Title:50 Part:4203

PART 4203 INSURANCE DATA REPORTING REQUIREMENTS : Sections Listing

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER vv: INSURANCE COST CONTAINMENT
PART 4203 INSURANCE DATA REPORTING REQUIREMENTS

SUBPART A: COST CONTAINMENT REPORTING

Section 4203.10 Applicability
Section 4203.20 Purpose and Scope
Section 4203.30 Data Collection Procedures
Section 4203.40 General Submission Guidelines
Section 4203.50 Required Data Types (Lines, Classes, and Coverages)
Section 4203.60 Line Item Matrix For Cost Containment Reporting
Section 4203.70 Coding Conventions for Other Liability/Excess Insurance, Medical Malpractice, Earthquake, Commercial Auto Liability, and Business Owners Packages
Section 4203.80 Coding Conventions for Homeowner and Residential Fire Insurance
Section 4203.90 Coding Conventions for Private Passenger Auto Liability Insurance (Excluding PIP)
Section 4203.100 Coding Conventions for Private Passenger Auto Physical Damage
Section 4203.110 Record Layout for the Four Formats

SUBPART B: MEDICAL MALPRACTICE REPORTING

Section 4203.200 Applicability
Section 4203.210 Purpose and Scope
Section 4203.220 Definitions
Section 4203.230 Reports

SUBPART C: MARKET SURVEY FOR OCCURRENCE INSURANCE COVERAGE OF STATE RESPONSE ACTION CONTRACTORS

Section 4203.300 Purpose (Repealed)
Section 4203.310 Declaration (Repealed)
Section 4203.APPENDIX A Filing Requirements for Medical Malpractice Reporting
Section 4203.APPENDIX B Guidelines for Submission of Medical Malpractice Reporting (Repealed)

AUTHORITY: Implementing Article XLII and authorized by Sections 401 and 1204 of the Illinois Insurance Code [215 ILCS 5].

SOURCE: Adopted at 22 Ill. Reg. 4853, effective March 3, 1998; amended at 31 Ill. Reg. 2287, effective January 22, 2007; amended at 33 Ill. Reg. 2285, effective January 26, 2009; amended at 36 Ill. Reg. 18744, effective December 17, 2012; amended at 39 Ill. Reg. 2603, effective February 6, 2015; amended at 42 Ill. Reg. 20370, effective November 1, 2018.

SUBPART A: COST CONTAINMENT REPORTING

Section 4203.10 Applicability

This Part applies to each company licensed to write property or casualty insurance in this State pursuant to Section 4, Class 2 (a)-(l) and Class 3 (a)-(i) of the Illinois Insurance Code (Code) [215 ILCS 5]. These procedures apply to all direct property and liability business written by insurers licensed by the State of Illinois. The data filings are not to include premiums received from, or losses paid to, other insurers because of the reinsurance assumed by the reporting insurers; nor shall any deductions be made by the reporting insurers for premiums ceded to, or for losses recovered from, other insurers because of the reinsurance ceded.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.20 Purpose and Scope

The purpose of this Part is to establish content, form and data reporting requirements for information required to be reported to the Director of the Illinois Department of Insurance (Director) pursuant to Section 1204(A) through (D) of the Code. This Part also provides for the collection of data required to implement Article XXXIII of the Code. In addition, this Part establishes the medium for this information to be transmitted to the Director.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.30 Data Collection Procedures

a) Scope of Procedure

Each insurer shall report its business written separately for Illinois and multi-state (including Illinois) for each line, subline, or class, or endorsement specified by this Part. Where zip code reporting is required, each line, subline, class or endorsement shall be reported separately for each zip code. Only data for the voluntary market will be reported.

b) Methods of Compiling Annual Experience

All data contained in this data call shall be submitted on a calendar year basis. For the calendar year experience method, the insurer or agent will report evaluations as of December 31. Data will be reported for the current year minus one year. (For example, the 2017 report will contain data for 2016, evaluated as of December 31, 2016, the latest complete, calendar year experience year.)

c) Experience Method By Line

In reporting the required data, please note the following clarifications:

1) The "Other Liability" line includes classes from liquor liability, day care centers, and lawyers professional liability, and excess/umbrella coverage.

2) Data from Beach Plans and Assigned Risk Plans will not be reported. (The Illinois FAIR Plan Association will submit Illinois-only data for homeowners.) Insurers will not report any FAIR Plan data.

d) Preparation and Completion of Statistical Reports

1) Insurers may report statistics directly, or through an agent. Agents reporting data for more than one insurer will report each insurer's data on separate records.

2) Insurers will report their data within the required time frame using the codes and record formats provided in Sections 4203.50 through 4203.110.

3) Exemption requests:

A) All companies requesting exemption from data submission requirements must notify the Department prior to each filing date. The notice must contain the following information:

i) Name of company or agent;

ii) FEIN (not applicable to agents);

iii) NAIC group and company number (not applicable to agents);

iv) Filing date (e.g., 11/25/06);

v) Address, City, State and Zip code;

vi) Contact person;

vii) Phone number of contact person;

viii) Email address for contact person; and

ix) Reason for exemption.

B) All data for each line of business must be submitted as a complete submission. In the event data is resubmitted, all data previously submitted for that line of business by that insurer will be deleted and replaced by the resubmitted data.

