PART 939 MEDICAL LIABILITY INSURANCE LOSS REPORTS : Sections Listing

TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF INSURANCE
SUBCHAPTER l: PROVISIONS APPLICABLE TO ALL COMPANIES
PART 939 MEDICAL LIABILITY INSURANCE LOSS REPORTS

AUTHORITY: Implementing and authorized by Sections 155.25 and 401 of the Illinois Insurance Code (Ill. Rev. Stat. 1991, ch. 73, pars. 767.25 and 1013) [215 ILCS 5/155.25 and 401].

SOURCE: Adopted at 10 Ill. Reg. 8751, effective May 9, 1986; amended at 17 Ill. Reg. 15838, effective September 14, 1993.

 

Section 939.10  Purpose

 

The purpose of this Part is to implement Section 155.25 of the Illinois Insurance Code (Ill. Rev. Stat. 1991, ch. 73, par. 767.25) [215 ILCS 5/155.25 and 401] by listing that information which upon request of the Director of Insurance shall be filed with the Director regarding the direct claims experience of insurance companies licensed to write medical liability insurance in this State.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)

 

Section 939.20  Required Information

 

a)         Any insurance company licensed to sell the type of insurance listed in Class 2(c) of Section 4 of the Illinois Insurance Code (Ill. Rev. Stat. 1991, ch. 73, par. 616) [215 ILCS 5/4] and which is writing or has written medical liability insurance in this State, may be required by the Director to file a report with the Director in the format, and containing the information, as specified in Illustrations A, B, C, D, E, and F.

 

b)         The report shall be filed as specified in the Director's request on or before June 1 of each year.  It should be directed to the Casualty Actuary, Illinois Department of Insurance, Springfield, Illinois  62767.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)

 

Section 939.30  Penalties

 

Failure of a company to timely file the report which may be required by the Director under this Part and Section 155.25 of the Illinois Insurance Code shall subject the company to the provisions of Section 403A of the Illinois Insurance Code (Ill. Rev. Stat. 1991, ch. 73, par. 1015A) [215 ILCS 5/403A].

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)




Section 939.ILLUSTRATION A   Policies Covering Physicians and Surgeons-Claims Payments

 

Illinois Medical Liability Insurance

Loss Report Format – Policies

Covering Physicians and Surgeons – Claim Payments

 

Year In Which Losses

Were Incurred

 

Loss Payments For

Closed Claims

 

 

 

As of

 

Difference

 

 

 

 

a) 12/31/84,

b) 12/31/85,

 

b)   –   a)

 

 

 

Prior to 1978

 

 

 

 

 

 

 

 

1978

 

 

 

 

 

 

 

 

1979

 

 

 

 

 

 

 

 

1980

 

 

 

 

 

 

 

 

1981

 

 

 

 

 

 

 

 

1982

 

 

 

 

 

 

 

 

1983

 

 

 

 

 

 

 

 

1984

 

 

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

 

 

Year In Which Losses

Were Incurred

Loss Payments For Open

And Reopened Claims

 

 

 

 

As of

 

 

Difference

 

 

 

 

 

a)  12/31/84,

b) 12/31/85,

 

b)   –   a)

 

 

 

Prior to 1978

 

 

 

 

 

 

 

 

1978

 

 

 

 

 

 

 

 

1979

 

 

 

 

 

 

 

 

1980

 

 

 

 

 

 

 

 

1981

 

 

 

 

 

 

 

 

1982

 

 

 

 

 

 

 

 

1983

 

 

 

 

 

 

 

 

1984

 

 

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

General Instructions

 

1)         The above information is due on June 1, 1986 and on June 1 every year thereafter as may be required by the Director.  For subsequent due dates of June 1, 1987, June 1, 1988, etc.) all years shown in this Illustration should be advanced by one, two, etc.

 

2)         If a loss payment is included in "loss payments for closed claims", it shall not be included in "loss payments for open and reopened claims", or vice versa.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)


Section 939.ILLUSTRATION B   Policies Covering Physicians and Surgeons-Reserves

 

Year In Which Losses

Were Incurred

 

Losses Unpaid On

Reported Claims

 

As of

 

Difference

 

 

 

 

a)  12/31/84,

b) 12/31/85,

 

b)   –   a)

 

 

 

Prior to 1978

 

 

 

 

 

 

 

 

1978

 

 

 

 

 

 

 

 

1979

 

 

 

 

 

 

 

 

1980

 

 

 

 

 

 

 

 

1981

 

 

 

 

 

 

 

 

1982

 

 

 

 

 

 

 

 

1983

 

 

 

 

 

 

 

 

1984

 

 

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Losses Unpaid On Incurred

But Not Reported Claims

 

