claims standard user guide - lloyd's of london · 6 transactions if you are reporting on a...

claims reporting – A standard for coverholders and TPAs

User Guide 11th February 2011

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Introduction 3 The purpose of this document 3 Why have coverholder claims reporting standards? 3 What does this mean for me as a coverholder? What should I do next? 3 Providing information to London 4 Spreadsheets 4 XML 4 Other media 4 Providing information to Lloyd’s local offices 4 Mandatory fields 5 Conditional mandatory fields 5 Management information fields 5

Transactions 6 Claims outside agreed authority 6 Open and closed claims 6 Paid and outstanding claims 6 Claims Reporting Standard, recommended layout mandatory fields only 7 Claims reporting standard, recommended layout, all fields 8

Field content and conditions for completion 9

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Introduction

The purpose of this document This document provides guidance on the information required, expected content and circumstances under which information should be provided when reporting claims to the Lloyd’s market. It provides a list of information requirements that are mandatory and must be provided in all cases. There is also a recommended report format. This is a suggested layout only.

Why have coverholder claims reporting standards? To make it easier for coverholders to do business with the Lloyd’s market by:

• Replacing many differing requests from syndicates and brokers with one agreed set of claims information requirements

• Giving a clear statement of the information that is needed by Lloyd’s syndicates, brokers and Lloyd’s itself for the servicing of claims

• Enabling reduction of keystrokes, automation and ultimately straight through processing by standardising information flows whilst allowing coverholders to choose their own technologies and systems

• To ensure the correct movement of monies between market participants

• To ensure Lloyd’s is able to meet regulatory reporting obligations and maintain its licences around the world

• To support improved claims performance management, both within the Lloyd’s syndicates, Lloyd’s brokers and Lloyd’s itself

• To support Lloyd’s syndicates business plans and underwriting decisions.

What does this mean for me as a coverholder? What should I do next? • Compare your current submission against the claims standard. Talk to your Lloyd’s broker; you may not need to

take any action yet. Alternatively, contact [email protected]

• If you manually create spreadsheets each month or currently submit on paper or word processing documents consider using the spreadsheet template for claims reporting being provided by Lloyd’s. This can be found at www.lloyds.com/acord

• If you have a system which you use for reporting claims, talk to your system vendor about the ease of changing systems to meet the standard. Let Lloyd’s know which system you use so they can talk to vendors on behalf of the market as a whole; please contact [email protected]

• Users of Lineage (Lloyd’s coverholder system in Canada) are already meeting the requirements of the claims standard and will require no further action

• If any changes are needed, agree a sensible target date with your broker in London and your system vendor.

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Providing information to London Coverholders typically provide claims information as a monthly submission on a bordereau. The information will usually be provided to the London broker as a statement of what needs to be collected from the Lloyd’s syndicate.

Spreadsheets

Information is often provided as a spreadsheet. This guide provides a recommended spreadsheet format; however, the information requirements may already be met in a satisfactory manner by an existing format. If the recommended spreadsheet format is used, then where fields are not required it is recommended such columns are hidden.

XML

Some coverholders are now able to provide XML and this is an acceptable format. It is the intention that a standard XML schema will be created in 2011.

Other media

It is recommended that coverholders agree with the London broker and Lloyd’s syndicate the means by which they will provide electronic structured information and which of the fields need to be reported.

Providing information to Lloyd’s local offices In some territories, there is a requirement for the coverholder to report directly to the local Lloyd’s office. Such reporting is often not specific to claims information, but may incorporate information on premiums and risks, or require the provision of certificates or other documents. Where coverholders are reporting direct to the local Lloyd’s office they are encouraged to discuss information requirements with such offices.

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What is the standard?

The standard is the minimum information required from coverholders when reporting claims to the Lloyd’s market.

Mandatory fields

The standard includes a series of mandatory fields; these must always be reported. In the recommended layout on page 7 these are shown in red.