C) Insurers need not submit a record (for either Illinois only or multi-state) for any line, class, or endorsement if written premiums, earned premiums, and paid and outstanding losses in the Illinois-only data are all zeroes.

e) Reporting of Exposures

A count of the number of written exposures will be reported separately for each line, type of business and classification. Section 4203.50 provides the exposure basis for each.

f) Reporting of Premiums

The premium reported will be the premium charged for the policies within each classification. Excess insurance premiums will be reported separately as addressed in subsection (o). Premiums will be reported on both a written and earned basis.

g) Reporting of Losses

Separate fields are provided for both paid losses and outstanding losses. Losses will be reported net as to third party recoveries (under salvage and subrogation). Paid losses are defined as all sums paid to claimants or policyholders in direct settlement of losses covered by the policies. Outstanding losses are defined as the amounts of loss reserves established for paying claims for the reporting period that have not been paid as of the evaluation date. Losses covered by an excess policy will be reported separately as addressed in subsection (p).

h) Reporting of Allocated Loss Adjustment Expenses

Allocated loss adjustment expense (ALAE) includes all expenses of the company which can be identified with and hence allocated to a particular claim. Insurers will report the amount of paid and outstanding ALAE for the private passenger auto liability, medical malpractice, other liability and commercial auto liability lines. Also, ALAE will be collected for business owners insurance and excess insurance. In those situations where an insurer cannot separate indemnity and ALAE, the insurer will submit a separate record; however, the insurer will enter the combined loss and ALAE total in the paid loss or outstanding loss fields and will identify this option by coding the corresponding paid ALAE or outstanding ALAE fields with the word "combined".

i) Reporting Paid Claims Count

Insurers will report the count of their paid claims. A claim closed without a loss payment is not to be reported. A claim involving only allocated loss adjustment expense is not to be reported with a claim count. A claim count is to be reported only for those cases where a loss payment has been made or a loss reserve has been established. A paid claim is defined as a claim for which a payment has been made. In cases where a claim is partially paid with an associated case reserve still maintained, insurers have the option to report the claim count as either paid or outstanding. A case involving loss payments or loss reserves under more than one classification will have a claim count under each classification.

j) Reporting Outstanding Claims Count

Insurers will report the count of outstanding claims. An outstanding claim is defined as a claim for which a case loss reserve exists as of the evaluation date. In cases where a claim is partially paid with an associated case reserve still maintained, insurers have the option to report the claim count as either paid or outstanding. A case involving loss payments or loss reserves under more than one classification will have a claim count under each classification.

k) Run-off Business

Companies with no written or earned premiums, but with paid or outstanding losses in a line, class, subclass, or endorsement for Illinois-only data must report data for that line, class, subclass, or endorsement for both Illinois-only and multi-state. If the aforementioned situation occurs in only the multi-state data, the insurer will not be required to report that data.

l) All Prepaid Policies

Premiums for all policies not having a one-year term shall be reported using a pro rata allocation formula. In all cases policy periods shall be annual or less.

m) Treatment of Installment Payments

All premiums for policies written on an installment basis will be reported as though they were prepaid policies.

n) Rounding Rule

Data will be reported in whole numbers. All decimals will be rounded to the nearest integer. (Decimals less than .5 will be rounded down to the nearest whole number while decimals .5 and above will be rounded up to the nearest whole number.)

o) Reporting Excess Insurance Premiums

Written and earned premiums for excess insurance will be entered in the appropriate fields for this type class. (See Section 4203.70.) Premiums for excess insurance are defined as that premium charged for coverage in excess of the primary policy limits added by a different policy (e.g., umbrella policy or through an endorsement to the policy).

p) Reporting Excess Insurance Losses

Paid losses and outstanding losses for excess insurance will be entered in the appropriate fields for this class. (See Section 4203.70.) An excess loss is defined as a loss resulting in an incurred cost to the insurer in excess of the primary policy limits and covered by a different policy or an endorsement to the policy. Examples include umbrella policies and excess limits endorsements.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.40 General Submission Guidelines

a) Guidelines for Data Submission and Collection

Data must be submitted electronically to the Illinois Department of Insurance no later than November 30 of each year.

b) Penalties

Failure to comply with any of these specifications may subject the insurer to those penalties described in Section 1204 of the Code.

c) Leading Zeros

Since fields are not fixed-length, leading zeros and spaces should be omitted.

d) Negative Numbers

Negative numbers will be submitted as a dash before the number (without a space between the negative and number). For example a negative one hundred dollar premium would be coded -100.

e) Data Reported by Illinois and Multi-State

All required data will be reported in the aggregate for:

1) Illinois only; and

2) multi-state, including Illinois.

f) Required Data Elements

Data shall be reported for the following nine insurance elements:

1) Number of written exposures;

2) Amount of direct written premiums;

3) Amount of direct earned premiums;

4) Amount of paid losses;

5) Amount of outstanding losses;

6) Amount of paid allocated loss adjustment expenses;

7) Amount of outstanding allocated loss adjustment expenses;

8) Number of paid claims; and

9) Number of outstanding claims.

g) Required Lines or Coverages of Insurance

The Department requires that data be submitted for classes within the following 9 lines or coverage types of insurance.

Coverage Type	Line of business
Residential Fire	01.0
Homeowners Multiple Peril	04.0
Business Owners Packages	05.0
Medical Malpractice	11.0
Earthquake	12.0
Other Liability	17.0
Private Passenger Automobile Liability	19.2
Commercial Automobile Liability	19.4
Private Passenger Automobile Physical Damage	21.1

h) Reported by Zip Code

All Illinois data reported for line 01.0, 04.0, 19.2 and 21.1 must be reported by zip code. All other data within the data call is to be reported on a statewide basis.

i) Reported by Form Type

There will be a separate record for each line, class, or type of coverage for each form type used in writing a policy. Note that an insurer may use any one or more of the form types within the same line or class of insurance. When multiple form types are used the insurer must generate a record for each of those form types.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.50 Required Data Types (Lines, Classes, and Coverages)

Within the required lines of insurance identified in Section 4203.40(g), the Department requires data for specified lines, classes or coverages. There are 9 categories contained in the following table that summarize the data that must be filed in Illinois pursuant to this Part.

