments of
$414,337 and net income for the period of $892,510.

Liquidity and Capital Resources

MDHC's cash flow is generated from its operations and investment portfolio.  Net
cash provided by operating activities at September 30, 1997, increased by
$4,442,648, to $832,257, compared to cash used of $3,610,391 at September 30,
1996, to an increase in cash provided by operating activities of $832,257 at
September 30, 1997.  This increase in cash provided by operating activities was
primarily a combination of a decrease in claim loss and loss adjustment expense
payments of approximately $3.8 million and an increase in the net effect of
current and deferred taxes of approximately $3.4 million for the nine months
ended September 30, 1997, compared to the same period in 1996.  These increases
were partially offset by a decline in premiums written of approximately $2.1
million and other various changes of approximately $0.6 million, when compared
to the same periods in 1996.

MDHC's investing activities resulted in a net decrease in cash used by investing
activities of $1,316,433 at September 30, 1997, compared to an increase in cash
provided by investing activities of $3,864,578 for the same period in 1996.
This decrease was due to the utilization of proceeds from operating activities
for the acquisition of new fixed-maturity investments and short-term
investments.

MDHC's cash flow from operations and its investment portfolio are utilized to
meet its obligations related to payment of losses and loss adjustment expenses,
payment of operating expenses, and other needs as deemed necessary from time to
time.  MDHC anticipates that its future cash flow will be sufficient to meet the
Company's ongoing obligations for the foreseeable future.

In February 1997, the Financial Accounting Standards Board issued Statement of
Financial Accounting Standards No. 128, "Earnings Per Share" ("SFAS 128").  SFAS
No. 128 specifies revised computational guidelines, presentation and disclosure
requirements for earnings per share and supersedes Accounting Principal Board
Opinion No. 15.  SFAS No. 128 is effective for financial statements issued for
periods ending after December 15, 1997, including interim periods.  Earlier
application is not permitted, however, upon adoption SFAS No. 128 requires
restatement of all prior periods earnings per share information.  The Company
has not yet determined the impact SFAS No. 128 would have on earnings per share.

In June 1997, the Financial Accounting Standards Board issued Statement of
Financial Accounting Standards No. 130, Reporting Comprehensive Income ("SFAS
130"), which is effective for fiscal years beginning after December 31, 1997.
SFAS 130 establishes standards for reporting and display of comprehensive income
and its components (revenues, expenses, gains, and losses) in a full set of
general-purpose financial statements.  The Company has not yet determined the
effect SFAS 130 will have on the financial statements.

                                       20
<PAGE>
 
                          PART II - OTHER INFORMATION


Item 1.   Legal Proceedings.
  None.

Item 2.   Changes in Securities.
  None.

Item 3.   Defaults Upon Senior Securities.
  None.

Item 4.   Submission of Matters to a Vote of Security Holders.
  None.

Item 5.   Other Information.
  None.

Item 6.   Exhibits and Reports on Form 8-K.
  (a)  Exhibits.
       The exhibits to this report are listed in the Exhibit Index on pages E-1
       and E-2 of this report, which index is incorporated herein by reference.

  (b)  Reports on Form 8-K.
       None.

                                      21
<PAGE>
 
                                   SIGNATURES


Pursuant to the requirements of the Securities Exchange Act of 1934, the
registrant has duly caused this report to be signed on its behalf by the
undersigned thereunto duly authorized.


<TABLE>
<CAPTION>
                                                                              Medical Defense Holding Co.
                                                                                      (Registrant)
 
 
        November 10, 1997                                                     /s/ Ronald G. Benson
- ----------------------------------                          -------------------------------------------------------------
               Date                                                               Ronald G. Benson
<S>                                                           <C>
                                                                             President, CEO, and Chairman
                                                                                of the Board (principal
                                                                             executive officer); Director
 
 
 
       November 10, 1997                                                       /s/ Samuel J. Pippin
- ----------------------------------                          -------------------------------------------------------------
             Date                                                                  Samuel J. Pippin
                                                                              Director of Accounting and
                                                                             Finance (principal financial
                                                                                and accounting officer)
 
</TABLE>

                                      22
<PAGE>
 
                                 EXHIBIT INDEX
<TABLE>
<CAPTION>
 
Exhibit                                                                                                               Page
  No.                                                 Description                                                      No.
- -------                                               -----------                                                     ----         
 
<S>            <C>                                                                                                  <C>
  3.1        --Articles of Incorporation of Medical Defense Holding Co. (Filed as Exhibit 3.1 to the
               Registrant's Registration Statement on Form S-1 (file #33-87444) and hereby incorporated
               by reference.)............................................................................
 