 

 

As of

 

Difference

 

 

 

 

a)  12/31/84,

b) 12/31/85,

 

b)   –   a)

 

 

 

Prior to 1978

 

 

 

 

 

 

 

 

1978

 

 

 

 

 

 

 

 

1979

 

 

 

 

 

 

 

 

1980

 

 

 

 

 

 

 

 

1981

 

 

 

 

 

 

 

 

1982

 

 

 

 

 

 

 

 

1983

 

 

 

 

 

 

 

 

1984

 

 

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Other Unpaid Losses

 

 

 

 

As of

 

Difference

 

 

 

 

a)  12/31/84,

b) 12/31/85,

 

b)   –   a)

 

 

 

Prior to 1978

 

 

 

 

 

 

 

 

1978

 

 

 

 

 

 

 

 

1979

 

 

 

 

 

 

 

 

1980

 

 

 

 

 

 

 

 

1981

 

 

 

 

 

 

 

 

1982

 

 

 

 

 

 

 

 

1983

 

 

 

 

 

 

 

 

1984

 

 

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

 

TOTALS

 

 

 

 

 

 

General Instructions

 

 

The above information is due on June 1, 1986 and on June 1 every year thereafter as may be required by the Director.  For subsequent due dates of June 1, 1987, June 1, 1988 etc., all years shown in this Illustration should be advanced by one, two etc.

 

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)


Section 939.ILLUSTRATION C   Policies Covering Physicians and Surgeons–Number of Claims

Illinois Medical Liability Insurance

Loss Report Format – Policies Covering

Physicians and Surgeons – Number of Claims

 

Year in Which Losses

Were Incurred

 

Number of Closed

Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Number of Open And

Reopened Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

General Instructions

 

1)         The above information is due on June 1, 1986 and on June 1 every year thereafter as may be required by the Director.  For subsequent due dates of June 1, 1987, June 1, 1988, etc., all years in this Illustration should be advanced by one, two, etc.

 

2)         If a claim count is included in "number of closed claims", it shall not be included in "number of open and reopened claims", or vice versa.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)


Section 939.ILLUSTRATION D   Other Policies-Claim Payments

 

Illinois Medical Liability Insurance

Loss Report Format – Other Policies – Claim Payments

 

Year in Which Losses

Were Incurred

 

Loss Payments for

Closed Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Loss Payments For Open

and Reopened Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

General Instructions

 

1)         The above information is due on June 1, 1986 and on June 1 every year thereafter as may be required by the Director.  For subsequent due dates of June 1, 1987, June 1, 1988, etc., all years shown in this Illustration should be advanced by one, two, etc.

 

2)         If a loss payment is included in "loss payments for closed claims", it shall not be included in "loss payments for open and reopened claims", or vice versa.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)


Section 939.ILLUSTRATION E   Other Policies-Reserves

 

Illinois Medical Liability Insurance

Loss Report Format – Other Policies – Reserves

 

Year in Which Losses

Were Incurred

 

Loss Unpaid on

Reported Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

 

TOTALS

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Losses Unpaid on Incurred

But Not Reported Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Other Unpaid

Losses

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

 

General Instructions

 

The above information is due on June 1, 1986 and on June 1 every year thereafter as may be required by the Director.  For subsequent due dates of June 1, 1987, June 1, 1988, etc., all years shown in this Illustration should be advanced by one, two, etc.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)


Section 939.ILLUSTRATION F   Other Policies-Number of Claims

 

Illinois Medical Liability Insurance

Loss Report Format  –  Other Policies  –  Number of Claims

 

Year in Which Losses

Were Incurred

 

Number of Closed

Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

Year In Which Losses

Were Incurred

 

Number of Open And

Reopened Claims

 

 

As of

 

Difference

 

 

a) 12/31/84,

b) 12/31/85,

(b)     –     a)

 

Prior to 1978

 

 

 

 

 

 

1978

 

 

 

 

 

 

1979

 

 

 

 

 

 

1980

 

 

 

 

 

 

1981

 

 

 

 

 

 

1982

 

 

 

 

 

 

1983

 

 

 

 

 

 

1984

 

 

 

 

 

 

1985

x

 

 

 

x

 

 

 

TOTALS

 

 

 

 

 

 

General Instructions

 

1)         The above information is due on June 1, 1986 and on June 1 every year thereafter as may be required by the Director.  for subsequent due dates of June 1, 1987, June 1, 1988, etc., all years shown in this Illustration should be advanced by one, two, etc.

 

2)         If a claim or loss payment is included in "number of closed claims", it shall not be included in "number of open and reopened claims", or vice versa.

 

(Source:  Amended at 17 Ill. Reg. 15838, effective September 14, 1993)