TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS

SUBPART A: COST CONTAINMENT REPORTING

Section 4203.10 Applicability

Section 4203.20 Purpose and Scope

Section 4203.30 Data Collection Procedures

Section 4203.40 General Submission Guidelines

Section 4203.50 Required Data Types (Lines, Classes, and Coverages)

Section 4203.60 Line Item Matrix For Cost Containment Reporting

Section 4203.70 Coding Conventions for Other Liability/Excess Insurance, Medical Malpractice, Earthquake, Commercial Auto Liability, and Business Owners Packages

Section 4203.80 Coding Conventions for Homeowner and Residential Fire Insurance

Section 4203.90 Coding Conventions for Private Passenger Auto Liability Insurance (Excluding PIP)

Section 4203.100 Coding Conventions for Private Passenger Auto Physical Damage

Section 4203.110 Record Layout for the Four Formats

SUBPART B: MEDICAL MALPRACTICE REPORTING

Section 4203.200 Applicability

Section 4203.210 Purpose and Scope

Section 4203.220 Definitions

Section 4203.230 Reports

SUBPART C: MARKET SURVEY FOR OCCURRENCE INSURANCE COVERAGE OF STATE RESPONSE ACTION CONTRACTORS

Section 4203.300 Purpose (Repealed)

Section 4203.310 Declaration (Repealed)

Section 4203.APPENDIX A Filing Requirements for Medical Malpractice Reporting

Section 4203.APPENDIX A Filing Requirements for Medical Malpractice Reporting

Section 4203.APPENDIX B Guidelines for Submission of Medical Malpractice Reporting (Repealed)

SUBPART A: COST CONTAINMENT REPORTING

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.10 APPLICABILITY


 

Section 4203.10  Applicability

 

This Part applies to each company licensed to write property or casualty insurance in this State pursuant to Section 4, Class 2 (a)-(l) and Class 3 (a)-(i) of the Illinois Insurance Code (Code) [215 ILCS 5]. These procedures apply to all direct property and liability business written by insurers licensed by the State of Illinois.  The data filings are not to include premiums received from, or losses paid to, other insurers because of the reinsurance assumed by the reporting insurers; nor shall any deductions be made by the reporting insurers for premiums ceded to, or for losses recovered from, other insurers because of the reinsurance ceded.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.20 PURPOSE AND SCOPE


 

Section 4203.20  Purpose and Scope

 

The purpose of this Part is to establish content, form and data reporting requirements for information required to be reported to the Director of the Illinois Department of Insurance (Director) pursuant to Section 1204(A) through (D) of the Code.  This Part also provides for the collection of data required to implement Article XXXIII of the Code. In addition, this Part establishes the medium for this information to be transmitted to the Director.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.30 DATA COLLECTION PROCEDURES


 

Section 4203.30  Data Collection Procedures

 

a)         Scope of Procedure

Each insurer shall report its business written separately for Illinois and multi-state (including Illinois) for each line, subline, or class, or endorsement specified by this Part.  Where zip code reporting is required, each line, subline, class or endorsement shall be reported separately for each zip code.  Only data for the voluntary market will be reported.

 

b)         Methods of Compiling Annual Experience

All data contained in this data call shall be submitted on a calendar year basis.  For the calendar year experience method, the insurer or agent will report evaluations as of December 31.  Data will be reported for the current year minus one year.  (For example, the 2017 report will contain data for 2016, evaluated as of December 31, 2016, the latest complete, calendar year experience year.)

 

c)         Experience Method By Line

In reporting the required data, please note the following clarifications:

 

1)         The "Other Liability" line includes classes from liquor liability, day care centers, and lawyers professional liability, and excess/umbrella coverage.

 

2)         Data from Beach Plans and Assigned Risk Plans will not be reported.  (The Illinois FAIR Plan Association will submit Illinois-only data for homeowners.)  Insurers will not report any FAIR Plan data.

 

d)         Preparation and Completion of Statistical Reports

 

1)         Insurers may report statistics directly, or through an agent.  Agents reporting data for more than one insurer will report each insurer's data on separate records.

 

2)         Insurers will report their data within the required time frame using the codes and record formats provided in Sections 4203.50 through 4203.110.

 

3)         Exemption requests:

 

A)        All companies requesting exemption from data submission requirements must notify the Department prior to each filing date.  The notice must contain the following information:

 

i)          Name of company or agent;

 

ii)         FEIN (not applicable to agents);

 

iii)        NAIC group and company number (not applicable to agents);

 

iv)        Filing date (e.g., 11/25/06);

 

v)         Address, City, State and Zip code;

 

vi)        Contact person;

 

vii)       Phone number of contact person;

 

viii)      Email address for contact person; and

 

ix)        Reason for exemption.

 

B)        All data for each line of business must be submitted as a complete submission.  In the event data is resubmitted, all data previously submitted for that line of business by that insurer will be deleted and replaced by the resubmitted data.

 

C)        Insurers need not submit a record (for either Illinois only or multi-state) for any line, class, or endorsement if written premiums, earned premiums, and paid and outstanding losses in the Illinois-only data are all zeroes.

 

e)         Reporting of Exposures

A count of the number of written exposures will be reported separately for each line, type of business and classification.  Section 4203.50 provides the exposure basis for each. 

 

f)         Reporting of Premiums

The premium reported will be the premium charged for the policies within each classification.  Excess insurance premiums will be reported separately as addressed in subsection (o).  Premiums will be reported on both a written and earned basis.

 

g)         Reporting of Losses

Separate fields are provided for both paid losses and outstanding losses.  Losses will be reported net as to third party recoveries (under salvage and subrogation).  Paid losses are defined as all sums paid to claimants or policyholders in direct settlement of losses covered by the policies.  Outstanding losses are defined as the amounts of loss reserves established for paying claims for the reporting period that have not been paid as of the evaluation date. Losses covered by an excess policy will be reported separately as addressed in subsection (p).

 

h)         Reporting of Allocated Loss Adjustment Expenses

Allocated loss adjustment expense (ALAE) includes all expenses of the company which can be identified with and hence allocated to a particular claim.  Insurers will report the amount of paid and outstanding ALAE for the private passenger auto liability, medical malpractice, other liability and commercial auto liability lines. Also, ALAE will be collected for business owners insurance and excess insurance.  In those situations where an insurer cannot separate indemnity and ALAE, the insurer will submit a separate record; however, the insurer will enter the combined loss and ALAE total in the paid loss or outstanding loss fields and will identify this option by coding the corresponding paid ALAE or outstanding ALAE fields with the word "combined".

 

i)          Reporting Paid Claims Count

Insurers will report the count of their paid claims. A claim closed without a loss payment is not to be reported.  A claim involving only allocated loss adjustment expense is not to be reported with a claim count.  A claim count is to be reported only for those cases where a loss payment has been made or a loss reserve has been established.  A paid claim is defined as a claim for which a payment has been made. In cases where a claim is partially paid with an associated case reserve still maintained, insurers have the option to report the claim count as either paid or outstanding.  A case involving loss payments or loss reserves under more than one classification will have a claim count under each classification.

 

j)          Reporting Outstanding Claims Count

Insurers will report the count of outstanding claims. An outstanding claim is defined as a claim for which a case loss reserve exists as of the evaluation date.  In cases where a claim is partially paid with an associated case reserve still maintained, insurers have the option to report the claim count as either paid or outstanding.  A case involving loss payments or loss reserves under more than one classification will have a claim count under each classification.

 

k)         Run-off Business

Companies with no written or earned premiums, but with paid or outstanding losses in a line, class, subclass, or endorsement for Illinois-only data must report data for that line, class, subclass, or endorsement for both Illinois-only and multi-state.  If the aforementioned situation occurs in only the multi-state data, the insurer will not be required to report that data.

 

l)          All Prepaid Policies

Premiums for all policies not having a one-year term shall be reported using a pro rata allocation formula.  In all cases policy periods shall be annual or less.

 

m)        Treatment of Installment Payments

All premiums for policies written on an installment basis will be reported as though they were prepaid policies.

 

n)         Rounding Rule

Data will be reported in whole numbers. All decimals will be rounded to the nearest integer.  (Decimals less than .5 will be rounded down to the nearest whole number while decimals .5 and above will be rounded up to the nearest whole number.)

 

o)         Reporting Excess Insurance Premiums

Written and earned premiums for excess insurance will be entered in the appropriate fields for this type class.  (See Section 4203.70.) Premiums for excess insurance are defined as that premium charged for coverage in excess of the primary policy limits added by a different policy (e.g., umbrella policy or through an endorsement to the policy).

 

p)         Reporting Excess Insurance Losses

Paid losses and outstanding losses for excess insurance will be entered in the appropriate fields for this class.  (See Section 4203.70.)  An excess loss is defined as a loss resulting in an incurred cost to the insurer in excess of the primary policy limits and covered by a different policy or an endorsement to the policy.  Examples include umbrella policies and excess limits endorsements.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.40 GENERAL SUBMISSION GUIDELINES


 

Section 4203.40  General Submission Guidelines

 

a)         Guidelines for Data Submission and Collection

Data must be submitted electronically to the Illinois Department of Insurance no later than November 30 of each year.