The following fields are mandatory:

• Coverholder name

• Reference for the binder contract

• Binding authority contract inception and expiry dates

• Reporting period (month and year)

• Class of business, Lloyd’s risk code or section number of the contract

• Original currency

• Certificate reference

• Claim reference

• (Re)insured name and location

• Risk inception and expiry date or the period of cover

• Location of the loss

• Cause of the loss

• Date of the loss or the date claim made

• Status of the claim

• Refer to underwriters indicator

• Denial indicator

• Indemnity and fees paid this month

• Indemnity and fees previously paid (not including the “this month” amounts)

• Indemnity and fees reserved/outstanding

• Total incurred amount of the claim and any fees

Conditional mandatory fields

The standard includes a series of conditional mandatory fields which are mandatory under certain conditions. Whether or not these are mandatory will usually be dependent on the territory and/or class of business; however, there may be other factors to consider. In the recommended layout below these are shown in yellow. The condition(s) under which these fields must be reported is included in the table on Page 9.

Management information fields

The standard also includes a set of management information fields. It is preferable that as many of these fields are reported where possible and applicable. Please discuss with the Lloyd’s syndicate which fields are required to be completed. Lloyd’s syndicates often use this information for reporting and analysis purposes. In the recommended layout these fields are shown in white.

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Transactions

If you are reporting on a spreadsheet, then as a general rule each claim should appear as one row on the spreadsheet. However, some claims may have more than one movement in a reporting period and Lloyd’s syndicates vary in how they would like to see these reported. As a general rule an aggregation of the movements should be reported, but it is recommended that this is discussed with the Lloyd’s syndicate to understand their requirements.

Claims for multiple locations For property risks, it is recommended that the claim is split by location with a location identifier, preferably using the “Location ID” column (this is one of the white columns in the standard).

Claims outside agreed authority Any claims outside a coverholder or TPA’s claims handling authority should be reported, even if they are also reported individually. These claims must be clearly stated throughout the whole life of the claim and they are distinguished by marking a “Y” in the “referred to underwriters” column in the report (a mandatory field).

Open and closed claims Lloyd’s syndicates vary in whether they would like open and closed claims to be reported separately. It is recommended that this is discussed with the Lloyd’s syndicate to understand their requirements.

Paid and outstanding claims It is recommended that paid and outstanding claims to be included on the same report.

Catastrophe claims A catastrophe is deemed to be a severe loss characterised by extreme force, sizeable financial loss and/or multiple injuries. These are often abbreviated to “CAT” and often assigned a code to uniquely identify an occurrence of a catastrophe.

Lloyd’s syndicates tend to manage catastrophe claims differently to how they manage other claims. They are accounted for separately and it is very important to distinguish these claims so that the syndicate can manage their reserves to meet future needs. There are three fields in the claims standard in which a CAT claim can be distinguished:- the PCS code, Lloyd’s catastrophe code or the catastrophe name.

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Claims reporting standard, recommended layout mandatory fields only The standard is comprised of a series of mandatory fields which must always be completed. The mandatory fields are shown in red.

Please note, the Contract Details fields can either be headers (if the information applies to the whole report and every transaction), or they can be presented as columns.

One or more items from the yellow groups must be reported:

• Either an agreement number or a UMR (unique market reference)

• Either a class of business, Lloyd’s risk code or a section number

• Either a risk inception and expiry date, or where the period of cover cannot be defined by specific dates, a period of cover narrative

• The cause of loss must be reported either with a code-set (pre-agreed with the Lloyd’s underwriter) or a free text description (Loss Description) or both

• There are three methods to report the date of loss:

• If the event causing the loss occurred on just one date, use “Date of Loss”

• If the event causing the loss occurred over a period of days, use “Date of Loss(from)” and “Date of Loss(to)”

• If the policy is a claims made policy, use “Date Claim Made.”

Please see overleaf for all mandatory/conditional fields and management information fields.

*Transaction Details - repeat fields in settlement currency as appropriate.

