Lloyd s Coverholder Reporting Standards Version 5

Transcription

1 Lloyd s Coverholder Reporting Standards Version 5 Premiums, claims and risk data for tax and regulation 18 July 2016 Lloyd s 1

2 Introduction Lloyd s managing agents and syndicates have agreed a core set of regulatory, tax, premiums and claims information, this is specified below. The standards apply to all coverholders and to TPAs with claims authority. Full details are provided in the User Guide. Spreadsheet templates and links to ACORD XML messages are also provided. Note - Lloyd s syndicates and managing agents will need to request further information for underwriting and exposure management and Lloyd s local offices will need to request additional information to facilitate tax and regulatory reporting locally. Lloyd s 2

3 What has changed? Australia - Requirements of the Australian Prudential Regulation Authority (APRA) which apply to Australian public/product liability and professional indemnity insurance have been included together with those in relation to Australian terrorism reporting. South Africa - The new requirements of the South African regulator, the Financial Standards Board (FSB) for conduct data have been included; these are effective from June 2016, with a two year phase in period. UK - The requirements of the Employers Liability Tracing Office (ELTO) have been included; these apply to UK Employers liability business only. UK - The risk requirements of Flood Re which apply to UK Flood Re property business only have been included. UK - The requirements of Pool Re which apply to UK Pool Re property business only have been included. UK and EEA - High Product Risk Products - Claimant address, postcode and country (CR0308/9/10) are NOT required for High Product Risk Products. US - The requirements of US Terrorism, TRIA which apply to US business only have been included. All Claims - Date claim opened (CR0300) and Date claim first advised (CR0136) are now mandatory. All Claims - Claims MI requirements have been included, although these do not have to be reported with other claims information. Lloyd s 3

4 Premiums (including core risk data for tax and reg) Information required on each submission Reporting period - Each submission must include a Reporting period end date (CR0002) and it is preferred that a Reporting period start date is also included (CR0001). Notes - Comments may also be provided (CR0169) Core risk data The following core risk data must be reported Coverholder Name (CR0013); and Coverholder PIN (CR0014) where this is known Unique Market reference (CR0005) or the Binder, Agreement No (CR0006) where this is not known Certificate reference (CR0029) Class of business - One or more of Section Number (CR0007), Written description of the class of Business (CR0017) or Risk Code (CR0016) Type of insurance (direct or type of reinsurance) (CR0019) Inception Date (CR0030) and Expiry Date (CR0031) Location of Risk Country (CR0050) Sum Insured Currency (CR0051) and Amount (CR0052) Total Gross Written Premium, Sum of all instalments (C00021) Insured Full name, last name or company name (CR0035), Insured Country (CR0041) Insured, First name of the individual insured (CR0034) Insured, Country sub-division (CR0039) Risk, Location of Risk Country sub-division (CR0048) Insured, Address (CR0038), Postcode (CR0040) Risk, Location, Address (CR0046), County (CR0047), Postcode (CR0049) Risk, Policy or Group Ref (CR0026) Risk, Transaction Type (CR0022) Risk, Deductible/Excess, Currency (CR0053), Amount (CR0054) and Basis (CR0055) Risk, Policy Issuance Date (CR0315) Effective Date of Endorsement, Transaction etc. (CR0057) and Expiry Date of Endorsement, Transaction etc. (CR0058) Intermediaries The following must be reported for all intermediaries Intermediary, Role (CR0089) Name (CR0090) Reference No (CR0091) Address (CR0092), Country Sub-Division (CR0093), Postcode (CR0094), Country (CR0095) Taxes The following must be reported for all taxes Jurisdiction (CR0077) Tax Type (CR0078) Amount of Taxable Premium (CR0079) % (CR0080) Fixed Rate (CR0081) Multiplier (CR0082) Tax Amount (CR0083) Administered By (CR0084) Payable By (CR0085) Fees The following must be reported for all fees Fees, Description (CR0086) Amount (CR0087) Paid premium data The following must be reported for each paid premium transaction Transaction Type, Original Premium etc. (CR0056) Original Currency (CR0020) Gross Premium Paid this time (CR0059) Commission % (CR0061) Commission Amount (CR0062) Net Premium to London (CR0065) Settlement Currency (CR0066) Transaction, Terrorism Premium (CR0060) Transaction, Accessori (Italy) (CR0063) Transaction, Total taxes and levies (CR0064) Transaction, Rate of Exchange (CR0067) Transaction, Converted Net Premium to London (CR0068) The London broker is expected to supplement the data with the following before submission to the bureau: London broker reference (CR0011) Year of account (CR0010) Transaction, brokerage, % of gross premium (CR0069) and amount, original currency (CR0070) Transaction, Final net premium, original currency (CR0071) Transaction, settlement currency (CR0072), rate of exchange (CR0073) Transaction, brokerage amount, settlement currency (CR0074) Transaction, final net premium, settlement currency (CR0075) Transaction, % for Lloyd s (CR0076) Aircraft, Vehicles, Vessels and Ships for aircraft, vehicles, vessels and ships Risk, Country of Registration (CR0226) Risk, Name or Registration No of Aircraft Vehicle Vessel etc. (CR0033) Risk, IMO Ship Identification No (CR0225) Risk, Period of Cover Narrative (CR0032) Risk, Number of Policies (CR0027) Risk, Number of Vehicles (CR0028) Risk, Wet Marine Indicator (CR0018) Europe in Europe Risk, Referred to London Flag (CR0227) Insured, Fiscal Code (CR0036) Lloyd s 4