 

b)         Penalties

Failure to comply with any of these specifications may subject the insurer to those penalties described in Section 1204 of the Code.

 

c)         Leading Zeros

Since fields are not fixed-length, leading zeros and spaces should be omitted.

 

d)         Negative Numbers

Negative numbers will be submitted as a dash before the number (without a space between the negative and number).  For example a negative one hundred dollar premium would be coded -100.

 

e)         Data Reported by Illinois and Multi-State

All required data will be reported in the aggregate for:

 

1)         Illinois only; and

 

2)         multi-state, including Illinois.

 

f)         Required Data Elements

Data shall be reported for the following nine insurance elements:

 

1)         Number of written exposures;

 

2)         Amount of direct written premiums;

 

3)         Amount of direct earned premiums;

 

4)         Amount of paid losses;

 

5)         Amount of outstanding losses;

 

6)         Amount of paid allocated loss adjustment expenses;

 

7)         Amount of outstanding allocated loss adjustment expenses;

 

8)         Number of paid claims; and

 

9)         Number of outstanding claims.

 

g)         Required Lines or Coverages of Insurance

The Department requires that data be submitted for classes within the following 9 lines or coverage types of insurance.

 

Coverage Type

Line of business

Residential Fire

01.0

Homeowners Multiple Peril

04.0

Business Owners Packages

05.0

Medical Malpractice

11.0

Earthquake

12.0

Other Liability

17.0

Private Passenger Automobile Liability

19.2

Commercial Automobile Liability

19.4

Private Passenger Automobile Physical Damage

21.1

 

h)         Reported by Zip Code

All Illinois data reported for line 01.0, 04.0, 19.2 and 21.1 must be reported by zip code.  All other data within the data call is to be reported on a statewide basis.

 

i)          Reported by Form Type

There will be a separate record for each line, class, or type of coverage for each form type used in writing a policy.  Note that an insurer may use any one or more of the form types within the same line or class of insurance.  When multiple form types are used the insurer must generate a record for each of those form types.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.50 REQUIRED DATA TYPES (LINES, CLASSES, AND COVERAGES)


 

Section 4203.50  Required Data Types (Lines, Classes, and Coverages)

 

Within the required lines of insurance identified in Section 4203.40(g), the Department requires data for specified lines, classes or coverages. There are 9 categories contained in the following table that summarize the data that must be filed in Illinois pursuant to this Part.

 

OTHER LIABILITY

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

DAY CARE CENTERS

 

 

 

 

Day care center liability – day nurseries

 

82115

 

square feet

Day care center liability – day care centers

 

41714

 

person-months

Day care center liability individual insurer program not rated using one of the exposure bases noted above.1

 

81714

 

NA

LAWYERS PROFESSIONAL LIABILITY

 

 

 

 

Lawyers professional liability – lawyers

 

81400

 

person-months

Lawyers professional liability – employed law clerks, investigators, abstractors, and paralegals

 

81420

 

person-months

Lawyer's professional liability individual insurance program not rated using one of the exposure bases noted above.2

 

81401

 

NA

LIQUOR LIABILITY

 

 

 

 

Clubs

 

70412

 

receipts

Package stores, and other retail establishments

 

59211

 

receipts

Manufacturers, wholesalers, and distributors

 

50911

 

receipts

Restaurants, taverns, hotels, motels incl:  package sales

 

58161

 

receipts

Temporary licenses

 

58168

 

NA

Owners or lessors of premises used by others

 

58169

 

NA

Liquor liability – not otherwise classified

 

11111

 

NA

Liquor liability individual insurer programs not rated using one of the exposure bases noted above.1

 

81111

 

NA

 

EXCESS INSURANCE

 

 

Commercial Automobile

9772

NA

Personal Umbrella

99930

NA

Commercial Umbrella

99935

NA

Excess Insurance – All Other

88888

NA

OTHER

 

 

All other coverage contained in line 17.1 and 17.2 of the company's state page exhibit for the filing year

OTHR

NA

 

Table:

 

1    Individual insurer programs that are not rated using one of the exposure bases above with this specified class definition will be reported as classification codes 81111 and 81714, respectively.

 

2    Individual insurer programs that are not rated using one of the exposure bases noted above with this specified class definition will be reported as classification code 81401.

 

 

MEDICAL MALPRACTICE

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

MD1

 

DO2

CARDIAC SURGERY

 

 

 

 

 

 

Surgery – cardiac

 

80141

 

NA

 

person-months

Surgery – cardiovascular disease

 

80150

 

84150

 

person-months

CARDIAC – OTHER

 

 

 

 

 

 

Cardiovascular disease – minor surgery

 

80281

 

84281

 

person-months

Cardiovascular disease – no surgery

 

80255

 

84255

 

person-months

CRITICAL CARE MEDICINE

 

 

 

 

 

 

Intensive care medicine. Applies to any general practitioner or specialist employed in intensive care hospital unit

 

80283

 

84283

 

person-months

DENTISTS

 

 

 

 

 

 

Oral surgery with anesthesia

 

80210

 

NA

 

person-months

Oral surgery without anesthesia

 

80211

 

NA

 

person-months

EMERGENCY ROOM SURGERY

 

 

 

 

 

 

Emergency medicine – including major surgery

 

80157

 

84157

 

person-months

EMERGENCY ROOM – OTHER

 

 

 

 

 

 

Emergency room – no major surgery

 

80102

 

84102

 

person-months

GENERAL PRACTITIONER (FAMILY PRACTICE)

 

 

 

 

 

 

Family physician or general practitioner – no surgery

 

80420

 

84420

 

person-months

Family physician or general practitioner – minor surgery

 

80421

 

84421

 

person-months

Surgery – general practice or family practice

 

80117

 

NA

 

person-months

GENERAL SURGERY

 

 

 

 

 

 

Surgery – general – not otherwise classified. Does not apply to family or general practitioner or to any specialist who occasionally performs major surgery.

 

80143

 

84143

 

person-months

NEUROSURGERY

 

 

 

 

 

 

Surgery – neurology – including child

 

80152

 

84152

 

person-months

Neurology – including child – minor surgery

 

80288

 

84288

 

person-months

OBSTETRICS/GYNECOLOGY – SURGERY

 

 

 

 

 

 

Surgery – gynecology

 

80167

 

84167

 

person-months

Surgery – obstetrics

 

80168

 

NA

 

person-months

Surgery – obstetrics – gynecology

 

80153

 

84153

 

person-months

OBSTETRICS/GYNECOLOGY – OTHER

 

 

 

 

 

 

Gynecology – minor surgery

 

80277

 

84277

 

person-months

Gynecology – no surgery

 

80244

 

84244

 

person-months

ORTHOPEDIC SURGERY

 

 

 

 

 

 

Surgery – orthopedic

 

80154

 

84154

 

person-months

PHYSICIANS, SURGEONS, AND DENTISTS

 

 

 

 

 

 

Physicians, Surgeons, and Dentists not otherwise classified

 

94999

 

94999

 

person-months

Physicians, Surgeons, and Dentists individual programs not rated using one of the exposure bases noted above

 

90430

 

NA

 

person-months

PLASTIC SURGERY

 

 

 

 

 

 

Surgery – plastic – not otherwise classified

 

80156

 

84156

 

person-months

Surgery – plastic – otorhinolaryngology

 

80155

 

84155

 

person-months

THORACIC SURGERY

 

 

 

 

 

 

Surgery – thoracic

 

80144

 

84144

 

person-months

VASCULAR SURGERY

 

 

 

 

 

 

Surgery – vascular

 

80146

 

NA

 

person-months

OTHER

 

 

 

 

 

 

All other coverage contained in line 11.0 of the company's state page exhibit for the filing year

 

OTHR

 

 

 

NA

 

Table:

 

1    MD = Medical Doctor

 

2    DO = Doctor of Osteopathy

 

 

COMMERCIAL AUTO LIABILITY

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

 

 

 

 

 

Fleet and non-fleet combined trucks, tractors, and trailers – zone rated

 

1A

1B

1C

 

car-months (BI)

receipts

number of miles

Fleet and non-fleet combined trucks, tractors, and trailers – all other, regardless of miles

 

2A

 

car-months (BI)

Fleet and non-fleet taxicabs, and public livery, regardless of mileage, including limousines

 

3A

3B

3C

 

car-months (BI)

receipts

number of miles

OTHER

 

 

 

 

All other coverage contained in line 19.4 of the company's state page exhibit for the filing year.

