LexisNexis C.L.U.E. Commercial How to Read

Transcription

1 LexisNexis C.L.U.E. Commercial How to Read March 2012

2 LexisNexis C.L.U.E. Commercial How to Read March 2012 ALL NAMES IN THE TEXT OR ON THE SAMPLE REPORTS SHOWN IN THIS DOCUMENT ARE OF FICTITIOUS PERSONS AND ENTITIES. ANY SIMILARITY TO THE NAME OF ANY REAL PERSON, ADDRESS, SCHOOL, BUSINESS, OR OTHER ENTITY IS PURELY COINCIDENTAL. LexisNexis and the Knowledge Burst logo are registered trademarks of Reed Elsevier Properties Inc., Used under license. C.L.U.E. is a registered trademark of LexisNexis Risk Solutions Inc. Other products and services may be trademarks or registered trademarks of their respective companies. C opyr ight 2012 L exisnexis. A ll r ights r eser ved.

3 Table of Contents Introduction... 4 Sample... 5 Search Criteria Section Claim Match Summary Section Account Claim Summary Section Line of Business Claim Summary Section Claim Details Additional Open Claims Section Appendix A: Policy Type Appendix B: Cause of Loss Glossary Copyright 2012 LexisNexis. All rights reserved. 3

4 Introduction LexisNexis C.L.U.E. Commercial is a new contributory database for commercial lines claims that can significantly reduce underwriting expenses through the efficient and automated delivery of real time, electronic commercial claims information. Contributions to the database include claims from the standard commercial lines BOP, Package, Commercial Auto, Workers Compensation, and Umbrella lines, and will provide carriers with information on claims for business and commercial property addresses. Only carriers that contribute their claims information are able to order reports from the database. By ordering a C.L.U.E. Commercial report, commercial carriers can eliminate the manual process of collecting loss history runs. In addition, they will not only see claims from the most current carrier, but may also see claims from other past carriers. Copyright 2012 LexisNexis. All rights reserved. 4

11 Search Criteria Section This section includes a summary of the results as well as the input data from the inquiry. [1] Case/Quoteback ID: The quoteback for a C.L.U.E. Commercial report matches the report to your quote submission or policy. Often the quoteback used is the quote/policy number, but can be any value you designate. Because you may need to match one C.L.U.E. Commercial report to multiple lines of business, you may enter up to five quotebacks. [2] Reference Number: This uniquely identifies the C.L.U.E. Commercial report using a LexisNexis generated number. Refer to this number when you call the LexisNexis Support Center with questions regarding a report. [3] Line of Business Requested: This reports the requested line(s) of business for the order. It may display up to four lines of business: Business Insurance, Small Business, Commercial Auto, and Workers Compensation. [4] Additional Line of Business Included: This can result in two conditions. 1) When Business Insurance line was requested (no Small Business indicated), a search for Small Business claims is always performed. If Small Business claims were found, Small Business will be shown here. 2) If Small Business was requested (no Business Insurance indicated) and Business Insurance claims were found, Business Insurance will show here. NOTE: Condition number one is always searched. Condition number two is an account set up option. Contact your LexisNexis National Account Manger or Customer Manager if you have questions. [5] Reporting Period: This returns the date entered on the C.L.U.E. Commercial inquiry form on which all data is organized for reporting purposes in the C.L.U.E. Commercial report. For example, if you entered 7/1/2011 for the reporting period, you would receive losses from 7/1/2006 to 7/1/2011. Claims are only provided based on the reporting period. In the 7/1/ Copyright 2012 LexisNexis. All rights reserved. 11

12 2011 example, if a claim occurred on 7/2/2011, it would not be shown. If you have requested to receive additional open claims over the reporting threshold, a message will be reported if claims were or were not found. NOTE: Additional years can be searched for both open and/or closed claims up to ten years at a nominal additional investment. Contact your LexisNexis National Account Manager. [6] Search Type: This specifies the type of searched used for the report. Search requirements are as follows: - Name & Address requires a minimum of one subject and one primary address. - Location requires a minimum of a subject name, and a primary address although subject name is not used as part of the search. - Policy Number requires a minimum of one prior policy number and a business/subject name. [7] System Messages: This provides a message indicating the status of the search. For example, The report request processed successfully. The Report request resulted in an error. [8] Inquiry Result: This returns additional details for the results. If on your report, item 7 above indicates The report requested processed successfully you will always see either item A or item B below. If your company's account set up requires claims reporting for longer than the standard five years, you will always see either item C or item D below in addition to A or B. If your company recently ordered this report and has requested a new report, item E will also be reported. If your company does not contribute all lines of business and you try to order a line of business your company does not contribute, you will receive any one or more of the items F through item I below. NOTE: If your company orders more than one line of business and your company does not contribute all the lines you requested, rather than not processing the entire request, LexisNexis will search on the eligible lines of business and may return any of the following: A. Claim(s) Found B. No Claims Found C. Additional Open Claim(s) Found D. Additional Open Claims Not Found E. Secondary Report F. Account is not authorized for access to Business Insurance claims. Request for Business Insurance was not processed. G. Account is not authorized for access to Small Business claims. Request for Small Business was not processed. H. Account is not authorized for access to Commercial Auto claims. Request for Commercial Auto was not processed. I. Account is not authorized for access to Workers Compensation claims. Request for Workers Compensation was not processed. If on your report, item 7 above indicates The report requested resulted in an error you will receive one or more of the error messages below. A. The C.L.U.E. Commercial database is temporarily unavailable for processing. B. Insufficient data was entered to conduct search; request not processed. C. Invalid LexisNexis Account Number; request not processed. D. More than 5 names and/or more than 5 addresses received on the inquiry; request not processed. Resubmit with a maximum of 5 names and/or 5 addresses. E. Policy Effective date is greater than 180 days in the future; request not processed. F. Line(s) of Business requested are not allowed for this account; request not processed. G. Policy Effective Date(s) is invalid. Resubmit with a valid date. Copyright 2012 LexisNexis. All rights reserved. 12

