Re: Claim count definitions

Mary Frances Miller ( Mary_Frances_Miller@sedgus.com )
Wed, 5 Aug 1998 09:47:21 -0500

Is switching to all claimant-based reporting the right thing to do?
Provided coverage is on a split limits basis, claimant-based is mostly
ok. You lose the ability to put occurrences together to get the total
occurrence cost. If you're going to make a change, wouldn't it be
better to try to get both claimant data and occurrence totals?

I encounter this problem all the time with my self-insured clients.
There are a number of third party administrators that cannot capture
data on an occurrence basis, but only by claimant. Makes it very hard
to limit losses to the client's retention, which is almost always on a
per-occurrence basis (and often crosses LOB lines -- how are you going
to capture that?).

Mary Frances Miller

______________________________ Reply Separator _________________________________
Subject: Claim count definitions
Author: INS1008@VMHOST.CDP.STATE.NE.US at _internet
Date: 7/30/98 8:20 PM

For statistical reporting, ISO wants claimant-based reports. For the
example just given, there would be 2 reserves ultimately replaced by 2
paid amounts. NAII and NISS will accept claim counting on either basis,
but they request that insurers remain consistent with whatever method
that they select to use.


The dilemma faced by the NAIC working group is that a mandated change
from accident- based reporting to claimant-based reporting would be a
fundamental and therefore expensive change for a large number of
insurers.


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