 

OTHR

 

NA

 

 

PRIVATE PASSENGER AUTO LIABILITY

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

PPA Liability

 

LIAB

 

car-months (BI)

OTHER

 

 

 

 

All other coverage contained in line 19.2 of the company's state page exhibit for the filing year

 

OTHR

 

NA

 

 

HOMEOWNER MULTI-PERIL

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

 

 

 

 

 

HO-1

 

HO-1

 

house-months

HO-2

 

HO-2

 

house-months

HO-3

 

HO-3

 

house-months

HO-4

 

HO-4

 

house-months

HO-5

 

HO-5

 

house-months

HO-6

 

HO-6

 

house-months

HO-8

 

HO-8

 

house-months

Mobile Homes

 

Mobile

 

house-months

HOMEOWNER ENDORSEMENTS

 

 

 

 

Home Day Care endorsement

 

323

 

house-months

Earthquake endorsement

 

HEQ

 

house-months

OTHER

 

 

 

 

All other coverage contained in line 04.0 of the company's state page exhibit for the filing year

 

OTHR

 

NA

 

 

BUSINESS OWNERS PACKAGE

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

Business Owners Package (BOP)

 

77777

 

NA

Other coverage contained in line 05.1 and 05.2 of the company's state page exhibit for the filing year

 

OTHR

 

NA

 

 

PRIVATE PASSENGER AUTO PHYSICAL DAMAGE

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

PPA Physical Damage

 

PHYD

 

car-months (comp)

Other coverage contained in line 21.1 of the company's state page exhibit for the filing year

 

OTHR

 

NA

 

 

EARTHQUAKE (REQ ONLY)

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

Residential Earthquake

 

REQ

 

NA

Other coverage contained in line 12.0 of the company's state page exhibit for the filing year

 

OTHR

 

NA

 

 

RESIDENTIAL FIRE

 

CLASS OR DATA TYPE

 

CLASS CODE

 

EXPOSURE BASE

Building and Contents – owner-occupied, 1-4 units

 

9A

 

house-months

Contents only

 

9B

 

house-months

Building only – non-owner-occupied

 

9C

 

house-months

Earthquake endorsement

 

HEQ

 

house-months

Other coverage contained in line 01.0 of the company's state page exhibit for the filing year

 

OTHR

 

NA

 

(Source:  Amended at 39 Ill. Reg. 2603, effective February 6, 2015)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.60 LINE ITEM MATRIX FOR COST CONTAINMENT REPORTING


 

Section 4203.60  Line Item Matrix For Cost Containment Reporting

 

Revised Field #

Other Liability, Medical Malpractice, Earthquake (REQ), BOP, Excess Insurance & Commercial Auto

Homeowners & Residential Fire

Private Passenger Auto Liability

Private Passenger Physical Damage

1

FEIN

FEIN

FEIN

FEIN

2

Filing Method

Filing Method

Filing Method

Filing Method

3

Line of Business

Line of Business

Line of Business

Line of Business

4

State ID

State ID

State ID

State ID

5

Class Code

Class Code

Class Code

Class Code

6

Statistical Year

Statistical Year

Statistical Year

Statistical Year

7

Not used

Zip Code

Zip Code

Zip Code

8

Form Type

Not used

BI Written Premium

Comp Written Premium

9

Written Premium

Written Premium

BI Earned Premium

Comp Earned Premium

10

Earned Premium

Earned Premium

BI Paid Loss

Comp Paid Loss

11

Paid Losses

Paid Losses

BI OS Loss

Comp OS Loss

12

Outstanding Losses

Outstanding Losses

BI PD ALAE

# Comp Wr. Exposure

13

Paid ALAE

Written Exposures

BI OS ALAE

# Comp Paid Claims

14

OS ALAE

# Paid Claims

# BI Written Exposure

# Comp OS Claims

15

Written Exposures

# OS Claims

#BI Paid Claims

Collision Wr. Premium

16

# Paid Claims

 

#BI OS Claims

Collision Er. Premium

17

# OS Claims

 

PD Written Premium

Collision Paid Loss

18

 

 

PD Earned Premium

Collision OS Loss

19

 

 

PD Paid Loss

# Collision Paid Claims

20

 

 

PD OS Loss

# Collision OS Claims

21

 

 

PD Paid ALAE

Other Written Premium

22

 

 

PD OS ALAE

Other Earned Premium

23

 

 

# PD Paid Claims

Other Paid Loss

24

 

 

#PD OS Claims

Other OS Loss

25

 

 

UM/UIM Written Prem

# Other Paid Claims

26

 

 

UM/UIM Earned Prem

# Other OS Claims

27

 

 

UM/UIM Paid Loss

 

28

 

 

UM/UIM OS Loss

 

29

 

 

UM/UIM Paid ALAE

 

30

 

 

UM/UIM OS ALAE

 

31

 

 

# UM/UIM Paid Claims

 

32

 

 

# UM/UIM OS Claims

 

33

 

 

Med Pay Written Prem

 

34

 

 

Med Pay Earned Prem

 

35

 

 

Med Pay Paid Loss

 

36

 

 

Med Pay OS Loss

 

37

 

 

Med Pay Paid ALAE

 

38

 

 

Med Pay OS ALAE

 

39

 

 

# Med Pay Paid Claims

 

40

 

 

# Med Pay  OS Claims

 

41

 

 

Other Written Prem

 

42

 

 

Other Earned Prem

 

43

 

 

Other Paid Loss

 

44

 

 

Other OS Loss

 

45

 

 

Other Paid ALAE

 

46

 

 

Other OS ALAE

 

47

 

 

# Other Paid Claims

 

48

 

 

# Other OS Claims

 

49

 

 

# SL Written Exposures

 

50

 

 

SL Written Prem

 

51

 

 

SL Earned Prem

 

52

 

 

BI SL Paid Loss

 

53

 

 

BI SL OS Loss

 

54

 

 

BI SL Paid ALAE

 

55

 

 

BI SL OS ALAE

 

56

 

 

# BI SL Paid Claims

 

57

 

 

# BI SL OS Claims

 

58

 

 

PD SL Paid Loss

 

59

 

 

PD SL OS Loss

 

60

 

 

PD SL Paid ALAE

 

61

 

 

PD SL OS ALAE

 

62

 

 

# PD SL Paid Claims

 

63

 

 

# PD SL OS Claims

 

 

            (Source:  Amended at 39 Ill. Reg. 2603, effective February 6, 2015)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.70 CODING CONVENTIONS FOR OTHER LIABILITY/EXCESS INSURANCE, MEDICAL MALPRACTICE, EARTHQUAKE, COMMERCIAL AUTO LIABILITY, AND BUSINESS OWNERS PACKAGES


 

Section 4203.70  Coding Conventions for Other Liability/Excess Insurance, Medical Malpractice, Earthquake, Commercial Auto Liability, and Business Owners Packages

 

This Section provides instructions for coding the fields for other liability, medical malpractice, earthquake, commercial auto liability, and business owners packages (BOP).  The following provides a detailed description of each data field:

 

a)         FEIN – This alpha-numeric field reflects the Federal Employer Identification Number assigned to the insurer.  (Do not include the hyphen; for example 555555555.)

 

b)         Filing Method – This one-character alpha-numeric field identifies the source of the data as either an agent or an insurance company.  Possible codes are:

 

1

=

American Association of Insurance Services (AAIS)

2

=

Insurance Services Office, Inc. (ISO)

3

=

Property Casualty Insurers Association of America (PCI)

4

=

National Independent Statistical Service (NISS)

5

=

Company Direct – Partial

6

=

Company Direct – 100 Percent

7

=

Other

 

c)         Line of Business – This alpha-numeric field identifies the line or general classification to which the data belongs.  Possible codes are:

 

05.0

=

BOP (Business Owners Package)

11.0

=

Medical Malpractice

12.0

=

Earthquake

17.0

=

Other/Excess Liability

19.4

=

Commercial Auto Liability

 

d)         State Identifier – This field identifies the geographical source of the data.  Possible codes are:

 

12

=

Illinois only

MS

=

Multi-state

 

e)         Class Code – The data call requires specific data for each Type of Insurance and class code identified below.

 

05.0 = BOP (Business Owners Package)

 

77777

=

Business Owners Package (BOP)

 

Other

 

OTHR

=

All other coverage contained in line 05.1 and 05.2

 

11.0 = Medical Malpractice

 

Cardiac – Other

 

80281

=

cardiovascular disease – minor surgery by MD

84281

=

cardiovascular disease – minor surgery by DO

80255

=

cardiovascular disease – no surgery by MD

84255

=

cardiovascular disease – no surgery by DO

 

Cardiac – Surgery

 

80141

=

surgery – cardiac by MD

80150

=

surgery – cardiovascular disease by MD

84150

=

surgery – cardiovascular disease by DO

 

Critical Care Medicine

 

80283

=

intensive care medicine – applies to any general practitioner or specialist employed in intensive care hospital unit by MD

84283

=

intensive care medicine – applies to any general practitioner or specialist employed in intensive care hospital unit by DO

 

Dentists

 

80210

=

Oral surgery with anesthesia

80211

=

Oral surgery without anesthesia

 

Emergency Room – Other

 

80102

=

emergency room – no major surgery by MD

84102

=

emergency room – no major surgery by DO

 

Emergency Room – Surgery

 

80157

=

emergency medicine – including major surgery by MD

84157

=

emergency medicine – including major surgery by DO

 

General Surgery

 

80143

=

surgery – general – not otherwise classified. Does not apply to family or general practitioner or to any specialist who occasionally performs major surgery by MD