5 Premiums (including core risk data for tax and reg) US with respect to US business US Classification (CR0025) US State of Filing (CR0088) Surplus Lines Broker Name (CR0096), Licence No (CR0097), Address (CR0099), State (CR0100), Zip Code (CR0101), Country (CR0102) New Jersey SLA No (CR0098) Reinsured, NAIC Code (CR0037) Terrorism Acceptance Date (CR0201) Terrorism Declination Date (CR0202) Australia, public and product liability and professional indemnity insurance in Australia for reporting to APRA on public and product liability and professional indemnity insurance Policy basis (CR0354) APRA Product Type (CR0360) Original inception date (CR0322) One of Insured, revenue or turnover (CR0280), Insured. Assets (CR0325), Insured, total number of employees (CR0279) or Professional Fees (CR0357) or other risk factor description (CR0358) and value (CR0359) Deductible/Excess amount (CR0054) Limit of indemnity (CR0356) Insured, occupation/nature or organisation (CR0324) Participation/% ceded (CR0175) South Africa mandated by conditions above, Lloyd s recommends coverholders start working towards making the following information available where the insured or the risk is located in South Africa excluding reinsurance; for any risks or claims attached to any annual binders renewing or inception get after 30 June 2016 and any existing binders as at 1 Jan 2017 Cover-type (CR0377) Distribution channel (CR0378) Effective date of transaction (CR0057) Reason for cancellation (CR0299) Aggregator fees, description (CR0086) Aggregator fees, amount (CR0087) High product risk products For all binders and risks/policies which incept on or after 1 January 2016, where the insured or reinsured is located in the UK or EEA and in respect of high product risk products it is mandatory that the following are provided; some of which are already detailed above:- Name of the policyholder/insured (CR0034, CR0035) The Policy type. Either; The insured policyholder type, retail, micro, SME, commercial or reinsurance. (CR0278). Or The insured total number of employees (CR0279) and the insured revenue or turnover (CR0280). The transaction type, and whether or not this is a renewal (CR0022) The inception (CR0030) and expiry dates (CR0031) or period of cover (CR0032) The unique policy reference (CR0029) The total gross written premium to be paid by the customer in connection with this product CR0021) The total other fees to be paid by the Lloyd s customer in connection with product (CR0086), (CR0087) The total Insurance Premium Tax, together with related information about the tax (CR0083) The amount to be paid to the insurer(s) net of commissions/brokerage (CR0071) For any cancellations.- the date of the cancellation (CR0057) and the reason for the cancellation (CR0299) Lloyd s 5