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Claims reporting standard, recommended layout, all fields Please note, the Contract Details fields can either be headers (if the information applies to the whole report and every transaction), or they can be presented as columns.

• Mandatory fields are shown in red

• Fields shown in yellow are mandatory/conditional, i.e. they are mandatory under certain conditions

• It is recommended that columns which are not required are hidden

• Some fields may be the same for all records; these can either be repeated on each record or shown once on the first record

• All fields should appear as one record/row on the spreadsheet for each claim, or location as applicable

• The transaction columns may be repeated for settlement currency, as appropriate

• The expert columns may be repeated for each expert being reported

• It is recommended that the total number of records/claim is stated and each row is given a unique number to aid with any queries.

These fields are a continuation of the above fields (they have the same headers)

These fields are in addition to those above and are more class specific

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Field Content and Conditions for Completion Type of

Information Field Description Conditions

Coverholder Name

The name of the coverholder who has created the submission, or the coverholder that the submission is on behalf of (if submitted by a TPA). If the coverholder has multiple locations or branches the branch should also be identified, where appropriate.

Mandatory for all transactions.

TPA Name

The name of the third party administrator who has created and is submitting the report.

Mandatory/Conditional Condition(s): Where a TPA is submitting the report.

Agreement No

The reference by which the binder agreement is known.

Mandatory/Conditional Condition(s): Either an agreement number or the UMR to be reported.

Unique Market Reference (UMR)

The unique reference for the binding authority contract allocated by the Lloyd's market. All UMRs start with B, followed by the Lloyd’s broker number and a series of characters. The UMR should not contain any spaces, hyphens, slashes or other punctuation; it should only contain the numbers 0-9 and the letters A-Z. Maximum length 17 characters. The UMR is stated on the first page of the binding authority agreement schedule.

Mandatory/Conditional Condition(s): Either an agreement number or the UMR to be reported.

Contract Details (these can be

headers or columns)

Contract Inception

The day that the binding authority contract incepted. Mandatory for all transactions.

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Type of Information Field Description Conditions

Contract Expiry

The day that the binding authority contract expired.


Reporting Period (End Date)

As a minimum the month and year of the reporting period must be given.


Class of Business A description of the class of business.

Mandatory/Conditional Condition(s): A free text class of business, section number or (if known) the Lloyd’s risk code must be given.

Lloyd’s Risk Code

Lloyd’s categorises information on risks, premiums and claims using a series of risk codes. If you are familiar with these, then please specify the risk code for this transaction.


Section No

The number of the section from the binding authority contract which authorises this class of business to be written.


Contract Details

Original Currency

The currency in which the claim will be paid to the claimant. It is recommended that the ISO 4217, 3 letter alphanumeric currency codes are used. More details can be found here:- http://www.iso.org/iso/support/faqs/faqs_widely_used_standards/widely_used_standards_other/currency_codes/currency_codes_list-1.htm

Mandatory for all transactions

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Settlement Currency

The currency in which the coverholder should be paid by the Lloyd’s syndicate. This may be the same or different to the original currency. It is recommended that the ISO 4217, 3 letter currency code be used. More details can be found here:- http://www.iso.org/iso/support/faqs/faqs_widely_used_standards/widely_used_standards_other/currency_codes/currency_codes_list-1.htm

Mandatory/Conditional. Condition(s): This field is mandatory where the settlement currency is different to the original currency.

Contract Details

Rate of Exchange

The rate of exchange between the original and settlement currency.

Mandatory/Conditional. Condition(s): This field is mandatory where the settlement currency is different to the original currency.

Certificate Reference

The unique reference for the risk to which the claim relates.


References Claim Reference

The unique claim reference for the claim being reported, this is normally generated by the coverholder or TPA.


Insured Details Full Name or company name

The name of the company or the full name of the individual insured; or for reinsurance, the name of the original insured and reinsured if necessary. Where the name of the insured/reinsured is not known a code to uniquely identify them should be supplied instead, where appropriate.