OTHER LIABILITY

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE
DAY CARE CENTERS
Day care center liability – day nurseries	82115	square feet
Day care center liability – day care centers	41714	person-months
Day care center liability individual insurer program not rated using one of the exposure bases noted above.¹	81714	NA
LAWYERS PROFESSIONAL LIABILITY
Lawyers professional liability – lawyers	81400	person-months
Lawyers professional liability – employed law clerks, investigators, abstractors, and paralegals	81420	person-months
Lawyer's professional liability individual insurance program not rated using one of the exposure bases noted above.²	81401	NA
LIQUOR LIABILITY
Clubs	70412	receipts
Package stores, and other retail establishments	59211	receipts
Manufacturers, wholesalers, and distributors	50911	receipts
Restaurants, taverns, hotels, motels incl: package sales	58161	receipts
Temporary licenses	58168	NA
Owners or lessors of premises used by others	58169	NA
Liquor liability – not otherwise classified	11111	NA
Liquor liability individual insurer programs not rated using one of the exposure bases noted above.¹	81111	NA

EXCESS INSURANCE
Commercial Automobile	9772	NA
Personal Umbrella	99930	NA
Commercial Umbrella	99935	NA
Excess Insurance – All Other	88888	NA
OTHER
All other coverage contained in line 17.1 and 17.2 of the company's state page exhibit for the filing year	OTHR	NA

Table:

¹ Individual insurer programs that are not rated using one of the exposure bases above with this specified class definition will be reported as classification codes 81111 and 81714, respectively.

² Individual insurer programs that are not rated using one of the exposure bases noted above with this specified class definition will be reported as classification code 81401.

MEDICAL MALPRACTICE

CLASS OR DATA TYPE	CLASS CODE		EXPOSURE BASE
CLASS OR DATA TYPE	MD¹	DO²	EXPOSURE BASE
CARDIAC SURGERY
Surgery – cardiac	80141	NA	person-months
Surgery – cardiovascular disease	80150	84150	person-months
CARDIAC – OTHER
Cardiovascular disease – minor surgery	80281	84281	person-months
Cardiovascular disease – no surgery	80255	84255	person-months
CRITICAL CARE MEDICINE
Intensive care medicine. Applies to any general practitioner or specialist employed in intensive care hospital unit	80283	84283	person-months
DENTISTS
Oral surgery with anesthesia	80210	NA	person-months
Oral surgery without anesthesia	80211	NA	person-months
EMERGENCY ROOM SURGERY
Emergency medicine – including major surgery	80157	84157	person-months
EMERGENCY ROOM – OTHER
Emergency room – no major surgery	80102	84102	person-months
GENERAL PRACTITIONER (FAMILY PRACTICE)
Family physician or general practitioner – no surgery	80420	84420	person-months
Family physician or general practitioner – minor surgery	80421	84421	person-months
Surgery – general practice or family practice	80117	NA	person-months
GENERAL SURGERY
Surgery – general – not otherwise classified. Does not apply to family or general practitioner or to any specialist who occasionally performs major surgery.	80143	84143	person-months
NEUROSURGERY
Surgery – neurology – including child	80152	84152	person-months
Neurology – including child – minor surgery	80288	84288	person-months
OBSTETRICS/GYNECOLOGY – SURGERY
Surgery – gynecology	80167	84167	person-months
Surgery – obstetrics	80168	NA	person-months
Surgery – obstetrics – gynecology	80153	84153	person-months
OBSTETRICS/GYNECOLOGY – OTHER
Gynecology – minor surgery	80277	84277	person-months
Gynecology – no surgery	80244	84244	person-months
ORTHOPEDIC SURGERY
Surgery – orthopedic	80154	84154	person-months
PHYSICIANS, SURGEONS, AND DENTISTS
Physicians, Surgeons, and Dentists not otherwise classified	94999	94999	person-months
Physicians, Surgeons, and Dentists individual programs not rated using one of the exposure bases noted above	90430	NA	person-months
PLASTIC SURGERY
Surgery – plastic – not otherwise classified	80156	84156	person-months
Surgery – plastic – otorhinolaryngology	80155	84155	person-months
THORACIC SURGERY
Surgery – thoracic	80144	84144	person-months
VASCULAR SURGERY
Surgery – vascular	80146	NA	person-months
OTHER
All other coverage contained in line 11.0 of the company's state page exhibit for the filing year	OTHR		NA

Table:

¹ MD = Medical Doctor

² DO = Doctor of Osteopathy

COMMERCIAL AUTO LIABILITY

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE

Fleet and non-fleet combined trucks, tractors, and trailers – zone rated	1A 1B 1C	car-months (BI) receipts number of miles
Fleet and non-fleet combined trucks, tractors, and trailers – all other, regardless of miles	2A	car-months (BI)
Fleet and non-fleet taxicabs, and public livery, regardless of mileage, including limousines	3A 3B 3C	car-months (BI) receipts number of miles
OTHER
All other coverage contained in line 19.4 of the company's state page exhibit for the filing year.	OTHR	NA

PRIVATE PASSENGER AUTO LIABILITY

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE
PPA Liability	LIAB	car-months (BI)
OTHER
All other coverage contained in line 19.2 of the company's state page exhibit for the filing year	OTHR	NA

HOMEOWNER MULTI-PERIL

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE

HO-1	HO-1	house-months
HO-2	HO-2	house-months
HO-3	HO-3	house-months
HO-4	HO-4	house-months
HO-5	HO-5	house-months
HO-6	HO-6	house-months
HO-8	HO-8	house-months
Mobile Homes	Mobile	house-months
HOMEOWNER ENDORSEMENTS
Home Day Care endorsement	323	house-months
Earthquake endorsement	HEQ	house-months
OTHER
All other coverage contained in line 04.0 of the company's state page exhibit for the filing year	OTHR	NA