84143

=

surgery – general – not otherwise classified. Does not apply to family or general practitioner or to any specialist who occasionally performs major surgery by DO

 

Neurosurgery

 

80152

=

surgery – neurology – including child by MD

84152

=

surgery – neurology – including child by DO

80288

=

neurology – including child – minor surgery by MD

84288

=

neurology – including child – minor surgery by DO

 

Obstetrics/Gynecology – Other

 

80277

=

gynecology – minor surgery by MD

84277

=

gynecology – minor surgery by DO

80244

=

gynecology – no surgery by MD

84244

=

gynecology – no surgery by DO

 

Obstetrics/Gynecology – Surgery

 

80167

=

surgery – gynecology by MD

84167

=

surgery – gynecology by DO

80168

=

surgery – obstetrics by MD

80153

=

surgery – obstetrics – gynecology by MD

84153

=

surgery – obstetrics – gynecology by DO

 

Orthopedic Surgery

 

80154

=

surgery – orthopedic by MD

84154

=

surgery – orthopedic by DO

 

Physicians and Surgeons

 

80420

=

family physician or general practitioner – no surgery by MD

84420

=

family physician or general practitioner – no surgery by DO

80421

=

family physician or general practitioner – minor surgery by MD

84421

=

family physician or general practitioner – minor surgery by DO

80117

=

surgery – general practice or family practice by MD

 

Physicians, Surgeons, and Dentists

 

94999

=

physicians, surgeons, and dentists classes not specifically listed

90430

=

physicians, surgeons, and dentists individual insurer programs not rated using one of the exposure bases noted above

 

Plastic Surgery

 

80156

=

surgery – plastic – not otherwise classified by MD

84156

=

surgery – plastic – not otherwise classified by DO

80155

=

surgery – plastic – otorhinolaryngology by MD

84155

=

surgery – plastic – otorhinolaryngology by DO

 

Vascular Surgery

 

80146

=

surgery – vascular by MD

80144

=

surgery – thoracic by MD

84144

=

surgery – thoracic by DO

 

OTHER  

 

OTHR

=

All other coverage contained in line 11.0

 

12.0 = Earthquake

 

•           REQ    =          Residential Earthquake

•           OTHR =          All other coverage contained in line 12.0

 

17.0 = Other Liability

 

Day care

 

82115

=

day care center liability – day nurseries

41714

=

day care center liability – day care centers

81714

=

day care center liability individual insurance not rated using one of the exposure bases noted above.

 

Lawyer

 

81400

=

lawyers professional liability – lawyers

81420

=

lawyers professional liability – employed law clerks, investigators, abstractors and paralegals

81401

=

lawyers professional liability individual insurance not rated using one of the exposure bases noted above.

 

Liquor

 

70412

=

clubs

59211

=

package stores and other retail establishments

50911

=

manufacturers, wholesalers, and distributors

58161

=

restaurants, taverns, hotels, motels including package sales

58168

=

temporary licenses

58169

=

owners or lessors of premises used by others

11111

=

liquor liability – not otherwise classified

81111

=

liquor liability individual insurer programs not rated using one of the exposure bases noted above.1

 

Excess Coverage

 

9772

=

commercial auto

99930

=

personnel umbrella

99935

=

commercial umbrella

88888

=

excess insurance – all other

 

Other

 

•           OTHR =          All other coverage contained in line 17.1 and 17.2

 

19.4 = Commercial Auto Liability  

 

1A

=

fleet and non-fleet combined trucks, tractors, and trailers – zone rated (car-months (BI))

1B

=

fleet and non-fleet combined trucks, tractors, and trailers – zone rated (receipts)

1C

=

fleet and non-fleet combined trucks, tractors, and trailers – zone rated (number of miles)

2A

=

fleet and non-fleet combined trucks, tractors, and trailers – all other, regardless of miles (car-months (BI))

3A

=

fleet and non-fleet taxicabs, and public livery, regardless of mileage, including limousines (car-months (BI))

3B

=

fleet and non-fleet taxicabs, and public livery, regardless of mileage, including limousines (receipts)

3C

=

fleet and non-fleet taxicabs, and public livery, regardless of mileage, including limousines (number of miles)

OTHR

=

All other coverage contained in line 19.4

 

f)         Statistical Data Year – This four-character alpha-numeric field reflects the experience year.  (For example, for the November 2017 annual data filing, the statistical data year will be coded 2016.) 

 

g)         Field Not Currently Used

 

h)         Form Type – This alpha-numeric field reflects the form type that was used in providing coverage.  The insurer will report a separate record for each form type for each class and geographic location (Illinois-only or multi-state).  Possible codes are:

 

C

=

claims-made

O

=

occurrence

T

=

claims-made tail coverage

 

i)          Amount of Written Premium – This field reflects the amount of total written premiums corresponding to each of the class codes.

 

j)          Amount of Earned Premium – This field reflects the total amount of earned premiums corresponding to each of the class codes.

 

k)         Amount of Paid Losses – This field reflects the amount of paid losses corresponding to each of the class codes.  Please see Section 4203.30(g) for the definition of paid losses.  If the insurer is unable to separate paid losses from ALAE, the insurer will follow the instructions provided in Section 4203.30(h).

 

l)          Amount of Outstanding Losses – This field reflects the amount of outstanding losses corresponding to each of the class codes.  Please see Section 4203.30(g) for the definition of outstanding losses and Section 4203.30(h) for special instructions for those situations where separating outstanding losses and outstanding ALAE are not possible.

 

m)        Amount of Paid ALAE – This field reflects the amount of paid ALAE for each of the class codes.  If an insurer is unable to separate paid ALAE from the paid losses, the combined paid losses and paid ALAE will be reported in the paid losses field for the line and the code "combined" will appear in the paid ALAE field.  For the earthquake data, the amount of paid ALAE field should be blank.

 

n)         Amount of Outstanding ALAE – This field reflects the amount of outstanding allocated loss adjustment expenses for each of the class codes.  If an insurer is unable to separate outstanding ALAE from the outstanding losses, the combined outstanding losses and outstanding ALAE will be reported in the outstanding losses field for the line and the code "combined" will appear in the ALAE field.  For the earthquake data, the amount of outstanding ALAE field should be blank.

 

o)         Number of Written Exposures – This field reflects the count of written exposures for each of the class codes.  The field "number of exposures" for BOP, earthquake, and excess insurance will be left blank.

 

p)         Number of Paid Claims – This field reflects the paid claims count corresponding to each of the class codes.  Please see Section 4203.30(i) for the definition of paid claims.

 

q)         Number of Outstanding Claims – This field reflects the outstanding claims count corresponding to each of the class codes.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.80 CODING CONVENTIONS FOR HOMEOWNER AND RESIDENTIAL FIRE INSURANCE


 

Section 4203.80  Coding Conventions for Homeowner and Residential Fire Insurance

 

This Section provides instructions for coding 15 fields included in the homeowner and residential fire insurance line.  All homeowner and residential fire records will be submitted by zip code.

 

a)         In the homeowner line, the insurer will code one record for each class for multi-state data and one record for each class for each zip code for Illinois-only data.  It is not necessary to submit a record that sums the data for all the zip codes in each class.

 

b)         The following provides a detailed description of each data field:

 

1)         FEIN – This alpha-numeric field reflects the Federal Employer Identification Number assigned to the insurer. (Do not include the hyphen, for example 555555555.)

 

2)         Filing Method – This one-character alpha-numeric field identifies the source of the data as either an agent or an insurance company.  Possible codes are:

 

1

=

American Association of Insurance Services (AAIS)

2

=

Insurance Services Office, Inc. (ISO)

3

=

Property Casualty Insurers Association of America (PCI)

4

=

National Independent Statistical Service (NISS)

5

=

Company Direct – Partial

6

=

Company Direct – 100 Percent

7

=

Other

 

3)         Line of Business – This alpha-numeric field identifies the general business line to which the data belongs.  The possible codes are:

 

04.0

=

Homeowners

01.0

=

Residential Fire

 

4)         State Identifier – This field identifies the geographical source of the data.  Possible codes are:

 

12

=

Illinois only

MS

=

Multi-state

 

5)         Class Code – Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line.  The insurer should report one record for multi-state data and one record for each class by zip code for Illinois-only data.  It is not necessary to report a record that sums all zip code data for a class.  Possible codes for the classification field are:

 

04.0

=

Homeowners

 

HO-1

 

HO-2

 

HO-3

 

HO-4

 

HO-5

 

HO-6

 

HO-8

 

Mobile

 

323

=

Day care endorsement

 

HEQ

=

Homeowner earthquake endorsement

 

OTHR

=

All other coverage contained in line 04.0

 

01.0

=

Residential Fire

9A

=

residential fire, building & contents (owner-occupied 1-4 units)

9B

=

residential fire (contents only)

9C

=

residential fire (building only for non-owner-occupied)

HEQ

=

earthquake endorsement

OTHR

=

All other coverage contained in line 01.0

 

6)         Statistical Data Year – This four-character alpha-numeric field reflects the experience year.  (For example, the statistical data year for the November 2017 annual filing for the calendar year method will be coded 2016.)