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State, Province, Territory, Canton etc

If the country in which the insured/reinsured is resident, if they are a private individual, or has its main operating address, if it is a corporate body is a country with sub-divisions such as states, then the sub-division.

Mandatory/Conditional. Condition(s): Required where the insured is located in a country with sub-divisions.

Insured Details

Country

The country in which the insured is resident, if they are a private individual, or has its main operating address, if it is a corporate body. For a global or multi-national policy, the country in which the insured’s head or main office is situated. For a master policy, the country in which the master policyholder is situated. If there are multiple parties with an interest in the risk domiciled in different countries, it is necessary to designate the country most appropriate in the circumstances as the “country of origin”. It is recommended that the ISO 3166 2 letter country codes are used. Further details can be found here: http://www.iso.org/iso/country_codes/iso_3166_code_lists/english_country_names_and_code_elements.htm


Location of Risk State, Province, Territory, Canton etc

If the risk is located in a country with sub-divisions, for example states, then the sub-division in which the risk is located. Some risks may need to be split across a series of rows of detail where elements of the risk are located in more than one country sub-division.

Mandatory/Conditional Condition(s): This field is only mandatory if the location of the risk is different to the Insured details already specified in the column “Insured or Reinsured State, Province, Territory, Canton etc.”

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Location of Risk Country

The country where the risk is located. This is used for regulatory purposes. Lloyd’s risk locator tool can be used to help confirm the location of the risk http://www.lloyds.com/The-Market/Operating-at-Lloyds/Resources/Risk_locator

Some risks may need to be split across a series of rows of detail where elements of the risk are located in more than one country. It is recommended that the ISO 3166 2 letter country codes are used. Further details can be found here: http://www.iso.org/iso/country_codes/iso_3166_code_lists/english_country_names_and_code_elements.htm

Mandatory/Conditional Condition(s): This field is only mandatory if the location of the risk is different to the Insured details already specified in the column “Insured or Reinsured Country.”

Risk Inception Date The inception date of the risk; the date on which coverage starts.

Mandatory/Conditional Condition(s): Mandatory for all transactions that can be expressed as dates; otherwise details should be provided in the”Period of Cover Narrative” field.

Risk Expiry Date The expiry date of the risk; the date on which coverage ends.

Mandatory/Conditional Condition(s): Mandatory for all transactions that can be expressed as dates; otherwise details should be provided in the” Period of Cover Narrative” field.

Risk Details

Period of Cover – Narrative

Where the period of cover cannot be defined by specific dates, a narrative description of the cover.

Mandatory/Conditional Condition(s): Required where the period of cover cannot be expressed as dates.

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State, Province, Territory, Canton etc

If the loss occurred in a country with sub-divisions, for example states, then the sub-division in which the loss occurred.

Mandatory/Conditional. Condition(s): Required when the loss location is in a country with sub-divisions.

Location of Loss

Country

The country where the loss occurred. It is recommended that the ISO 3166 2 letter country codes are used. Further details can be found here: http://www.iso.org/iso/country_codes/iso_3166_code_lists/english_country_names_and_code_elements.htm

Mandatory/Conditional. Condition(s): Mandatory for all transactions.

Cause of Loss Code

The event that brought about or triggered the loss or damage. This may be represented by a code from a list which has been pre-agreed by the coverholder and the Lloyd’s syndicate.

Mandatory/Conditional. Condition(s): Either a cause of loss code or a loss description is required.

Claim Details

Loss Description

The event that brought about or triggered the loss or damage. This field is a free text field.

Mandatory/Conditional. Condition(s): Either a cause of loss code or a loss description is required.

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Date of Loss (from)

The date the loss occurred or the policy was triggered according to the policy terms (if this is different). As a minimum this should be one date, however, it is recommended that date of loss from is always reported.

Mandatory/Conditional. Condition(s): Mandatory where the date can be expressed either as one date (Date of Loss) or using Date of Loss from.

Date of Loss to

The last date of loss. If an event occurred that caused the loss to be spread over a time frame longer then one day, the last day that the loss occurred should be reported.