BUSINESS OWNERS PACKAGE

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE
Business Owners Package (BOP)	77777	NA
Other coverage contained in line 05.1 and 05.2 of the company's state page exhibit for the filing year	OTHR	NA

PRIVATE PASSENGER AUTO PHYSICAL DAMAGE

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE
PPA Physical Damage	PHYD	car-months (comp)
Other coverage contained in line 21.1 of the company's state page exhibit for the filing year	OTHR	NA

EARTHQUAKE (REQ ONLY)

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE
Residential Earthquake	REQ	NA
Other coverage contained in line 12.0 of the company's state page exhibit for the filing year	OTHR	NA

RESIDENTIAL FIRE

CLASS OR DATA TYPE	CLASS CODE	EXPOSURE BASE
Building and Contents – owner-occupied, 1-4 units	9A	house-months
Contents only	9B	house-months
Building only – non-owner-occupied	9C	house-months
Earthquake endorsement	HEQ	house-months
Other coverage contained in line 01.0 of the company's state page exhibit for the filing year	OTHR	NA

(Source: Amended at 39 Ill. Reg. 2603, effective February 6, 2015)

Section 4203.60 Line Item Matrix For Cost Containment Reporting

Revised Field #	Other Liability, Medical Malpractice, Earthquake (REQ), BOP, Excess Insurance & Commercial Auto	Homeowners & Residential Fire	Private Passenger Auto Liability	Private Passenger Physical Damage
1	FEIN	FEIN	FEIN	FEIN
2	Filing Method	Filing Method	Filing Method	Filing Method
3	Line of Business	Line of Business	Line of Business	Line of Business
4	State ID	State ID	State ID	State ID
5	Class Code	Class Code	Class Code	Class Code
6	Statistical Year	Statistical Year	Statistical Year	Statistical Year
7	Not used	Zip Code	Zip Code	Zip Code
8	Form Type	Not used	BI Written Premium	Comp Written Premium
9	Written Premium	Written Premium	BI Earned Premium	Comp Earned Premium
10	Earned Premium	Earned Premium	BI Paid Loss	Comp Paid Loss
11	Paid Losses	Paid Losses	BI OS Loss	Comp OS Loss
12	Outstanding Losses	Outstanding Losses	BI PD ALAE	# Comp Wr. Exposure
13	Paid ALAE	Written Exposures	BI OS ALAE	# Comp Paid Claims
14	OS ALAE	# Paid Claims	# BI Written Exposure	# Comp OS Claims
15	Written Exposures	# OS Claims	#BI Paid Claims	Collision Wr. Premium
16	# Paid Claims		#BI OS Claims	Collision Er. Premium
17	# OS Claims		PD Written Premium	Collision Paid Loss
18			PD Earned Premium	Collision OS Loss
19			PD Paid Loss	# Collision Paid Claims
20			PD OS Loss	# Collision OS Claims
21			PD Paid ALAE	Other Written Premium
22			PD OS ALAE	Other Earned Premium
23			# PD Paid Claims	Other Paid Loss
24			#PD OS Claims	Other OS Loss
25			UM/UIM Written Prem	# Other Paid Claims
26			UM/UIM Earned Prem	# Other OS Claims
27			UM/UIM Paid Loss
28			UM/UIM OS Loss
29			UM/UIM Paid ALAE
30			UM/UIM OS ALAE
31			# UM/UIM Paid Claims
32			# UM/UIM OS Claims
33			Med Pay Written Prem
34			Med Pay Earned Prem
35			Med Pay Paid Loss
36			Med Pay OS Loss
37			Med Pay Paid ALAE
38			Med Pay OS ALAE
39			# Med Pay Paid Claims
40			# Med Pay OS Claims
41			Other Written Prem
42			Other Earned Prem
43			Other Paid Loss
44			Other OS Loss
45			Other Paid ALAE
46			Other OS ALAE
47			# Other Paid Claims
48			# Other OS Claims
49			# SL Written Exposures
50			SL Written Prem
51			SL Earned Prem
52			BI SL Paid Loss
53			BI SL OS Loss
54			BI SL Paid ALAE
55			BI SL OS ALAE
56			# BI SL Paid Claims
57			# BI SL OS Claims
58			PD SL Paid Loss
59			PD SL OS Loss
60			PD SL Paid ALAE
61			PD SL OS ALAE
62			# PD SL Paid Claims
63			# PD SL OS Claims

(Source: Amended at 39 Ill. Reg. 2603, effective February 6, 2015)

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	=	Company Direct – Partial
6	=	Company Direct – 100 Percent
7	=	Other

c) Line of Business – This alpha-numeric field identifies the line or general classification to which the data belongs. Possible codes are:

05.0	=	BOP (Business Owners Package)
11.0	=	Medical Malpractice
12.0	=	Earthquake
17.0	=	Other/Excess Liability
19.4	=	Commercial Auto Liability

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

12	=	Illinois only
MS	=	Multi-state

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)

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

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 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)

Section 4203.80 Coding Conventions for Homeowner and Residential Fire Insurance

This Section provides instructions for coding 15 fields included in the homeowner and residential fire insurance line. All homeowner and residential fire records will be submitted by zip code.

a) In the homeowner line, the insurer will code one record for each class for multi-state data and one record for each class for each zip code for Illinois-only data. It is not necessary to submit a record that sums the data for all the zip codes in each class.

b) 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	=	Property Casualty Insurers Association of America (PCI)
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 general business line to which the data belongs. The possible codes are:

04.0	=	Homeowners
01.0	=	Residential Fire

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

12	=	Illinois only
MS	=	Multi-state

5) Class Code – Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line. The insurer should report one record for multi-state data and one record for each class by zip code for Illinois-only data. It is not necessary to report a record that sums all zip code data for a class. Possible codes for the classification field are:

04.0			=	Homeowners
	•	HO-1
	•	HO-2
	•	HO-3
	•	HO-4
	•	HO-5
	•	HO-6
	•	HO-8
	•	Mobile
	•	323			=	Day care endorsement
	•	HEQ			=	Homeowner earthquake endorsement
	•	OTHR			=	All other coverage contained in line 04.0

01.0		=	Residential Fire
•	9A		=	residential fire, building & contents (owner-occupied 1-4 units)
•	9B		=	residential fire (contents only)
•	9C		=	residential fire (building only for non-owner-occupied)
•	HEQ		=	earthquake endorsement
•	OTHR		=	All other coverage contained in line 01.0

6) Statistical Data Year – This four-character alpha-numeric field reflects the experience year. (For example, the statistical data year for the November 2017 annual filing for the calendar year method will be coded 2016.)

7) Zip Code – This alpha-numeric field identifies the zip code where the homeowner exposure is located. Possible codes are:

Actual zip code	=	The range for Illinois zip codes (60001 through 62999).
99999	=	Code for Illinois-only data where zip code does not fall within the range for Illinois zip codes (60001 through 62999).

AGENCY NOTE: There should be one record for each represented zip code for each of the classes HO-1, HO-2, HO-3, HO-4, HO-5, HO-6, HO-8, mobile, 323, 9A, 9B, 9C, and OTHR for Illinois-only data and one record for each class reported for multi-state data.

8) Field Not Currently Used

9) Amount of Written Premium – This field reflects the amount of written premiums corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.

10) Amount of Earned Premium – This field reflects the amount of earned premium corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.

11) Amount of Paid Losses – This field reflects the paid losses corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR. Please see Section 4203.30(g) for the definition of paid losses.

12) Amount of Outstanding Losses – This field reflects the outstanding losses corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR.

13) Number of Written Exposures – This field reflects the count of exposures for each of the class codes HO-1 through HO-8, mobile, 9A, 9B, 9C, and OTHR.

14) Number of Paid Claims – This field reflects the paid claims count corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR. Please see Section 4203.30(i) for the definition of paid claims.

15) Number of Outstanding Claims – This field reflects the outstanding claims count corresponding to each of the class codes HO-1 through HO-8, mobile, 323, HEQ, 9A, 9B, 9C, and OTHR. Please see Section 4203.30(j) for the definition of outstanding claims.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.90 Coding Conventions for Private Passenger Auto Liability Insurance (Excluding PIP)

This Section provides instructions for coding the 63 fields in the private passenger auto liability records, excluding PIP. All private passenger auto liability records will be submitted by zip code.

a) No-fault data will be excluded.

b) In the private passenger auto liability line, the insurer will submit one record for each class for multi-state data and one record for each class for each zip code for Illinois-only data. It is not necessary to submit a record which sums the Illinois-only data for all the zip codes.

c) The applicable bodily injury and property damage data for split limit policies will be reported in Fields 8-48. The applicable data for single limit policies will be reported in Fields 49-63. Written exposures, written premium, and earned premium for single limit policies will be reported in Fields 49-51. Losses, loss adjustment expenses, and claims counts will be reported for bodily injury and property damage using the instructions in Fields 51-63.

d) 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	=	Property Casualty Insurer Association of America (PCI)
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 general business line to which the data belongs. The code is:

19.2

Private passenger auto liability

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

12	=	Illinois only
MS	=	Multi-state

5) Class Code – Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line. The insurer should report one record for each class for multi-state data and one record for each class for each zip code for Illinois-only data. It is not necessary to report a record that sums all zip code data for a class. Possible codes for the classification field are:

19.2	=	Private passenger auto liability
•		LIAB
•		OTHR = all other coverage contained in line 19.2

6) Statistical Data Year – This four-character alpha-numeric field reflects the experience year. (For example, the statistical data year field for the November 2017 annual filing will be coded 2016.)

7) Zip Code – This alpha-numeric field identifies the zip code where the automobile exposure is rated (auto is garaged). Possible codes are:

Actual zip code	=	The range for Illinois zip codes (60001 through 62999)
99999	=	Code for Illinois-only data where zip code does not fall within the range for Illinois zip codes (60001 through 62999)

AGENCY NOTE: There should be one record for each represented zip code for each class code LIAB and OTHR for Illinois-only data and one record for each class code reported for the multi-state data. Each insurer will report premium and exposure data by zip code for private passenger automobile liability. For multi-state data, the zip code field will be blank.

8) Amount of PPA Liability Bodily Injury (BI) Written Premium – This field reflects the amount of written premiums for BI.

9) Amount of PPA Liability BI Earned Premium – This field reflects the amount of earned premiums for BI.

10) Amount of PPA Liability BI Paid Losses – This field reflects the paid losses for BI. Please see Section 4203.30(g) for the definition of paid losses.

11) Amount of PPA Liability BI Outstanding Losses – This field reflects the outstanding losses for BI. Please see Section 4203.30(g) for the definition of outstanding losses.

12) Amount of PPA Liability BI Paid ALAE – This field reflects the ALAE for BI. If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

13) Amount of PPA Liability BI Outstanding ALAE – This field reflects the ALAE for BI. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

14) Number of PPA Liability BI Written Exposures – This field reflects the count of written exposures for the line. PPA liability exposures are based on the bodily injury component.

15) Number of PPA Liability BI Paid Claims – This field reflects the paid claims count for BI. Please see Section 4203.30(i) for the definition of paid claims.

