Section 4203.APPENDIX B Guidelines for Submission of Medical Malpractice Reporting
State of Illinois
Department of Financial and Professional Regulation
Division of Insurance
Guidelines for the Submission of Medical Malpractice Insurance Information
Pursuant to Section 1204 of the Illinois Insurance Code [215 ILCS 5/1204]
To assist insurers and other reporting entities in the submission of medical malpractice insurance information as required by the State of Illinois and outlined in Section 1204, the Illinois Department of Financial and Professional Regulation-Division of Insurance (DOI) offers these instructions containing submission guidelines and other useful information.
TABLE OF CONTENTS
OVERVIEW............................................................................................................................... 16
FILE PROTOCOLS................................................................................................................... 16
A) File Types................................................................................................................. 16
1. CONTROL FILE.................................................................................................... 16
2. DATA FILE........................................................................................................... 16
3. WORD/PDF DOCUMENT.................................................................................... 16
b) File Formats............................................................................................................ 17
1. TEXT FORMATTING............................................................................................ 17
2. DECIMAL FORMATTING.................................................................................... 17
3. LIMITS FORMATTING......................................................................................... 17
FILE NAMING CONVENTIONS............................................................................................ 18
A) standard Files........................................................................................................ 18
1. DATA FILES......................................................................................................... 18
2. CONTROL FILES................................................................................................. 18
3. WORD/PDF DOCUMENT................................................................................... 18
B) ZIP Files................................................................................................................... 19
SUBMISSION OF MEDIA....................................................................................................... 19
A) Electronic Submission − Browser..................................................................... 19
B) Electronic Submission − DOS.............................................................................. 23
C) Mail Submission..................................................................................................... 26
TYPE CATEGORIES................................................................................................................. 26
POLICY TYPE................................................................................................................ 26
EXPOSURE TYPE......................................................................................................... 27
HEALTH CARE INSURER TYPE............................................................................... 27
LOSS TYPE.................................................................................................................... 27
RESERVE STUDY LOSS TYPE................................................................................... 27
CLAIM TYPE................................................................................................................. 27
COUNTY CODES...................................................................................................................... 27
RECORD LAYOUTS................................................................................................................. 30
Control File − ASCII Formatted.............................................................................. 30
File 1 − Exhibit 1 − ASCII Formatted........................................................................ 31
File 2 − Exhibit 2a Reserves − ASCII Formatted..................................................... 33
File 3 − Exhibit 2a Surplus − ASCII Formatted1..................................................... 34
File 4 − Exhibit 2b − Word/PDF Document............................................................... 35
Guidelines for the Submission of Medical Malpractice Insurance Information
Pursuant to Section 1204 of the Illinois Insurance Code [215 ILCS 5/1204]
Section 1204 of the Illinois Insurance Code [215 ILCS 5/1204] requires medical malpractice insurers to file insurance information with the Illinois Department of Financial and Professional Regulation's Division of Insurance. Section 1204 mandates that every medical malpractice insurer shall file an annual submission with the Director of the Division of Insurance. The purpose of this document is to provide uniform guidelines to assist medical malpractice insurers in the proper and timely submission.
There will be three types of files contained in an insurer's submission.
As its name implies, this file will contain control information that allows DOI to track the submission, such as the insurer FEIN, NAIC control code and company contact information. There will only be one control file with each submission.
These files will contain Exhibit 1, Exhibit 2a Reserve and Exhibit 2a Surplus data records as defined in this document. There will be one of each of these files for each reporting year in a submission.
This document will contain answers to the Exhibit 2b Reserve and Exhibit 2b Surplus questions. Additionally, it will contain the Consulting Actuarial Report and Data Supporting the Company's Rate Filing, a listing and descriptions of Company Defined Items and a narrative description regarding the Reconciliation of the data as set forth in Appendix A Filing Requirements for Medical Malpractice Reporting.
The record layouts, which are displayed following these guidelines, are based on the actuarial specifications set forth in this document. Each record in the control and data file will end in a standard carriage return/line feed (CRLF). A separate file will be created for each year of data submitted.
The document containing the responses to the Exhibit 2b Reserve and Surplus Study questions, the Consulting Actuarial Report and Data Supporting the Company's Rate Filing, Company Defined Items and the Reconciliation narrative will be stored either in a Microsoft® Word compatible format or in portable document format (PDF) compatible with Adobe® Acrobat Reader 6.0 or greater.
The control file and data files will be stored in ASCII formatted, non-delimited text files. Text fields will be non-delimited and may be mixed case. Text fields may also contain spaces.
In any field where the number formatting is designated to be Dec (3, 2) or Dec (5,3), the number is considered to be a percentage item. For example, a percentage of 23.5% in a field designated Dec (3,2) should be shown in the field as 02350.
In Exhibit 1civ of the file that holds Exhibit 1 data, there is a field that holds the corresponding tail factor for the Maturity Year. This is a numeric, non-percentage field formatted as Dec (1,3). For example, a tail factor of 0.925 would be shown in the field as 0925.
For reporting policy limits, both occurrence and aggregate limits are to be provided. The format for reporting limits is as follows: occurrence limit/aggregate limit with the ending ($000) omitted. For example, a limit of $1,000,000 per occurrence and $3,000,000 aggregate would be reported as "1000/3000". This field will be read as text, so leading zeros are not necessary.
Data file names will be based on the type of exhibit data and the reporting year contained in the file. For example,
EXHIBIT1_123456789_1998.TXT
will contain Exhibit 1 data for the 1998 calendar reporting year from an insurer with a FEIN of 12-3456789. A file named
EXHIBIT2a_Surplus_987654321_2001.TXT
will contain Exhibit 2a Surplus Study actuarial data from the 2001 calendar reporting year from an Insurer with a FEIN designation of 98-7654321. Note that all data files will carry a .txt extension.