Mandatory/Conditional. Condition(s): Mandatory where a loss has occurred over a period of longer then one day.

Date Claim Made

The date that the insured first notified the claim. This is used for claims made policies which are a form of insurance that pays claims notified during the term of the contract or within a specific term after its expiration.

Mandatory/Conditional Condition(s): Mandatory for all claims made policies.

Claim Status

The status of the claim as a result of the transaction. This can be one of the following: Open Closed Closed this month Re-opened Subrogation


Refer to Underwriters

An indicator for claims that are required to be referred to the underwriters. This should be “Y” or “N.”


Claim Details

Denial

An indicator for claims that have been denied. This should be a “Y” or “N.”


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Claimant Name Claimant Name The person or organisation that has alleged that it is entitled to redress from the insured.

Mandatory/Conditional Condition(s): This is mandatory where the claimant is not the insured.

Loss County

The US county in which the claim occurred.

Mandatory/Conditional Condition(s): Mandatory for all claims where the loss is located in the United States and the cause of loss is deemed to be a catastrophe.

State of Filing The US state in which the premium was filed.

Mandatory/Conditional Condition(s): Mandatory for all direct insurance risks filed in the US.

US Details

PCS Code

The PCS code which is applicable for the cause of loss. ISO's Property Claim Services (PCS) unit is the recognised authority on insured property losses from catastrophes in the United States, Puerto Rico, and the U.S. Virgin Islands. When a disaster strikes anywhere in the United States, Puerto Rico, or the U.S. Virgin Islands, PCS investigates to determine whether the damage will meet the definition of a catastrophe. PCS now defines catastrophes as events that cause $25 million or more in direct insured losses to property and that affect a significant number of policyholders and insurers. For further information please see: http://www.iso.com/Products/Property-Claim-Services/PCS-Catastrophe-Serial-Numbers.html

Mandatory/Conditional Condition(s): If the loss is located in the US and the cause of loss is classed as a catastrophe, one of the following must be completed: “PCS code” ”Lloyd’s catastrophe code” “Catastrophe Name”

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Medicare – Status Check Indicator

Where the coverholder/TPA has taken responsibility for checking that the claim is Medicare eligible and/or has contacted their agreed third party to perform the check the claim should be flagged as “Y”, all other claims should be flagged as “N”.

Mandatory/Conditional Condition(s): Applicable to US liability claims involving bodily injury.

Medicare – Outcome of Status Check

The result of the Medicare status check; this confirms if the claim is Medicare eligible. For further information, visit the Lloyd’s Medicare website page: http://www.lloyds.com/The-Market/Communications/Regulatory-Communications-Homepage/Key-Regulatory-Projects There is also a page for Lloyd’s syndicates only which requires registration with Lloyds.com http://www.lloyds.com/The-Market/Communications/Regulatory-Communications-Homepage/Key-Regulatory-Projects/Information-for-managing-agents/Medicare-information-for-managing-agents Medicare enquiries can be sent to [email protected]


US Details

Medicare Incurred Amount

The amount of the claim that is Medicare eligible. This is an incurred amount and should include the payable amount this month, previously paid and reserved.


Paid this month – Indemnity

The amount of the claim that is to be collected from the Lloyd’s syndicate this month.

Mandatory for all transactions

Transaction Details Paid this month

- Fees

Fees paid to third parties that are to be collected from the Lloyd’s syndicate this month.


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Previously paid - Indemnity

The amount of the claim that has already been paid, not including the amount in the column “paid this month - indemnity.”


Previously paid - Fees

The amount of fees to third parties that has already been paid, not including the amount in the column “paid this month – fees.”


Reserve – Indemnity

The amount outstanding which the coverholder or TPA still expects the Lloyd’s syndicate to pay out in respect of the claim or claim item.


Reserve – Fees

The amount outstanding for fees to third parties.


Change this month - Indemnity

The change in the “Total Incurred Indemnity” since the last report month.