 

7)         Zip Code – This alpha-numeric field identifies the zip code where the homeowner exposure is located.  Possible codes are:

 

Actual zip code

=

The range for Illinois zip codes (60001 through 62999).

99999

=

Code for Illinois-only data where zip code does not fall within the range for Illinois zip codes (60001 through 62999).

 

AGENCY NOTE: There should be one record for each represented zip code for each of the classes HO-1, HO-2, HO-3, HO-4, HO-5, HO-6, HO-8, mobile, 323, 9A, 9B, 9C, and OTHR for Illinois-only data and one record for each class reported for multi-state data. 

 

8)         Field Not Currently Used

 

9)         Amount of Written Premium – This field reflects the amount of written premiums corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.

 

10)         Amount of Earned Premium – This field reflects the amount of earned premium corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.

 

11)         Amount of Paid Losses – This field reflects the paid losses corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.  Please see Section 4203.30(g) for the definition of paid losses.

 

12)         Amount of Outstanding Losses – This field reflects the outstanding losses corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.

 

13)         Number of Written Exposures – This field reflects the count of exposures for each of the class codes HO-1 through HO-8, mobile, 9A, 9B, 9C, and OTHR.

 

14)         Number of Paid Claims – This field reflects the paid claims count corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.  Please see Section 4203.30(i) for the definition of paid claims.

 

15)         Number of Outstanding Claims – This field reflects the outstanding claims count corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.90 CODING CONVENTIONS FOR PRIVATE PASSENGER AUTO LIABILITY INSURANCE (EXCLUDING PIP)


 

Section 4203.90  Coding Conventions for Private Passenger Auto Liability Insurance (Excluding PIP)

 

This Section provides instructions for coding the 63 fields in the private passenger auto liability records, excluding PIP.  All private passenger auto liability records will be submitted by zip code.

 

a)         No-fault data will be excluded.

 

b)         In the private passenger auto liability line, the insurer will submit one record for each class for multi-state data and one record for each class for each zip code for Illinois-only data.  It is not necessary to submit a record which sums the Illinois-only data for all the zip codes.

 

c)         The applicable bodily injury and property damage data for split limit policies will be reported in Fields 8-48.  The applicable data for single limit policies will be reported in Fields 49-63.  Written exposures, written premium, and earned premium for single limit policies will be reported in Fields 49-51.  Losses, loss adjustment expenses, and claims counts will be reported for bodily injury and property damage using the instructions in Fields 51-63.

 

d)         The following provides a detailed description of each data field:

 

1)         FEIN – This alpha-numeric field reflects the Federal Employer Identification Number assigned to the insurer.  (Do not include the hyphen, for example 555555555.)

 

2)         Filing Method – This one-character alpha-numeric field identifies the source of the data as either an agent or an insurance company.  Possible codes are:

 

1

=

American Association of Insurance Services (AAIS)

2

=

Insurance Services Office, Inc. (ISO)

3

=

Property Casualty Insurer Association of America (PCI)

4

=

National Independent Statistical Service (NISS)

5

=

Company Direct – Partial

6

=

Company Direct – 100 Percent

7

=

Other

 

3)         Line of Business – This alpha-numeric field identifies the general business line to which the data belongs.  The code is:

 

19.2

=

Private passenger auto liability

 

4)         State Identifier – This field identifies the geographical source of the data.  Possible codes are:

 

12

=

Illinois only

MS

=

Multi-state

 

5)         Class Code – Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line.  The insurer should report one record for each class for multi-state data and one record for each class for each zip code for Illinois-only data.  It is not necessary to report a record that sums all zip code data for a class.  Possible codes for the classification field are:

 

19.2

=

Private passenger auto liability

 

LIAB

 

OTHR = all other coverage contained in line 19.2

 

6)         Statistical Data Year – This four-character alpha-numeric field reflects the experience year.  (For example, the statistical data year field for the November 2017 annual filing will be coded 2016.)

 

7)         Zip Code – This alpha-numeric field identifies the zip code where the automobile exposure is rated (auto is garaged).  Possible codes are:

 

Actual zip code

=

The range for Illinois zip codes (60001 through 62999)

99999

=

Code for Illinois-only data where zip code does not fall within the range for Illinois zip codes (60001 through 62999)

 

AGENCY NOTE: There should be one record for each represented zip code for each class code LIAB and OTHR for Illinois-only data and one record for each class code reported for the multi-state data.  Each insurer will report premium and exposure data by zip code for private passenger automobile liability.  For multi-state data, the zip code field will be blank.

 

8)         Amount of PPA Liability Bodily Injury (BI) Written Premium – This field reflects the amount of written premiums for BI.

 

9)         Amount of PPA Liability BI Earned Premium – This field reflects the amount of earned premiums for BI.

 

10)         Amount of PPA Liability BI Paid Losses – This field reflects the paid losses for BI.  Please see Section 4203.30(g) for the definition of paid losses.

 

11)         Amount of PPA Liability BI Outstanding Losses – This field reflects the outstanding losses for BI.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

12)         Amount of PPA Liability BI Paid ALAE – This field reflects the ALAE for BI.  If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

13)         Amount of PPA Liability BI Outstanding ALAE – This field reflects the ALAE for BI.  If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

 

14)         Number of PPA Liability BI Written Exposures – This field reflects the count of written exposures for the line.  PPA liability exposures are based on the bodily injury component.

 

15)         Number of PPA Liability BI Paid Claims – This field reflects the paid claims count for BI.  Please see Section 4203.30(i) for the definition of paid claims.

 

16)         Number of PPA Liability BI Outstanding Claims – This field reflects the outstanding claims count for BI.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

17)         Amount of PPA Liability Property Damage Written Premium – This field reflects the amount of written premiums for property damage liability.

 

18)         Amount of PPA Liability Property Damage Earned Premium – This field reflects the amount of earned premiums for property damage liability.

 

19)         Amount of PPA Liability Property Damage Paid Losses – This field reflects the paid losses for property damage liability.  Please see Section 4203.30(g) for the definition of paid losses.

 

20)         Amount of PPA Liability Property Damage Outstanding Losses – This field reflects the outstanding losses for property damage liability.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

21)         Amount of PPA Paid Liability Property Damage ALAE – This field reflects ALAE for property damage liability.  If an insurer is unable to separate paid ALAE from the paid loss, the combined paid loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

22)         Amount of PPA Outstanding Liability Property Damage ALAE – This field reflects outstanding ALAE for property damage liability.  If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined outstanding loss and outstanding ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

 

23)         Number of PPA Liability Property Damage Paid Claims – This field reflects the paid claims count for property damage liability.  Please see Section 4203.30(l) for the definition of paid claims.

 

24)         Number of PPA Liability Property Damage Outstanding Claims – This field reflects the outstanding claims count for property damage liability.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

25)         Amount of PPA Liability UM/UIM Written Premium – This field reflects the written premiums for UM/UIM.

 

26)         Amount of PPA Liability UM/UIM Earned Premium – This field reflects the earned premiums for UM/UIM.

 

27)         Amount of PPA Liability UM/UIM Paid Losses – This field reflects the paid losses for UM/UIM.  Please see Section 4203.30(g) for the definition of paid losses.

 

28)         Amount of PPA Liability UM/UIM Outstanding Losses – This field reflects the outstanding losses for UM/UIM.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

29)         Amount of PPA Liability UM/UIM Paid ALAE – This field reflects the ALAE for UM/UIM liability.  If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

30)         Amount of PPA Liability UM/UIM Outstanding ALAE – This field reflects the outstanding ALAE for UM/UIM liability.  If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the outstanding ALAE field.

 

31)         Number of PPA Liability UM/UIM Paid Claims – This field reflects the paid claims count for UM/UIM liability.  Please see Section 4203.30(i) for the definition of paid claims.

 

32)         Number of PPA Liability UM/UIM Outstanding Claims – This field reflects the outstanding claims count for UM/UIM liability.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

33)         Amount of PPA Liability Medical Payments Written Premium – This field reflects the amount of written premiums for medical payments.

 

34)         Amount of PPA Liability Medical Payments Earned Premium – This field reflects the amount of earned premiums for medical payments.

 

35)         Amount of PPA Liability Medical Payments Paid Losses – This field reflects the paid losses for medical payments.  Please see Section 4203.30(g) for definition of paid losses.

 

36)         Amount of PPA Liability Medical Payments Outstanding Losses – This field reflects the outstanding losses for medical payments.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

37)         Amount of PPA Liability Medical Payments Paid ALAE – This field reflects ALAE for medical payments.  If an insurer is unable to separate paid ALAE from the paid loss, the "combined" loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

38)         Amount of PPA Liability Medical Payments Outstanding ALAE – This field reflects ALAE for medical payments.  If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the paid ALAE field.

 

39)         Number of PPA Liability Medical Payments Paid Claims – This field reflects the paid claims count for medical payments.  Please see Section 4203.30(i) for the definition of paid claims.

