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

This Section provides instructions for coding the fields for other liability, medical malpractice, earthquake, commercial auto liability, Business Owners Packages (BOP), and excess insurance records. For the calendar year premium-only requirement only Fields 1 through 10 and 15 (see Section 4203.110) are to be reported for the classes in other liability, medical malpractice, earthquake, commercial automobile liability, Business Owners Policy, and excess insurance. Insurers writing earthquake and excess insurance on calendar-accident year basis must also submit calendar year premium-only records.

a) Data for commercial auto liability and BOP are to be reported on a calendar-accident year basis. Data for medical malpractice and other liability are to be reported on a policy year basis. Data for earthquake (REQ) are to be reported using either the calendar year or the calendar-accident year method. Excess insurance data are to be reported either on a calendar year, calendar-accident year, or policy year basis.

b) In the medical malpractice, other liability, commercial auto liability, BOP, and excess insurance the insurer will submit one record for each class for multi-state data and one record for each class for Illinois-only data. For earthquake (REQ), only Illinois-only data are required.

c) For all classes reported under the calendar-accident or policy year methods of compiling annual experience, premium and exposure data are to be reported as calendar year premium-only for non-personal line classes or by calendar year premium-only by zip code for homeowner and residential fire, using the instructions for reporting calendar year premium-only data.

d) Insurers should note that earthquake data refers to stand alone earthquake policies (non-commercial) (REQ) and should be reported separately from the earthquake data for homeowners and residential fire, addressed in Section 4203.80. If an insurer is unable to make this distinction, it will report all earthquake data under the stand alone earthquake class REQ. Also, for earthquake data, the form type, # of written exposures, and amount of paid ALAE, amount of outstanding ALAE fields for earthquake should be blank.

e) 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	=	National Association of Independent Insurers (NAII)
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 line or general classification to which the data belongs. Possible codes are:

1	=	Other Liability
2	=	Medical Malpractice
3	=	Commercial Auto Liability
6	=	BOP (Business Owners Package)
8	=	Earthquake
9	=	Excess Insurance

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

12	=	Illinois only
MS	=	Multi-state

AGENCY NOTE: MS does not apply to earthquake (REQ).

5) Experience Method – This one-character alpha-numeric field designates the experience method for the statistical data year reported. Possible codes are:

C	=	Calendar year
A	=	Calendar-accident year
P	=	Policy year
X	=	Calendar year premium-only

6) Statistical Data Year – This four-character alpha-numeric field reflects the experience year. (For example, for the November 1996 annual data filing, the statistical data year will be coded 1995 for lines that use the calendar year experience method. For lines using the calendar-accident and policy year experience methods, the statistical data year field will be coded for one of the years 1990-1994 and for one of the years 1989-1993, respectively.)

7) Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line. The insurer should report one record for Illinois-only data and one record for multi-state data for the medical malpractice, other liability, commercial auto liability, Business Owners Package (BOP), and excess insurance. For earthquake data, Illinois-only data are required but multi-state data are not required. Possible codes for Field 7 by line of business or type of coverage are:

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

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 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

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)

Business Owners Package

•

77777

business owners package (BOP)

Earthquake

•

REQ

residential earthquake (stand alone policies)

Excess Insurance

•	9772	=	commercial auto
•	99930	=	personnel umbrella
•	99935	=	commercial umbrella
•	88888	=	excess insurance – all other

8) 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, geographic location (Illinois-only or multi-state), and zip code, if required. Possible codes are:

C	=	claims-made
O	=	occurrence
T	=	claims-made tail coverage

For the earthquake data, the form type field should be left blank.

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

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

11) 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).

12) 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.

13) 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.

14) 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.

15) 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.

16) 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.

17) 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 31 Ill. Reg. 2287, effective January 22, 2007)