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
|
=
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Company
Direct – Partial
|
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6
|
=
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Company
Direct – 100 Percent
|
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7
|
=
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Other
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c) Line of Business – This alpha-numeric field identifies the
line or general classification to which the data belongs. Possible codes are:
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05.0
|
=
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BOP (Business Owners Package)
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|
11.0
|
=
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Medical Malpractice
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12.0
|
=
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Earthquake
|
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17.0
|
=
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Other/Excess Liability
|
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19.4
|
=
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Commercial Auto Liability
|
d) State Identifier – This field identifies the geographical
source of the data. Possible codes are:
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12
|
=
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Illinois only
|
|
MS
|
=
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Multi-state
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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)
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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
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Dentists
|
•
|
80210
|
=
|
Oral surgery with anesthesia
|
|
•
|
80211
|
=
|
Oral surgery without
anesthesia
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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
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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)