16) Number of PPA Liability BI Outstanding Claims – This field reflects the outstanding claims count for BI. Please see Section 4203.30(j) for the definition of outstanding claims.

17) Amount of PPA Liability Property Damage Written Premium – This field reflects the amount of written premiums for property damage liability.

18) Amount of PPA Liability Property Damage Earned Premium – This field reflects the amount of earned premiums for property damage liability.

19) Amount of PPA Liability Property Damage Paid Losses – This field reflects the paid losses for property damage liability. Please see Section 4203.30(g) for the definition of paid losses.

20) Amount of PPA Liability Property Damage Outstanding Losses – This field reflects the outstanding losses for property damage liability. Please see Section 4203.30(g) for the definition of outstanding losses.

21) Amount of PPA Paid Liability Property Damage ALAE – This field reflects ALAE for property damage liability. If an insurer is unable to separate paid ALAE from the paid loss, the combined paid loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

22) Amount of PPA Outstanding Liability Property Damage ALAE – This field reflects outstanding ALAE for property damage liability. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined outstanding loss and outstanding ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

23) Number of PPA Liability Property Damage Paid Claims – This field reflects the paid claims count for property damage liability. Please see Section 4203.30(l) for the definition of paid claims.

24) Number of PPA Liability Property Damage Outstanding Claims – This field reflects the outstanding claims count for property damage liability. Please see Section 4203.30(j) for the definition of outstanding claims.

25) Amount of PPA Liability UM/UIM Written Premium – This field reflects the written premiums for UM/UIM.

26) Amount of PPA Liability UM/UIM Earned Premium – This field reflects the earned premiums for UM/UIM.

27) Amount of PPA Liability UM/UIM Paid Losses – This field reflects the paid losses for UM/UIM. Please see Section 4203.30(g) for the definition of paid losses.

28) Amount of PPA Liability UM/UIM Outstanding Losses – This field reflects the outstanding losses for UM/UIM. Please see Section 4203.30(g) for the definition of outstanding losses.

29) Amount of PPA Liability UM/UIM Paid ALAE – This field reflects the ALAE for UM/UIM liability. If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

30) Amount of PPA Liability UM/UIM Outstanding ALAE – This field reflects the outstanding ALAE for UM/UIM liability. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the outstanding ALAE field.

31) Number of PPA Liability UM/UIM Paid Claims – This field reflects the paid claims count for UM/UIM liability. Please see Section 4203.30(i) for the definition of paid claims.

32) Number of PPA Liability UM/UIM Outstanding Claims – This field reflects the outstanding claims count for UM/UIM liability. Please see Section 4203.30(j) for the definition of outstanding claims.

33) Amount of PPA Liability Medical Payments Written Premium – This field reflects the amount of written premiums for medical payments.

34) Amount of PPA Liability Medical Payments Earned Premium – This field reflects the amount of earned premiums for medical payments.

35) Amount of PPA Liability Medical Payments Paid Losses – This field reflects the paid losses for medical payments. Please see Section 4203.30(g) for definition of paid losses.

36) Amount of PPA Liability Medical Payments Outstanding Losses – This field reflects the outstanding losses for medical payments. Please see Section 4203.30(g) for the definition of outstanding losses.

37) Amount of PPA Liability Medical Payments Paid ALAE – This field reflects ALAE for medical payments. If an insurer is unable to separate paid ALAE from the paid loss, the "combined" loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

38) Amount of PPA Liability Medical Payments Outstanding ALAE – This field reflects ALAE for medical payments. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the paid ALAE field.

39) Number of PPA Liability Medical Payments Paid Claims – This field reflects the paid claims count for medical payments. Please see Section 4203.30(i) for the definition of paid claims.

40) Number of PPA Liability Medical Payments Outstanding Claims – This field reflects the outstanding claims count for medical payments. Please see Section 4203.30(j) for the definition of outstanding claims.

AGENCY NOTE: Fields 41-48 will be blank for the majority of private passenger auto liability insurers. The purpose of the other component is to capture any private passenger auto liability data from insurers that do not fall within bodily injury, property damage, UM/UIM, or medical payments.

41) Amount of PPA Liability Other Written Premium – This field reflects the amount of written premiums for other (not fitting any other private passenger auto liability field).

42) Amount of PPA Liability Other Earned Premium – This field reflects the amount of earned premiums for other (not fitting any other private passenger auto liability field).

43) Amount of PPA Liability Other Paid Losses – This field reflects the paid losses for other (not fitting any other private passenger auto liability field). Please see Section 4203.30(g) for the definition of paid losses.

44) Amount of PPA Liability Other Outstanding Losses – This field reflects the outstanding losses for other (not fitting any other private passenger auto liability field). Please see Section 4203.30(g) for the definition of outstanding losses.

45) Amount of PPA Liability Other Paid ALAE – This field reflects the paid ALAE for other (not fitting any other private passenger auto liability field). If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

46) Amount of PPA Liability Other Outstanding ALAE – This field reflects the outstanding ALAE for other (not fitting any other private passenger auto liability field). If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

47) Number of PPA Liability Other Paid Claims – This field reflects the paid claims count for other (not fitting any other liability field). Please see Section 4203.30(i) for the definition of paid claims.

48) Number of PPA Liability Other Outstanding Claims – This field reflects the outstanding claims count for other (not fitting any other liability field). Please see Section 4203.30(j) for the definition of outstanding claims.

AGENCY NOTE: Fields 49-63 provide the fields for an insurer to report its private passenger auto liability policies written with a single limit. If none were written for the experience period, these fields will be left blank.

49) Number of PPA Liability Single Limit (SL) Written Exposures – This field reflects the count of exposures written under single limit policies.