 

40)         Number of PPA Liability Medical Payments Outstanding Claims – This field reflects the outstanding claims count for medical payments.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

AGENCY NOTE: Fields 41-48 will be blank for the majority of private passenger auto liability insurers. The purpose of the other component is to capture any private passenger auto liability data from insurers that do not fall within bodily injury, property damage, UM/UIM, or medical payments.

 

41)         Amount of PPA Liability Other Written Premium – This field reflects the amount of written premiums for other (not fitting any other private passenger auto liability field).

 

42)         Amount of PPA Liability Other Earned Premium – This field reflects the amount of earned premiums for other (not fitting any other private passenger auto liability field).

 

43)         Amount of PPA Liability Other Paid Losses – This field reflects the paid losses for other (not fitting any other private passenger auto liability field).  Please see Section 4203.30(g) for the definition of paid losses.

 

44)         Amount of PPA Liability Other Outstanding Losses – This field reflects the outstanding losses for other (not fitting any other private passenger auto liability field).  Please see Section 4203.30(g) for the definition of outstanding losses.

 

45)         Amount of PPA Liability Other Paid ALAE – This field reflects the paid ALAE for other (not fitting any other private passenger auto liability field). If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

46)         Amount of PPA Liability Other Outstanding ALAE – This field reflects the outstanding ALAE for other (not fitting any other private passenger auto liability field).  If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

 

47)         Number of PPA Liability Other Paid Claims – This field reflects the paid claims count for other (not fitting any other liability field).  Please see Section 4203.30(i) for the definition of paid claims.

 

48)         Number of PPA Liability Other Outstanding Claims – This field reflects the outstanding claims count for other (not fitting any other liability field). Please see Section 4203.30(j) for the definition of outstanding claims.

 

AGENCY NOTE: Fields 49-63 provide the fields for an insurer to report its private passenger auto liability policies written with a single limit.  If none were written for the experience period, these fields will be left blank.

 

49)         Number of PPA Liability Single Limit (SL) Written Exposures – This field reflects the count of exposures written under single limit policies.

 

50)         Amount of PPA Liability for Single Limit (SL) Written Premium – This field reflects the amount of written premiums for policies written under single limit policies.

 

51)         Amount of PPA Liability for SL Earned Premium – This field reflects the amount of earned premiums for policies written under single limit policies.

 

52)         Amount of PPA Liability BI Paid Losses for SL Policies – This field reflects the amount of paid losses for bodily injury under single limit policies.  Please see Section 4203.30(g) for the definition of paid losses.

 

53)         Amount of PPA Liability BI Outstanding Losses for SL Policies – This field reflects the amount of outstanding losses for bodily injury under single limit policies.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

54)         Amount of PPA Liability BI Paid ALAE for SL Policies – This field reflects the paid ALAE for bodily injury under single limit policies.  If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

55)         Amount of PPA Liability BI Outstanding ALAE for SL Policies – This field reflects the outstanding ALAE for bodily injury under single limit policies. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

 

56)         Number of PPA Liability BI Paid Claims for SL Policies – This field reflects the paid claims count for bodily injury under single limit policies. Please see Section 4203.30(i) for the definition of paid claims.

 

57)         Number of PPA Liability BI Outstanding Claims for SL Policies – This field reflects the outstanding claims count for bodily injury under single limit policies.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

58)         Amount of PPA Liability Property Damage (PD) Paid Losses for SL Policies – This field reflects the paid losses for property damage under single limit policies.  Please see Section 4203.30(g) for the definition of paid losses.

 

59)         Amount of PPA Liability PD Outstanding Losses for SL Policies – This field reflects the outstanding losses for property damage under single limit policies.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

60)         Amount of PPA Liability PD Paid ALAE for SL Policies – This field reflects the paid ALAE for property damage under single limit policies.  If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

 

61)         Amount of PPA Liability PD Outstanding ALAE for SL Policies – This field reflects the outstanding ALAE for property damage under single limit policies. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

 

62)         Number of PPA Liability PD Paid Claims – This field reflects the paid claims count for property damage under single limit policies.  Please see Section 4203.30(i) for the definition of paid claims.

 

63)         Number of PPA Liability PD Outstanding Claims – This field reflects the outstanding claims count for property damage under single limit policies. Please see Section 4203.30(j) for the definition of outstanding claims.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.100 CODING CONVENTIONS FOR PRIVATE PASSENGER AUTO PHYSICAL DAMAGE


 

Section 4203.100  Coding Conventions for Private Passenger Auto Physical Damage

 

This Section provides instructions for coding the 26 fields included in the private passenger auto physical damage records.

 

a)         In the private passenger physical damage line, the insurer will code one record for the line for multi-state data and one record for the line for each zip code represented in the Illinois-only data. It is not necessary to submit a record that sums the Illinois-only data for all the zip codes.

 

b)         The following provides a detailed description of each data field:

 

1)         FEIN – This alpha-numeric field reflects the Federal Employer Identification Number assigned to the insurer. (Do not include the hyphen, for example 555555555.)

 

2)         Filing Method – This one-character alpha-numeric field identifies the source of the data as either an agent or an insurance company.  Possible codes are:

 

1

=

American Association of Insurance Services (AAIS)

2

=

Insurance Services Office, Inc. (ISO)

3

=

Property Casualty Insurer Association of America (PCI)

4

=

National Independent Statistical Service (NISS)

5

=

Company Direct – Partial

6

=

Company Direct – 100 Percent

7

=

Other

 

3)         Line of Business – This alpha-numeric field identifies the general business line to which the data belongs.  The code for private passenger auto physical damage is:

 

21.1

=

Private passenger auto physical damage

 

4)         State Identifier – This field identifies the geographical source of the data.  Possible codes are:

 

12

=

Illinois only

MS

=

Multi-state

 

5)         Class Code/Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line.  The insurer should report one record for each class code for multi-state data and one record for each class for each zip code for Illinois-only data.  It is not necessary to report a record that sums all zip code data for a class.  Possible codes for the classification field are:

 

21.1

=

Private passenger auto physical damage

 

PHYD

 

OTHR = All other coverage contained in line 21.1

 

6)         Statistical Data Year – This four-character alpha-numeric field reflects the experience year.  (For example, the statistical data year for the November 2017 annual filing will be coded 2016.)

 

7)         Zip Code – This alpha-numeric field identifies the zip code where the Illinois-only exposure is written.  Possible codes are:

 

Actual zip code

=

The range for Illinois zip codes (60001 through 62999).

99999

=

Code for Illinois-only data where zip code does not fall within the range for Illinois zip codes (60001 through 62999).

 

AGENCY NOTE: There should be one record for each represented zip code for private passenger auto physical damage for Illinois-only data.  It is unnecessary to submit a record that sums the data for all the zip codes.  For multi-state data, the zip code field should be blank.

 

8)         Amount of PPA Physical Damage Comprehensive (Comp) Written Premium – This field reflects the amount of written premiums for comprehensive.

 

9)         Amount of PPA Comprehensive Earned Premium – This field reflects the amount of earned premiums for comprehensive.

 

10)         Amount of PPA Comprehensive Paid Losses – This field reflects the paid losses for comprehensive.  Please see Section 4203.30(g) for the definition of paid losses.

 

11)         Amount of PPA Comprehensive Outstanding Losses – This field reflects the outstanding losses for comprehensive.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

12)         Number of PPA Comprehensive Written Exposures – This field reflects the written exposure count for private passenger auto physical damage – using the comprehensive component.

 

13)         Number of PPA Comprehensive Paid Claims – This field reflects the paid claims count for comprehensive.  Please see Section 4203.30(i) for the definition of paid claims.

 

14)         Number of PPA Comprehensive Outstanding Claims – This field reflects the outstanding claims count for comprehensive.  Please see Section 4203.30(j) for the definition of outstanding claims.

 

15)         Amount of PPA Collision Written Premium – This field reflects the amount of written premiums for collision.

 

16)         Amount of PPA Collision Property Damage Earned Premium – This field reflects the amount of earned premiums for collision.

 

17)         Amount of PPA Collision Paid Losses – This field reflects the paid losses for collision.  Please see Section 4203.30(g) for the definition of paid losses.

 

18)         Amount of PPA Collision Outstanding Losses – This field reflects the outstanding losses for collision.  Please see Section 4203.30(g) for the definition of outstanding losses.

 

19)         Number of PPA Collision Paid Claims – This field reflects the paid claims count for collision.  Please see Section 4203.30(i) for the definition of paid claims.

 

20)         Number of PPA Collision Outstanding Claims – This field reflects the outstanding claims count for collision.  Please see Section 4203.30(j) for the definition of paid claims.

 

AGENCY NOTE: Fields 21-26 will be blank for the majority of private passenger auto physical damage insurers. The purpose of the other category is to capture any private passenger auto physical damage data from insurers that do not fall within the comprehensive or collision components.

 

21)         Amount of PPA Other Written Premium – This field reflects the amount of written premiums for other (not fitting in comp or collision).

 

22)         Amount of PPA Other Earned Premium – This field reflects the amount of earned premiums for other (not fitting in comp or collision).

 

23)         Amount of PPA Other Paid Losses – This field reflects the paid losses for other (not fitting in comp or collision).  Please see Section 4203.30(g) for the definition of paid losses.