6 Premiums (including core risk data for tax and reg) UK Employers Liability Tracing Office (ELTO) for employers liability business where the insured is located in the UK The following information must be provided by the coverholder, some of which is detailed above:- Master Policy Number; the UMR (CR0005) or Agreement Number (CR0006) Broker Reference Number; the certificate reference (CR0029) Policy Type, whether this is parent or child record (CR0326) Cover Start Date, the risk inception date (CR0030) Cover End Date, the risk expiry date (CR0031) Policyholder Name, the name of the insured (CR0035) Employer Name (CR0327) ERN Exempt Flag which identifies if the employer reference number is applicable to this policy record (CR0328) Employer Reference Number, the unique ID / PAYE code (CR0329) It is mandatory to provide an address for the parent company and optional for any child records:- Insured address (CR0038) Insured country subdivision, county (CR0039) Insured country (CR0041) Insured postcode (CR0040) The following information must be provided by the Lloyd s underwriter, this is not required from the coverholder Current Insurer ID Original Insurer ID Dummy Policy Flag UK Flood Re for UK flood re risks Risk, reason for cancellation (CR0299) Risk, reason for endorsement (CR0320) Risk, reason for reinstatement (CR0321) Risk, number of locations (CR0323) Property, FRID (CR0330) Property, Property Type (CR0331) Property, Eligibility Category (CR0332) Property, Resilience Work (CR0333) Property, Basement (CR0334) Property, Basement Usage (CR0335) Property, Number of Bedrooms (CR0336) Property, Wall Construction (CR0337) Property, Roof Construction (CR0338) Property, Rebuilding Cost (CR03369) Property, Rebuilding Basis Indicator (CR0340) Property, Transaction Rating Date (CR0341) Property, Building Excess Amount (CR0342) Property, Building New Annual Premium (CR0343) Property, Building Transaction Premium (CR0344) Property, Building Alternative Accommodation Limit (CR0345) Property, High Value Art (CR0346) Property, Contents Blanket Sum Insured (CR0347) Property, Contents Transaction Rating Date (CR0348) Property, Contents Excess Sum (CR0349) Property, Contents New Annual Premium (CR0350) Property, Contents Transaction Premium (CR0351) Property, Contents Alternative Accommodation Limit (CR0352) Property, Total Premium Payable (CR0353) UK Pool Re Properties for UK pool re risks Pool Re zone (CR0374) Insured, occupation/nature or organisation (CR0324) A-Buildings (CR0170) C-Contents (CR0172) D-Business Interruption or ALE (CR0173) Lloyd s 6