50) Amount of PPA Liability for Single Limit (SL) Written Premium – This field reflects the amount of written premiums for policies written under single limit policies.

51) Amount of PPA Liability for SL Earned Premium – This field reflects the amount of earned premiums for policies written under single limit policies.

52) Amount of PPA Liability BI Paid Losses for SL Policies – This field reflects the amount of paid losses for bodily injury under single limit policies. Please see Section 4203.30(g) for the definition of paid losses.

53) Amount of PPA Liability BI Outstanding Losses for SL Policies – This field reflects the amount of outstanding losses for bodily injury under single limit policies. Please see Section 4203.30(g) for the definition of outstanding losses.

54) Amount of PPA Liability BI Paid ALAE for SL Policies – This field reflects the paid ALAE for bodily injury under single limit policies. If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

55) Amount of PPA Liability BI Outstanding ALAE for SL Policies – This field reflects the outstanding ALAE for bodily injury under single limit policies. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

56) Number of PPA Liability BI Paid Claims for SL Policies – This field reflects the paid claims count for bodily injury under single limit policies. Please see Section 4203.30(i) for the definition of paid claims.

57) Number of PPA Liability BI Outstanding Claims for SL Policies – This field reflects the outstanding claims count for bodily injury under single limit policies. Please see Section 4203.30(j) for the definition of outstanding claims.

58) Amount of PPA Liability Property Damage (PD) Paid Losses for SL Policies – This field reflects the paid losses for property damage under single limit policies. Please see Section 4203.30(g) for the definition of paid losses.

59) Amount of PPA Liability PD Outstanding Losses for SL Policies – This field reflects the outstanding losses for property damage under single limit policies. Please see Section 4203.30(g) for the definition of outstanding losses.

60) Amount of PPA Liability PD Paid ALAE for SL Policies – This field reflects the paid ALAE for property damage under single limit policies. If an insurer is unable to separate paid ALAE from the paid loss, the combined loss and ALAE will be reported in the paid loss field for the line and the code "combined" will appear in the paid ALAE field.

61) Amount of PPA Liability PD Outstanding ALAE for SL Policies – This field reflects the outstanding ALAE for property damage under single limit policies. If an insurer is unable to separate outstanding ALAE from the outstanding loss, the combined loss and ALAE will be reported in the outstanding loss field for the line and the code "combined" will appear in the outstanding ALAE field.

62) Number of PPA Liability PD Paid Claims – This field reflects the paid claims count for property damage under single limit policies. Please see Section 4203.30(i) for the definition of paid claims.

63) Number of PPA Liability PD Outstanding Claims – This field reflects the outstanding claims count for property damage under single limit policies. Please see Section 4203.30(j) for the definition of outstanding claims.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.100 Coding Conventions for Private Passenger Auto Physical Damage

This Section provides instructions for coding the 26 fields included in the private passenger auto physical damage records.

a) In the private passenger physical damage line, the insurer will code one record for the line for multi-state data and one record for the line for each zip code represented in the Illinois-only data. It is not necessary to submit a record that sums the Illinois-only data for all the zip codes.

b) 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	=	Property Casualty Insurer Association of America (PCI)
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 general business line to which the data belongs. The code for private passenger auto physical damage is:

21.1

Private passenger auto physical damage

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

12	=	Illinois only
MS	=	Multi-state

5) Class Code/Classification Code – This alpha-numeric field identifies the class of insurance being reported in the line. The insurer should report one record for each class code for multi-state data and one record for each class for each zip code for Illinois-only data. It is not necessary to report a record that sums all zip code data for a class. Possible codes for the classification field are:

21.1	=	Private passenger auto physical damage
•		PHYD
•		OTHR = All other coverage contained in line 21.1

6) Statistical Data Year – This four-character alpha-numeric field reflects the experience year. (For example, the statistical data year for the November 2017 annual filing will be coded 2016.)

7) Zip Code – This alpha-numeric field identifies the zip code where the Illinois-only exposure is written. Possible codes are:

Actual zip code	=	The range for Illinois zip codes (60001 through 62999).
99999	=	Code for Illinois-only data where zip code does not fall within the range for Illinois zip codes (60001 through 62999).

AGENCY NOTE: There should be one record for each represented zip code for private passenger auto physical damage for Illinois-only data. It is unnecessary to submit a record that sums the data for all the zip codes. For multi-state data, the zip code field should be blank.

8) Amount of PPA Physical Damage Comprehensive (Comp) Written Premium – This field reflects the amount of written premiums for comprehensive.

9) Amount of PPA Comprehensive Earned Premium – This field reflects the amount of earned premiums for comprehensive.

10) Amount of PPA Comprehensive Paid Losses – This field reflects the paid losses for comprehensive. Please see Section 4203.30(g) for the definition of paid losses.

11) Amount of PPA Comprehensive Outstanding Losses – This field reflects the outstanding losses for comprehensive. Please see Section 4203.30(g) for the definition of outstanding losses.

12) Number of PPA Comprehensive Written Exposures – This field reflects the written exposure count for private passenger auto physical damage – using the comprehensive component.

13) Number of PPA Comprehensive Paid Claims – This field reflects the paid claims count for comprehensive. Please see Section 4203.30(i) for the definition of paid claims.

14) Number of PPA Comprehensive Outstanding Claims – This field reflects the outstanding claims count for comprehensive. Please see Section 4203.30(j) for the definition of outstanding claims.

15) Amount of PPA Collision Written Premium – This field reflects the amount of written premiums for collision.

16) Amount of PPA Collision Property Damage Earned Premium – This field reflects the amount of earned premiums for collision.

17) Amount of PPA Collision Paid Losses – This field reflects the paid losses for collision. Please see Section 4203.30(g) for the definition of paid losses.