  3.2        --Bylaws of Medical Defense Holding Co. (Filed as Exhibit 3.2 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
  4.1        --Right of First Refusal Agreement (Filed as Exhibit 4.1 to the Registrant's Registration
               Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.).............
 
  4.2        --Specimen Stock Certificate for Preferred Stock (Filed as Exhibit 4.2 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
  4.3        --Specimen Stock Certificate for Class A Common Stock (Filed as Exhibit 4.3 to the
               Registrant's Registration Statement on Form S-1 (file #33-87444) and hereby incorporated
               by reference.)............................................................................
 
  4.4        --Specimen Stock Certificate for Class B Common Stock (Filed as Exhibit 4.4 to the
               Registrant's Registration Statement on Form S-1 (file #33-87444) and hereby incorporated
               by reference.)............................................................................
 
  10.1       --1983 Management Agreement between Medical Defense Associates and Medical Defense Services
               Corp., as amended (Filed as Exhibit 10.1 to the Registrant's Registration Statement on
               Form S-1 (file #33-87444) and hereby incorporated by reference.)..........................
 
  10.2       --1983 Management Agreement between Medical Defense Insurance Company and Medical Defense
               Services Corp., as amended (Filed as Exhibit 10.2 to the Registrant's Registration
               Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.).............
 
  10.3       --Amended and Restated Employment Agreement between Ronald G. Benson and Medical Defense
               Services Corp., dated January 1, 1993 (Filed as Exhibit 10.3 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
  10.4       --Amended and Restated Employment Agreement between Geraldine Hatfield (Morrison) and
               Medical Defense Services Corp., dated January 1, 1993 (Filed as Exhibit 10.4 to the
               Registrant's Registration Statement on Form S-1 (file #33-87444) and hereby incorporated
               by reference.)............................................................................

  10.5       --Amended and Restated Employment Agreement between Arlen D. Winsky and Medical Defense
               Services Corp., dated January 1, 1993 (Filed as Exhibit 10.5 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
</TABLE>
                                      E-1
<PAGE>
 
<TABLE>
<CAPTION>
 
Exhibit                                                                                                               Page
  No.                                                 Description                                                      No.
- -------                                               -----------                                                     ----       
<S>            <C>                                                                                                  <C>
  10.6       --Amended and Restated Employment Agreement between David W. Brown and Medical Defense
               Services Corp., dated January 1, 1993 (Filed as Exhibit 10.6 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
  10.7       --Amended and Restated Employment Agreement between Gary L. Robinson and Medical Defense
               Services Corp., dated January 1, 1993 (Filed as Exhibit 10.7 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
  10.8       --Amended and Restated Employment Agreement between John J. Stamatis and Medical Defense
               Services Corp., dated January 1, 1993 (Filed as Exhibit 10.8 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
  10.9       --Medical Defense Services Corp. Integrated Money Purchase Pension and Trust Agreement,
               between, Medical Defense Services Corp. and Boatmen's Trust Company, as amended, dated
               December 31, 1990 (Filed as Exhibit 10.9 to the Registrant's Registration Statement on
               Form S-1 (file #33-87444) and hereby incorporated by reference.)..........................
 
 10.10       --Carnahan, Evans, Cantwell & Brown, P.C. Defined Contribution Prototype Plan and Trust
               Agreement, adopted December 31, 1990 (Filed as Exhibit 10.10 to the Registrant's
               Registration Statement on Form S-1 (file #33-87444) and hereby incorporated by reference.)
 