7 Claims Information required on each submission Reporting period - Each submission must include a Reporting period end date (CR0002) and it is preferred that a Reporting period start date is also included (CR0001) Notes - Comments may also be provided (CR0169) Claims requirements TPAs - Where a TPA is managing claims the following must be submitted with each claim; TPA name (CR0015) Coverholder, binder and risk information The following information must be submitted with each claim Coverholder name (CR0013) Unique Market reference (CR0005) or the Binder, Agreement No (CR0006) where this is not known Binder inception and expiry dates (CR0008 and CR0009) One or more of Section Number (CR0007), Class of Business (CR0017) or Risk Code (CR0016) The original currency (CR0109); and where appropriate the settlement currency (CR0110) and rate of exchange (CR0111) Certificate reference (CR0029) Either the Inception Date (CR0030) and Expiry Date (CR0031) for the risk, or the Period of Cover (CR0032) Insured Full name, last name or company name (CR0035) and Insured Country (CR0041) Insured, Country sub-division (CR0039) Risk, Location of Risk Country (CR0050) and Risk, Location of Risk Country sub-division (CR0048) Coverholder PIN (CR0014) Type of insurance, direct or type of reinsurance (CR0019) Policy or group reference (CR0026) Insured address (CR0038), postcode (CR0040) Location ID (CR0042), address (CR0046), postcode (CR0050) Deductible/excess amount (CR0054), basis (CR0055) Sum insured amount of the claim (CR0103) Name or registration number of aircraft, vessel etc. (CR0033) % Ceded (reinsurance) (CR0156) Claims The following must be reported for each claim Claim reference (CR0104) Location of loss, country (CR0116) At least one of cause of loss code (CR0117) or loss description (CR0118) One or more of date of loss from (CR0119), and/or date of loss to (CR0120) Claim status (CR0105) Refer to underwriters (CR0106) Denial indicator (CR0107) Date claim opened (CR0300) Date claim first advised/made (CR0136) Location of loss, country sub-division (CR0114). The full address of the loss (CR0112) and postcode (CR0115) may also be reported if known. Claimant name (CR0122) Date claim closed (CR0137) Lloyd s Cat code (CR0138) Catastrophe name (CR0139) Ex gratia payment (CR0317) Experts role (CR0162), Firm/Company Name (CR0163), Reference Number (CR0164), Address (CR0165), State etc. (CR0166), Postcode (CR0167), Country (CR0168) Claims transactions The following must be reported for each claim transaction Indemnity paid this month (CR0126), previously paid (CR0128), reserve (CR0130), total incurred (CR0134) Fees paid this month (CR0127), previously paid (CR0129), reserve (CR0131), total incurred (CR0135) mandated by conditions above the following may also be reported where the conditions apply to make it mandatory Indemnity change this month (CR0132) Fees change this month (CR0133) Expenses paid this month (CR0140), previously paid (CR0145), reserve (CR0150) Attorney coverage fees paid this month (CR0141), previously paid (CR0146), reserve (CR0151) Adjusters fees paid this month (CR0142), previously paid (CR0147), reserve (CR0152) Defence fees paid this month (CR0143), previously paid (CR0148), reserve (CR0153) Total incurred (CR0155) TPA fees paid this month (CR0144), previously paid (CR0149), reserve (CR0154) Accident and Health Accident and health plan (CR0157), patient name (CR0158), treatment type (CR0159), country of treatment (CR0160), date of treatment (CR0161) Lloyd s 7

8 Claims US with respect to US business Loss county (CR0113) State of filing (CR0088) PCS Code (CR0108) US, Medicare reported for claims involving bodily injury to US citizens United states bodily injury claim (CR0220) Eligibility check performance (CR0221) Outcome of eligibility status check (CR0222) Conditional payments (CR0223) MSP compliance services (CR0224) High product risk products for all claims which are open on or after 1 January 2016 where the insured or reinsured is located in the UK or EEA and in respect of high product risk products Date coverage confirmed (CR0301) Date claim amount agreed (CR0302) Date claims paid (final) (CR0303) Date fees paid (final) (CR0304) Date reopened (CR0306) Date of subrogation (CR0307) Date claim denied (CR0311) Reason for denial (CR0312) Amount claimed (CR0313) Date claim withdrawn (CR0316) Claim not paid as within excess (CR0319) TPA fees paid this month (CR0144), previously paid (CR0149), reserve (CR0154) Australia public and product liability and professional indemnity insurance in Australia for reporting to APRA on public and product liability and professional indemnity insurance Jurisdiction of court judgement of the claim or claimant address (CR0362) Deductible/Excess Amount (CR0054) General nature of loss (CR0364) Cause of loss (CR0117) Body functions or structures affected (CR0366) Severity of loss (CR0367) Litigation status (CR0368) Gross third party recoveries received (CR0375) Gross third party recoveries outstanding (CR0376) South Africa mandated by conditions above, Lloyd s recommends coverholders start working towards making the following information available where the insured or the risk is located in South Africa excluding reinsurance; for any risks or claims attached to any annual binders renewing or inception get after 30 June 2016 and any existing binders as at 1 Jan 2017: Date claims paid (final) (CR0303) Date fees paid (final) (CR0304) Date claim denied (CR0311) Amount claimed (CR0313) TPA fees paid this month (CR0144), previously paid (CR0149), reserve (CR0154) Claims management information mandated by conditions above, the following claims management information must be provided where the conditions. This does not need to be reported on the same submission as the other data discussed here but should be collected in the most appropriate way for the binder. Claim first notification acknowledgement date (CR0372) Date first reserve established (CR0371) Diary date (CR0369) Peer review date (CR0370) Lloyd s 8