18) Amount of PPA Collision Outstanding Losses – This field reflects the outstanding losses for collision. Please see Section 4203.30(g) for the definition of outstanding losses.

19) Number of PPA Collision Paid Claims – This field reflects the paid claims count for collision. Please see Section 4203.30(i) for the definition of paid claims.

20) Number of PPA Collision Outstanding Claims – This field reflects the outstanding claims count for collision. Please see Section 4203.30(j) for the definition of paid claims.

AGENCY NOTE: Fields 21-26 will be blank for the majority of private passenger auto physical damage insurers. The purpose of the other category is to capture any private passenger auto physical damage data from insurers that do not fall within the comprehensive or collision components.

21) Amount of PPA Other Written Premium – This field reflects the amount of written premiums for other (not fitting in comp or collision).

22) Amount of PPA Other Earned Premium – This field reflects the amount of earned premiums for other (not fitting in comp or collision).

23) Amount of PPA Other Paid Losses – This field reflects the paid losses for other (not fitting in comp or collision). Please see Section 4203.30(g) for the definition of paid losses.

24) Amount of PPA Other Outstanding Losses – This field reflects the outstanding losses for other (not fitting in comp or collision). Please see Section 4203.30(g) for the definition of outstanding losses.

25) Number of PPA Other Paid Claims – This field reflects the paid claims count for other (not fitting in comp or collision). Please see Section 4203.30(i) for the definition of paid claims.

26) Number of PPA Other Outstanding Claims – This field reflects the outstanding claims count for other (not fitting in comp or collision.) Please see Section 4203.30(j) for the definition of outstanding claims.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.110 Record Layout for the Four Formats

Due to space limitations, the following abbreviations were used in this table:

Wr Prem	=	Written Premium
OS	=	Outstanding
BI	=	Bodily Injury
Med Pay	=	Medical Payments
SL	=	Single Limit
E Prem	=	Earned Premium
ALAE	=	Allocated Loss Adjustment Expenses
PD	=	Property Damage
UM/UIM	=	Uninsured/Underinsured Motorists
Comp	=	Comprehensive

Coll	=	Collision, Other Liab, Medical
PIP	=	Personal Injury Protection

(Source: Amended at 39 Ill. Reg. 2603, effective February 6, 2015)

SUBPART B: MEDICAL MALPRACTICE REPORTING

Section 4203.200 Applicability

This Part applies to each company licensed to write medical malpractice insurance in this State pursuant to Section 4, Class 2(c) of the Code.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.210 Purpose and Scope

The purpose of this Part is to establish content, form and data reporting requirements for information required to be reported to the Director of Insurance pursuant to Section 1204 of the Code.

(Source: Amended at 36 Ill. Reg. 18744, effective December 17, 2012)

Section 4203.220 Definitions

Code means the Illinois Insurance Code [215 ILCS 5].

Department means the Illinois Department of Insurance.

Director means the Director of the Illinois Department of Insurance.

Insurance Claim means a formal or written demand for compensation under a medical malpractice liability insurance policy relating to allegations of liability on the part of one or more providers for any act, error or omission in the rendering of, or failure to render, medical services for medically related injuries. Insurance claim includes any instance for which benefits or compensation are payable, or eligible to be paid under any coverage under the policy.

(Source: Amended at 36 Ill. Reg. 18744, effective December 17, 2012)

Section 4203.230 Reports

All reports shall be completed, validated and filed in an electronic format in accordance with Appendix A no later than April 1 of each year.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

SUBPART C: MARKET SURVEY FOR OCCURRENCE INSURANCE COVERAGE OF STATE RESPONSE ACTION CONTRACTORS

Section 4203.300 Purpose (Repealed)

(Source: Repealed at 36 Ill. Reg. 18744, effective December 17, 2012)

Section 4203.310 Declaration (Repealed)

(Source: Repealed at 36 Ill. Reg. 18744, effective December 17, 2012)

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
002	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
003	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
004	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
005	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
006	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
007	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
…	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
002	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
003	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
004	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
005	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
006	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
007	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
…	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$

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	##	##	##	##	##	##	##	##	##	##
002	##	##	##	##	##	##	##	##	##	##
003	##	##	##	##	##	##	##	##	##	##
004	##	##	##	##	##	##	##	##	##	##
005	##	##	##	##	##	##	##	##	##	##
006	##	##	##	##	##	##	##	##	##	##
007	##	##	##	##	##	##	##	##	##	##
…	##	##	##	##	##	##	##	##	##	##

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
002	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
003	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
004	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
005	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
006	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
007	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
…	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
002	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
003	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
004	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
005	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
006	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
007	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
…	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$

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	##	##	##	##	##	##	##	##	##	##
002	##	##	##	##	##	##	##	##	##	##
003	##	##	##	##	##	##	##	##	##	##
004	##	##	##	##	##	##	##	##	##	##
005	##	##	##	##	##	##	##	##	##	##
006	##	##	##	##	##	##	##	##	##	##
007	##	##	##	##	##	##	##	##	##	##
…	##	##	##	##	##	##	##	##	##	##

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
002	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
003	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
004	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
005	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
006	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
007	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
…	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
002	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
003	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
004	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
005	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
006	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
007	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
…	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
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										$$

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	##	##	##	##	##	##	##	##	##	##
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										##

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	$$	$$	$$	$$	$$	$$	$$	$$	$$	$$
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										$$

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	##	##	##	##	##	##	##	##	##	##
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 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.

(Source: Amended at 42 Ill. Reg. 20370, effective November 1, 2018)

Section 4203.APPENDIX B Guidelines for Submission of Medical Malpractice Reporting (Repealed)

(Source: Repealed at 36 Ill. Reg. 18744, effective December 17, 2012)