 10.11       --Medical Defense Services Corp. Executive Compensation Plan, dated October 15, 1993 (Filed
               as Exhibit 10.11 to the Registrant's Registration Statement on Form S-1 (file #33-87444)
               and hereby incorporated by reference.)....................................................
 
 10.12       --Form of Deposit Agreement between Medical Defense Associates and Central Bank, Jefferson
               City, Missouri (Filed as Exhibit 10.12 to the Registrant's Registration Statement on Form
               S-1 (file #33-87444) and hereby incorporated by reference.)...............................

 10.13       --Form of Employment Guaranty Agreement by Medical Defense Holding Co. guaranteeing
               existing Medical Defense Services Corp.'s employment agreements (Filed as Exhibit 10.13
               to the Registrant's 1995 Annual Report on Form 10K (file #33-87444) and hereby
               incorporated by reference.)...............................................................
 
  11.1       --Statement re computation of per share earnings (Disclosed in Note 9 to the Registrant's
               accompanying unaudited consolidated financial statements included in Part I of this form
               10Q)......................................................................................
 
  21.1       --Subsidiaries of the registrant (Filed as Exhibit 21.1 to the Registrant's 1996 Annual
               Report on Form 10K and hereby incorporated by reference.).................................
 
  28.1       --Information from reports furnished to state insurance regulatory authorities(Filed as
               Exhibit 28.1 to the Registrant's 1996 Annual Report on Form 10K and hereby incorporated
               by reference.)............................................................................
</TABLE>

                                      E-2
                                        

<TABLE> <S> <C>

<PAGE>
 
<ARTICLE> 7
<LEGEND> This schedule contains summary financial information extracted from 
the Company's financial statements for the nine months ended September 30, 1997
and is qualified in its entirety by reference to such financial statements. 
</LEGEND>
       
<S>                             <C>
<PERIOD-TYPE>                   9-MOS
<FISCAL-YEAR-END>                          DEC-31-1997
<PERIOD-START>                             JAN-01-1997
<PERIOD-END>                               SEP-30-1997
<DEBT-HELD-FOR-SALE>                        76,794,619
<DEBT-CARRYING-VALUE>                                0
<DEBT-MARKET-VALUE>                                  0
<EQUITIES>                                           0
<MORTGAGE>                                           0
<REAL-ESTATE>                                        0
<TOTAL-INVEST>                              85,331,703
<CASH>                                       3,030,678
<RECOVER-REINSURE>                           1,411,000
<DEFERRED-ACQUISITION>                         113,098
<TOTAL-ASSETS>                              96,103,562
<POLICY-LOSSES>                             61,541,266
<UNEARNED-PREMIUMS>                          6,703,996
<POLICY-OTHER>                                       0
<POLICY-HOLDER-FUNDS>                          223,985
<NOTES-PAYABLE>                                      0
<COMMON>                                       516,614
                                0
                                  9,202,038
<OTHER-SE>                                  13,423,685
<TOTAL-LIABILITY-AND-EQUITY>                96,103,562
                                   8,688,523
<INVESTMENT-INCOME>                          3,987,970
<INVESTMENT-GAINS>                              29,740
<OTHER-INCOME>                                     536
<BENEFITS>                                  10,194,156
<UNDERWRITING-AMORTIZATION>                      6,592
<UNDERWRITING-OTHER>                         1,508,060
<INCOME-PRETAX>                                679,064
<INCOME-TAX>                                 (213,446)
<INCOME-CONTINUING>                            892,510
<DISCONTINUED>                                       0
<EXTRAORDINARY>                                      0
<CHANGES>                                            0
<NET-INCOME>                                   892,510
<EPS-PRIMARY>                                      .05
<EPS-DILUTED>                                      .05
<RESERVE-OPEN>                              63,205,000
<PROVISION-CURRENT>                         10,804,112
<PROVISION-PRIOR>                            (609,956)
<PAYMENTS-CURRENT>                             471,188
<PAYMENTS-PRIOR>                            10,846,702
<RESERVE-CLOSE>                             61,541,266
<CUMULATIVE-DEFICIENCY>                      (609,956)
        

</TABLE>


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