 

24)         Amount of PPA Other Outstanding Losses – This field reflects the outstanding losses for other (not fitting in comp or collision).  Please see Section 4203.30(g) for the definition of outstanding losses.

 

25)         Number of PPA Other Paid Claims – This field reflects the paid claims count for other (not fitting in comp or collision).  Please see Section 4203.30(i) for the definition of paid claims.

 

26)         Number of PPA Other Outstanding Claims – This field reflects the outstanding claims count for other (not fitting in comp or collision.)  Please see Section 4203.30(j) for the definition of outstanding claims.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.110 RECORD LAYOUT FOR THE FOUR FORMATS


 

Section 4203.110  Record Layout for the Four Formats

 

Due to space limitations, the following abbreviations were used in this table:

 

Wr Prem

=

Written Premium

OS

=

Outstanding

BI

=

Bodily Injury

Med Pay

=

Medical Payments

SL

=

Single Limit

E Prem

=

Earned Premium

ALAE

=

Allocated Loss Adjustment Expenses

PD

=

Property Damage

UM/UIM

=

Uninsured/Underinsured Motorists

Comp

=

Comprehensive

 

 

 

Coll

=

Collision, Other Liab, Medical

PIP

=

Personal Injury Protection

 

(Source:  Amended at 39 Ill. Reg. 2603, effective February 6, 2015)

SUBPART B: MEDICAL MALPRACTICE REPORTING

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.200 APPLICABILITY


 

Section 4203.200  Applicability

 

This Part applies to each company licensed to write medical malpractice insurance in this State pursuant to Section 4, Class 2(c) of the Code.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.210 PURPOSE AND SCOPE


 

Section 4203.210  Purpose and Scope

 

The purpose of this Part is to establish content, form and data reporting requirements for information required to be reported to the Director of Insurance pursuant to Section 1204 of the Code.

 

(Source:  Amended at 36 Ill. Reg. 18744, effective December 17, 2012)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.220 DEFINITIONS


 

Section 4203.220  Definitions

 

Code means the Illinois Insurance Code [215 ILCS 5].

 

Department means the Illinois Department of Insurance.

 

Director means the Director of the Illinois Department of  Insurance.

 

Insurance Claim means a formal or written demand for compensation under a medical malpractice liability insurance policy relating to allegations of liability on the part of one or more providers for any act, error or omission in the rendering of, or failure to render, medical services for medically related injuries. Insurance claim includes any instance for which benefits or compensation are payable, or eligible to be paid under any coverage under the policy.

 

(Source:  Amended at 36 Ill. Reg. 18744, effective December 17, 2012)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.230 REPORTS


 

Section 4203.230  Reports

 

All reports shall be completed, validated and filed in an electronic format in accordance with Appendix A no later than April 1 of each year.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

SUBPART C: MARKET SURVEY FOR OCCURRENCE INSURANCE COVERAGE OF STATE RESPONSE ACTION CONTRACTORS

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.300 PURPOSE (REPEALED)


 

Section 4203.300  Purpose (Repealed)

 

(Source:  Repealed at 36 Ill. Reg. 18744, effective December 17, 2012)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.310 DECLARATION (REPEALED)


 

Section 4203.310  Declaration (Repealed)

 

(Source:  Repealed at 36 Ill. Reg. 18744, effective December 17, 2012)

Section 4203.APPENDIX A Filing Requirements for Medical Malpractice Reporting

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.APPENDIX A FILING REQUIREMENTS FOR MEDICAL MALPRACTICE REPORTING


 

Section 4203.APPENDIX A   Filing Requirements for Medical Malpractice Reporting

 

General Instructions

 

●          All  reports shall include only direct Illinois medical malpractice insurance business. 

 

●          Each company must provide a Reconciliation as outlined in these Filing Requirements. 

 

●          Sample tables are provided to assist companies in understanding the required data elements.  They are provided for illustrative purposes only.

 

●          Reporting will be segregated by policy type.  The policy types are as follows:

 

1)         Claims made policy type that includes prior acts coverage

 

2)         Occurrence policy type that includes extended reporting endorsements

 

●          Reporting by claims made policy type will be aggregated by county.

 

●          Illinois counties will be identified in the data submission by a three digit code.  The following table lists the names of the 102 Illinois counties and the code designation for each:

 

County Name

County #

ADAMS

001

ALEXANDER

002

BOND

003

BOONE

004

BROWN

005

BUREAU

006

CALHOUN

007

CARROLL

008

CASS

009

CHAMPAIGN

010

CHRISTIAN

011

CLARK

012

CLAY

013

CLINTON

014

COLES

015

COOK

016

CRAWFORD

017

CUMBERLAND

018

DE KALB

019

DEWITT

020

DOUGLAS

021

DU PAGE

022

EDGAR

023

EDWARDS

024

EFFINGHAM

025

FAYETTE

026

FORD

027

FRANKLIN

028

FULTON

029

GALLATIN

030

GREENE

031

GRUNDY

032

HAMILTON

033

HANCOCK

034

HARDIN

035

HENDERSON

036

HENRY

037

IROQUOIS

038

JACKSON

039

JASPER

040

JEFFERSON

041

JERSEY

042

JO DAVIESS

043

JOHNSON

044

KANE

045

KANKAKEE

046

KENDALL

047

KNOX

048

LAKE

049

LA SALLE

050

LAWRENCE

051

LEE

052

LIVINGSTON

053

LOGAN

054

MCDONOUGH

055

MCHENRY

056

MCLEAN

057

MACON

058

MACOUPIN

059

MADISON

060

MARION

061

MARSHALL

062

MASON

063

MASSAC

064

MENARD

065

MERCER

066

MONROE

067

MONTGOMERY

068

MORGAN

069

MOULTRIE

070

OGLE

071

PEORIA

072

PERRY

073

PIATT

074

PIKE

075

POPE

076

PULASKI

077

PUTNAM

078

RANDOLPH

079

RICHLAND

080

ROCK ISLAND

081

SAINT CLAIR

082

SALINE

083

SANGAMON

084

SCHUYLER

085

SCOTT

086

SHELBY

087

STARK

088

STEPHENSON

089

TAZEWELL

090

UNION

091

VERMILION

092

WABASH

093

WARREN

094

WASHINGTON

095

WAYNE

096

WHITE

097

WHITESIDE

098

WILL

099

WILLIAMSON

100

WINNEBAGO

101

WOODFORD

102

OTHER

103

 

●          For all reports requiring by county information, the company may group the data by policy issuing county or other method that is consistent with its ratemaking practices.  The company must identify which method is used.  The company must use a consistent method to group the data in all by county reports.  Data grouped by territory is unacceptable. 

 

●          Reporting by occurrence policy type will be aggregated by state and will include only Illinois data.

 

●          Reports will contain 10 years of information on paid losses, paid allocated loss adjustment expenses, paid claim counts, incurred losses, incurred allocated loss adjustment expenses, incurred claim counts, earned exposures and earned premium, all on a direct reporting basis.

 

●          Provide the name, phone number and email address of the person responsible for filing this report with the Department of Insurance. 

 

●          Reports should be submitted via either Excel worksheet or .txt file format.  The submission shall be made electronically to the Illinois Department of Insurance.

 

Company Defined Items

 

●          Describe any changes made to the way in which the data has been grouped during the past 10 years and the impact of the changes on the reports.

 

●          Describe any changes made to reserving or claim payment practices in the past 10 years and the impact of the changes on the reports.

 

●          Explain/define the corporate policies written by the company.

 

Exhibits − Claims Made Policy Type

 

●          Direct paid losses by county for each of the past 10 report years.  For claims made policy type, direct paid losses and  direct paid allocated loss adjustment expenses shall be reported separately. 

 

●          Direct paid allocated loss adjustment expenses by county for each of the past 10 report years.  For claims made policy type, direct paid losses and direct paid allocated loss adjustment expenses shall be reported separately. 

 

●          Direct paid claim counts by county for each of the past 10 report years.

 

●          Direct incurred losses by county for each of the past 10 report years.  For claims made policy type, direct incurred losses and direct incurred allocated loss adjustment expenses shall be reported separately.

 

○          Incurred losses equal paid losses plus case reserves. 

○          Total incurred losses are required, not just incurred on open claims.

○          An accurate estimate for the claims related to that report year and county is required.  Average incurred severities are unacceptable.

 

●          Direct incurred allocated loss adjustment expenses by county for each of the past 10 report years.  For claims made policy type, direct incurred losses and direct incurred allocated loss adjustment expenses shall be reported separately. 

 

○          Total incurred allocated loss adjustment expenses are required, not just incurred on open claims.

 

●          Direct incurred claim counts by county for each of the past 10 report years. 

 

●          Direct earned exposures by county for each of the past 10 report years. 

 

●          Direct earned premium by county for each of the past 10 report years.