It is recommended to report this field.

Change this month - Fees

The change in the “Total Incurred Fees” since the last report month.

It is recommended to report this field.

Transaction Details

(Original currency)

Total Incurred - Indemnity

The total amount incurred as a result of the claim. This can be calculated as follows: The sum of: “Total paid this month indemnity” “Previously paid indemnity” “Reserve indemnity”


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Transaction Details

(Original currency)

Total Incurred – Fees

The total fee amount incurred as result of the claim, including expenses. This can be calculated as follows: The sum of: “Total paid this month fees” “Previously paid fees” “Reserve fees”


Coverholder PIN

The unique identifier for the coverholder branch which has been allocated by Lloyd's. This can be found in Lloyd’s Atlas system. The coverholder PIN is a 9 digit number. Further information on Atlas can be found here: http://www.lloyds.com/The-Market/Tools-and-Resources/Tools-E-Services/Atlas

To be supplied where known.

Reporting Period (Start Date)

The start date for the reporting period being submitted. To be supplied where known.

Contract Details

Type of Insurance

The type of insurance or reinsurance: - Direct - Facultative Reinsurance - Treaty Reinsurance - Excess of Loss


References

Policy or Group Reference

The unique identifier for the group of risks or certificates such as the policy, or group reference.

To be supplied where known, or as applicable.

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Address

The full address for the insured, or for reinsurance the full address of the reinsured. This should be where the insured/reinsured is resident, if they are a private individual, or has its main operating address, if it is a corporate body.


Insured Details

Postcode, Zip Code or Similar

The postcode, zipcode or similar for the insured, or reinsured. This should be where the insured/reinsured is resident, if they are a private individual, or has its main operating address, if it is a corporate body.


Location ID

A unique identifier for a property risk with more then one location. Each location should be identifiable, so there is clarity about which location the claim relates to.

To be supplied where known, or as applicable.

Address

The full address of the risk. Lloyd’s risk locator tool can be used to help confirm the location of the risk http://www.lloyds.com/The-Market/Operating-at-Lloyds/Resources/Risk_locator


Location of Risk

Postcode, Zip Code or similar

The post code, zip code or similar for the risk.


Deductible Amount

The deductible or excess for the policy. This should be 100% of the value and the percentage for the contract.


Deductible Basis The basis on which the deductible was calculated.

To be supplied where known. Risk Details

Sum Insured Amount

The total amount of the sum insured applicable at the location involved in the specific claim. This should be 100% of the value and the percentage for the contract.


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Address

The full address of the loss location. To be supplied where known.

Location of Loss Postcode, Zip Code or similar

The postcode/zip code etc of the loss location. To be supplied where known.

Date First Advised / Notification Date

The date that the notification of the claim was first received. To be supplied where known.

Date Closed

The date on which the claim is designated as settled or determined as not being payable or withdrawn. No further actions are required in the handling of the claim.


Lloyd’s Catastrophe Code

The Lloyd’s catastrophe code applicable to the cause of the loss. The code is allocated based upon the year the accident occurred, followed by an alphabet suffix. A loss attributable to a common cause which occurs over a period of time and is not date specific is assigned a code which may be prefixed by * or ! For more information and a code list please see: http://www.lloyds.com/The-Market/Operating-at-Lloyds/Resources/Catastrophe-codes

To be supplied where known, or as applicable. If the cause of loss is classed as a catastrophe, one of the following must be completed: “PCS code” ”Lloyd’s Catastrophe Code” “Catastrophe Name” Generally, it is the responsibility of the Lloyd’s broker to ensure the Lloyd’s Catastrophe code is complete where appropriate.

Claim Details

Catastrophe Name

The name of the catastrophe causing the loss.

To be supplied where known, or as applicable. If the cause of loss is classed as a catastrophe, one of the following must be completed: “PCS code” ”Lloyd’s Catastrophe Code” “Catastrophe Name”

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Paid this month -Expenses

Any expenses to be collected from the Lloyd’s syndicate(s) this month.