The control file contains insurer-specific company and contact information vital for a successful data submission. The file name will classify it as a control file and specify the FEIN to identify the submitting company. A file named
Control_123456789.txt
will be recognized as the file containing control information for the insurer with FEIN ID 12-3456789.
This will be word processor file in a format compatible with Microsoft® Word or in portable document format (PDF) compatible with Adobe® Acrobat Reader 6.0 or greater. Since it will contain responses to Exhibit 2b Reserve and Surplus Study questions, the Word document will be named
EXHIBIT2b_123456789.DOC
which will identify the file as the Exhibit 2b Reserve and Surplus Study file for the company with FEIN ID 12-3456789, and the .doc extension will classify the file as a Word document. In the event that Adobe® Acrobat Reader 6.0 or greater is the chosen format, the file will be named
EXHIBIT2b_123456789.PDF
which will identify it as the Exhibit 2b Reserve and Surplus Study file for the company with FEIN ID 12-3456789, and the .pdf extension will classify the file as an Adobe® Acrobat Reader document.
Since most submissions will contain a large number of files, if you have file archiving software, such as WinZip® or PKZip®, the control, data and documentation files may be archived in a zipped or self-expanding zipped file to shorten the upload process. In the event this process is utilized, the naming convention will be
Control_999999999.zip for a zipped archive file
Or
Control_999999999.exe for a self-expanding archive file
where 999999999 is the insurer's nine digit FEIN ID.
Media may be submitted electronically using file transfer protocol or by mail on CD-ROM. Insurers may choose which of the two methods best suits their needs.
A) Electronic Submission − Browser
1. Start your web browser (this example uses
Internet Explorer). Type ftp://163.191.27.5 in the address line and click 
or press Enter
2. A pop up box will appear for the login process. If your browser is using a pop up blocker, you will need to enable pop ups and will probably be prompted to do so. In the User name box, type ildpr\ftp then press Tab to move to the password box. For your password, type fprftp (exactly as written – the password is case sensitive). Now click the Log On button.
3. When you see the folder FPRFTP in the browser window, you know you have connection. Double click the folder to open it.
4. Go to the file to upload on your computer. The screen shots below show a file on a local computer in a folder called C:\Word on the left and the FTP site on the right. Click on your file, hold down the left mouse button and drag to the FTP window. If multiple files need to be transferred, they can be done as a group.
The status box shows the file copying:
5. When the files appear in both windows, the
upload was successful. Click on the 
in the upper corners of both windows
to close.
B) Electronic Submission − DOS
1. FTP file transfer can also be achieved using the DOS command line. Click on Start, and then Run. On the Open: line, type cmd and click OK.
2. At the C:\> prompt, type ftp followed by a space, then type 163.191.27.5. Press Enter.
3. When prompted for the User name, type ildpr\ftp and press Enter. At the password prompt, type Ftp&Fpr (remember, the password is case-sensitive and will not appear on screen) and press Enter. Once signed in you will be at an ftp> prompt.
4. This process utilizes a file transfer command called "Put" to upload your file. Type put followed by the complete path and file name of the file you wish to transfer. This example shows the file named medmal.txt in the C:\word folder being transferred. Type the command as follows:
put c:\word\medmal.txt
then press Enter. You will get a message acknowledging when the transfer is complete.
This transfer method works best when using a zip file or self-expanding zip file archive.
After the transfer is complete, type the command quit at the ftp> prompt, and you will be returned to your C:\> prompt. Type exit, then press Enter to close the session.
Data submitted by mail should be on recordable compact disc media (CD-R) in a sturdy mailer in order to prevent damage to the media during shipping. The media should be readable by software running under the Microsoft® Windows operating system. The sealed media should be mailed to:
|
Illinois Department of Financial and Professional Regulation |
|
Division of Insurance 1204 Data |
|
320 W. Washington |
|
Springfield IL 62786 |
|
|
|
Attn: Casualty Actuarial Section |
If submitting by mail, we recommend sending the media by certified mail, return receipt requested. This will provide a record of delivery.
Certain data elements being collected require a DOI defined code. These elements will be designated by the word (Code) following their name in the record layout later in this document. The category types, codes and their descriptions are as follows:
CMPA = Claims Made Including Prior Acts
OERE = Occurrence Including Extended Reporting Endorsements
INDL = Individual Policies
CORP = Corporate Policies
PHSU = Physicians, Surgeons and Osteopaths
HOSP = Hospitals
OHCP = Other Health Care Professionals (including Dentists)
OHCF = Other Health Care Facilities
PYPL = Policy Year Paid Losses
PYPA = Policy Year Paid Allocated Loss Adjustment Expenses
PYPL = Policy Year Incurred Losses
PYIA = Policy Year Incurred Allocated Loss Adjustment Expenses
ILDC = Incurred Direct and Assumed Loss and Defense & Cost Containment Expenses Reported at Yr. End
PLDC = Cumulative Direct and Assumed Paid Loss & Defense & Cost Containment Expenses Reported at Yr. End
IBNR = Bulk and IBNR Reserves on Direct and Assumed Loss and Defense & Cost Containment Expense Reported at Yr. End
CCWP = Cumulative Number of Claims Closed with Loss Payment, Direct & Assumed at Yr. End
COUT = Number of Claims Outstanding, Direct & Assumed at Yr. End
CREP = Cumulative Number of Claims Reported, Direct & Assumed at Yr. End
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 |
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