50 Ill. Adm. Code 4203.APPENDIX A
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
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002
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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
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002
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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
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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
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002
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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
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002
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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
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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
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002
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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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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
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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
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Current Year
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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
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1 Year Prior
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Current Year
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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
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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
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Current Year
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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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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
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Current Year
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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.