 

Examples of Reports for Claims Made Policy Type:

 

Paid Losses

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

 

County

 

 

 

 

 

 

 

 

 

 

001

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

002

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

003

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

004

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

005

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

006

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

007

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

 

 

 

 

 

 

 

 

 

 

 

Paid ALAE

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

County

001

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

002

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

003

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

004

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

005

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

006

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

007

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

 

 

 

 

 

 

 

 

 

 

 

Paid Counts

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

 

County

 

 

 

 

 

 

 

 

 

 

001

##

##

##

##

##

##

##

##

##

##

002

##

##

##

##

##

##

##

##

##

##

003

##

##

##

##

##

##

##

##

##

##

004

##

##

##

##

##

##

##

##

##

##

005

##

##

##

##

##

##

##

##

##

##

006

##

##

##

##

##

##

##

##

##

##

007

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

 

 

 

 

 

 

 

 

 

 

 

Incurred Losses

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

 

County

 

 

 

 

 

 

 

 

 

 

001

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

002

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

003

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

004

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

005

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

006

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

007

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

 

 

 

 

 

 

 

 

 

 

 

Incurred ALAE

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

County

001

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

002

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

003

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

004

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

005

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

006

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

007

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

 

 

 

 

 

 

 

 

 

 

 

Incurred Counts

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

 

County

 

 

 

 

 

 

 

 

 

 

001

##

##

##

##

##

##

##

##

##

##

002

##

##

##

##

##

##

##

##

##

##

003

##

##

##

##

##

##

##

##

##

##

004

##

##

##

##

##

##

##

##

##

##

005

##

##

##

##

##

##

##

##

##

##

006

##

##

##

##

##

##

##

##

##

##

007

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

##

 

 

 

 

 

 

 

 

 

 

 

Earned Exposures

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

 

County

 

 

 

 

 

 

 

 

 

 

001

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

002

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

003

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

004

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

005

$$

$$

$$

$$

$$

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006

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007

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$$

 

 

 

 

 

 

 

 

 

 

 

Earned Premium

 

 

 

 

 

 

 

 

 

 

Current Year

1 Year Prior

2 Year Prior

3 Year Prior

4 Year Prior

5 Year Prior

6 Year Prior

7 Year Prior

8 Year Prior

9 Year Prior

 

County

 

 

 

 

 

 

 

 

 

 

001

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002

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003

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004

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005

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006

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007

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Exhibits – Occurrence Policy Type

 

●          Exhibits require information and data pertaining to only Illinois medical malpractice liability business written.  This data should be aggregated to state level detail.  

 

●          Direct paid losses and allocated loss adjustment expenses for each of the past 10 accident years by evaluation date.  For occurrence policy type, direct paid losses and direct paid allocated loss adjustment expenses will be reported together.  This data array shall be reported in accordance with NAIC Annual Statement Schedule P Instructions.  The difference between a company's Schedule P and this requirement is that this array should contain direct Illinois medical malpractice data. 

 

●          Direct paid claim counts for each of the past 10 accident years by evaluation date.  This data array shall be reported in accordance with NAIC Annual Statement Schedule P Instructions.  The difference between a company's Schedule P and this requirement is that this array should contain direct Illinois medical malpractice data.

 

●          Direct incurred losses and incurred allocated loss adjustment expenses for each of the past 10 accident years by evaluation date.  For occurrence type policies, direct incurred losses and incurred allocated loss adjustment expenses shall be reported together.  This data array shall be reported in accordance with NAIC Annual Statement Schedule P Instructions.  The difference between a company's Schedule P and this requirement is that this array should contain direct Illinois medical malpractice data.

 

●          Direct incurred claim counts for each of the past 10 accident years by evaluation date.  This data array shall be reported in accordance with NAIC Annual Statement Schedule P Instructions.  The difference between a company's Schedule P and this requirement is that this array should contain direct Illinois medical malpractice data.

 

●          Direct earned exposures by accident year for each of the past 10 years. 

 

●          Direct earned premium by accident year for each of the past 10 years. 

 

Examples of Reports for Occurrence Policy Type:

 

Paid Losses and ALAE

 

 

Years in which losses were incurred

9

Year Prior

8 Year Prior

7 Year Prior

6 Year Prior

5 Year Prior

4 Year Prior

3 Year Prior

2 Year Prior

1 Year Prior

Current Year

 

9 Year Prior

$$

$$

$$

$$

$$

$$

$$

$$

$$

$$

8 Year Prior

 

$$

$$

$$

$$

$$

$$

$$

$$

$$

7 Year Prior

 

 

$$

$$

$$

$$

$$

$$

$$

$$

6 Year Prior

 

 

 

$$

$$

$$

$$

$$

$$

$$

5 Year Prior

 

 

 

 

$$

$$

$$

$$

$$

$$

4 Year Prior

 

 

 

 

 

$$

$$

$$

$$

$$

3 Year Prior

 

 

 

 

 

 

$$

$$

$$

$$

2 Year Prior

 

 

 

 

 

 

 

$$

$$

$$

1 Year Prior

 

 

 

 

 

 

 

 

$$

$$

Current Year

 

 

 

 

 

 

 

 

 

$$

 

 

 

 

 

 

 

 

 

 

 

Paid Counts

 

 

 

 

 

 

 

 

 

 

Years in which losses were incurred

 9    Year Prior

8 Year Prior

7 Year Prior

6 Year Prior

5 Year Prior

4 Year Prior

3 Year Prior

2 Year Prior

1 Year Prior

Current Year

 

9 Year Prior

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8 Year Prior

 

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7 Year Prior

 

 

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6 Year Prior

 

 

 

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5 Year Prior

 

 

 

 

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4 Year Prior

 

 

 

 

 

##

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3 Year Prior

 

 

 

 

 

 

##

##

##

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2 Year Prior

 

 

 

 

 

 

 

##

##

##

1 Year Prior

 

 

 

 

 

 

 

 

##

##

Current Year

 

 

 

 

 

 

 

 

 

##

 

 

 

 

 

 

 

 

 

 

 

Incurred Losses and ALAE

 

 

 

 

 

 

Years in which losses were incurred

 9    Year Prior

8 Year Prior

7 Year Prior

6 Year Prior

5 Year Prior

4 Year Prior

3 Year Prior

2 Year Prior

1 Year Prior

Current Year

 

9 Year Prior

$$

$$

$$

$$

$$

$$

$$

$$

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8 Year Prior

 

$$

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7 Year Prior

 

 

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6 Year Prior

 

 

 

$$

$$

$$

$$

$$

$$

$$

5 Year Prior

 

 

 

 

$$

$$

$$

$$

$$

$$

4 Year Prior

 

 

 

 

 

$$

$$

$$

$$

$$

3 Year Prior

 

 

 

 

 

 

$$

$$

$$

$$

2 Year Prior

 

 

 

 

 

 

 

$$

$$

$$

1 Year Prior

 

 

 

 

 

 

 

 

$$

$$

Current Year

 

 

 

 

 

 

 

 

 

$$

 

 

 

 

 

 

 

 

 

 

 

Incurred Counts

 

 

 

 

 

 

 

 

 

 

Years in which losses were incurred

 9    Year Prior

8 Year Prior

7 Year Prior

6 Year Prior

5 Year Prior

4 Year Prior

3 Year Prior

2 Year Prior

1 Year Prior

Current Year

 

9 Year Prior

##

##

##

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##

##

##

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8 Year Prior

 

##

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7 Year Prior

 

 

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6 Year Prior

 

 

 

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5 Year Prior

 

 

 

 

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4 Year Prior

 

 

 

 

 

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3 Year Prior

 

 

 

 

 

 

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2 Year Prior

 

 

 

 

 

 

 

##

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1 Year Prior

 

 

 

 

 

 

 

 

##

##

Current Year

 

 

 

 

 

 

 

 

 

##

 

Earned Exposures

 

Years in which losses were incurred

Direct and Assumed

 

 

 

9 Year Prior

 

8 Year Prior

 

7 Year Prior

 

6 Year Prior

 

5 Year Prior

 

4 Year Prior

3 Year Prior

2 Year Prior

1 Year Prior

Current Year

 

Earned Premium

 

Years in which losses were incurred

Direct and Assumed

 

9 Year Prior

 

8 Year Prior

 

7 Year Prior

 

6 Year Prior

 

5 Year Prior

 

4 Year Prior

 

3 Year Prior

 

2 Year Prior

 

1 Year Prior

 

Current Year

 

 

Reconciliation

 

Each company shall take steps to determine the data submitted under these requirements is accurate, reasonable, and appropriately reconciles to the most recently filed annual statutory financial statement. 

 

Describe the process used to reconcile the 1204 data, filed under this requirement, to the annual statutory financial statement.  Please include the magnitude of any discrepancies, a description of the differences, and the reasons for the differences. 

 

The company's senior financial officer and a qualified actuary must certify that the data filed under these requirements is accurate and reasonably reconciles with the most recently filed annual statutory financial statement.

 

(Source:  Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS
SECTION 4203.APPENDIX B GUIDELINES FOR SUBMISSION OF MEDICAL MALPRACTICE REPORTING (REPEALED)


 

Section 4203.APPENDIX B   Guidelines for Submission of Medical Malpractice Reporting (Repealed)

 

(Source:  Repealed at 36 Ill. Reg. 18744, effective December 17, 2012)