To be supplied where known or as applicable.

Paid this month -Attorney Coverage Fees

Attorney fees (fees incurred to determine the cover the Lloyd’s syndicate is liable to provide under the policy) to be collected from the Lloyd’s syndicate(s) this month.


Paid this month -Adjusters Fees

Any adjuster’s fees to be collected from the Lloyd’s syndicate(s) this month.


Paid this month -Defence Fees

Any attorney fees incurred in defending a claim made against the insured to be collected from the Lloyd’s syndicate(s) this month.


Paid this month -TPA Fees

Any third party administrator fees to be collected from the Lloyd’s syndicate(s) this month.


Previously Paid -Expenses

Any expenses previously paid, not including the amount in the column “paid this month – expenses.”


Previously Paid -Attorney Coverage Fees

Any attorney coverage fees previously paid (fees incurred to determine the cover the Lloyd’s syndicate is liable to provide under the policy), not including the amount in the column “paid this month – attorney coverage fees.”


Previously Paid -Adjusters Fees

Any adjuster’s fees previously paid, not including the amount in the column “paid this month – adjusters fees.”


Transaction Details

Previously Paid -Defence Fees

Any attorney fees incurred in defending a claim made against the insured previously paid, not including the amount in the column “paid this month – defence fees.”


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Previously Paid -TPA Fees

Any third party administrator fees previously paid, not including the amount in the column “paid this month – TPA fees.”


Reserve -Expenses

Any reserved or outstanding expenses. To be supplied where known or as applicable.

Reserve -Attorney Coverage Fees

Any reserved or outstanding attorney coverage fees (fees incurred to determine the cover the Lloyd’s syndicate is liable to provide under the policy).


Reserve -Adjusters Fees

Any reserved or outstanding adjuster’s fees. To be supplied where known or as applicable.

Reserve -Defence Fees

Any attorney fees incurred in defending a claim made against the insured reserved or outstanding.


Transaction Details

Reserve -TPA Fees

Any reserved or outstanding third party administrator fees. To be supplied where known or as applicable.

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Transaction Details

Total Incurred

The total amount incurred as a result of the claim and any fees paid. This can be calculated as follows: The sum of: “Total paid this month indemnity” “Previously paid indemnity” “Reserve indemnity” “Total paid this month fees” “Previously paid fees” “Reserve fees” Or the sum of: “Total Incurred Indemnity” “Total Incurred Fees” It is recommended that a total for this amount is given at the end of the report.


Name or Registration No of Aircraft Vehicle, Vessel etc

The name of the ship, the registration number of the aircraft, registration number of the vehicle etc.


Class of Business specific

Percentage Ceded

Used for reinsurance business; the percentage that has been ceded to reinsurers.


Plan

The plan that the insured has opted for.


Patient Name

The name of the patient receiving treatment.


Accident and Health / Medical

Expenses Treatment Type

The type of treatment that the patient is undertaking.


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Country of Treatment

The country in which the treatment is being undertaken.

To be supplied where known or as applicable. Accident and

Health / Medical Expenses

Date of Treatment

The date the treatment is due to/or is going to occur. .


Role The role of the expert.

Experts who are involved in the transaction should be specified, this could include adjusters, lawyers, accountants etc.

Firm / Company Name The name or company name of the expert.


Reference No Any reference number allocated to the expert; for example the open market correspondent number.


Address The address of the expert.


State, province, territory, canton etc

The state, province, territory or canton in which the expert is located.


Experts

Postcode, Zip Code or similar The postcode or zip code at which the expert is located.


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Country

The country where the expert is located. It is recommended that the ISO 3166 2 letter country codes are used. Further details can be found here: http://www.iso.org/iso/country_codes/iso_3166_code_lists/english_country_names_and_code_elements.htm

Experts who are involved in the transaction should be specified, this could include adjusters, lawyers, accountants etc. Experts

Notes Any notes or extra comments.

As required.

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