13 Claim Match Summary Section This section is only reported if claim(s) were found. This section allows you to review all the policy names and addresses that matched the name(s) and address(es) entered on your inquiry order form. Because of the advanced matching techniques employed in C.L.U.E. Commercial, if you see a claim matched to a named insured that doesn t appear to be similar to the inquiry, there is one possible reason. After C.L.U.E. Commercial finds a claim that matches your name(s) and address(es) inquiry, the carrier s AM Best number and policy number is used to search the remainder of the database. If other claims with the same exact policy number and AM Best carrier number are found, the claim is reported. If the insured changed name(s) or address(es) in their five year history, it may not appear to be a match, because the same carrier wrote the insured on the same exact policy number. Copyright 2012 LexisNexis. All rights reserved. 13

14 Account Claim Summary Section This section reports whenever more than one line of business was searched and at least one claim was found. If there is only one line of business, this section will not appear. [9] Lines of Business: Each line of business searched will be reported here along with a Y for claims found or a N for no claims found. [10] Line of Business: The line of business(es) reported with a Y for claims found will be listed in this section. [11] Policy Number & Carrier: The policy number and carrier name for all the claims found for each line of business. If more than one claim was found for a policy number for a line of business, the policy number only was listed once. Copyright 2012 LexisNexis. All rights reserved. 14

15 [12] Policy Period: Policy periods will be reported in increments of 12 months and will be based on the reporting period you requested on the order inquiry. [13] Claim Amount: The first line will be the total amount of claims found for that policy period for the line of business shown. If no claims were found, a -0- will be reported. [14] Number of Claims(): The total number of claims included in the claim amount shown. If no claims for the reporting period were found, a (-0-) will be reported. [15] Total: The total for each line of business for the reporting period. [16] Reserves: If a dollar amount reserve was reported for a claim it will be included in the claim amount paid and Total Incurred Amount and a -R- will be reported. If a carrier only reports reserves in dollar ranges no reserve amount is included in the claim amount paid or Total Incurred Amount. These are identified with a -X-. If more than one claim is reported in the policy period there is a possibility both a -R- and a -X- can be reported. See the Claim Detail section for dollar amount reserves and/or reserve range. [17] Total All Lines: This is a grand total for all lines of business for the reporting period. [18] Additional Open Claim(s): This section shows when additional open claims were requested for a period greater than the five years preceding the reporting period requested. If open claims were found prior to the reporting period, the claim summary for those claim(s) will be reported here. Copyright 2012 LexisNexis. All rights reserved. 15

16 Line of Business Claim Summary Section This section summarizes the losses for the line(s) of business searched. This section is always generated for each line of business search that had a claim. This is an example of a Business Insurance Summary. [19] Carrier Name: The name of the carrier that contributed the claim. The name reported is the name associated with the AM Best number. [20] Claim Count: The total number of claims included in the claim amount shown. If no claims were found in the reporting period, a 0 was reported. [21] Paid: The amount paid by the policy number/carrier shown for that reporting period. If no claims were found for a policy period, it will be blank. [22] Reserve: If no dollar amount or range was contributed, the value of $0 will be reported. If a dollar amount was contributed, it will be reported along with the paid amount in the total. If a dollar amount reserve was reported for a claim, it will be included in this field with a -R-. If a carrier only reports reserve in dollar ranges, no reserve amount is included in the Total Incurred field. These are identified with a -X-. If more than one claim is reported in the policy period, there is a possibility both a -R- and a -X- can be reported. See Claim Detail section for dollar amount reserves and/or reserve range. [23] Open: The number of claims that are reported as being in an Open vs Closed status. [24] Total Incurred: This is the sum total from all of the cause of loss amounts. The total incurred includes dollar amount reserves, but does not include the deductible or the LAE. Copyright 2012 LexisNexis. All rights reserved. 16

17 Claim Details This section contains claim details. Some claims may have the same claim number, but each reported claim is unique. The policy number, AM Best number, and the policy type are used to determine that a claim is not a duplicate. Claims are reported in order of newest to oldest. This is an example of a Business Insurance claim. [25] Claim Date: The date the claim occurred. [26] Claim Number: The claim number for this claim. [27] Policy Type: The type of policy for claims reported. See Appendix A for the complete list of policy types. [28] AMB: The AM Best number for the carrier that contributed the claim. [29] Catastrophe: Indicates whether the claim was the result of a catastrophe. If contributed, a catastrophe code may also be reported. [30] Named Insured: The named insured listing contributed by the carrier. Often, this is a text field that may contain multiple names as shown on the insured s policy name field. [31] Incident Location: The location at which the claim occurred. Some carriers do not collect this data element. Others collect it, but report it in the claim description field. [32] Claim Disposition: The disposition of the entire claim. Either Open or Closed will be reported. If one claim has two components and one is Closed and the other is Open, the entire claim shows Open. For example, a property claim due to a fire may have two components - contents damage which has been paid and closed, and a business interruption component that is still open. The entire claim is reported as Open. [33] Claimant/Vehicle Operator Name: For Business Insurance policies, Small Business policies, and Workers Compensation policies the name shown is the Claimant Name. For Commercial Auto policies, the name reported is the Vehicle Operator. [34] Cause of Loss: The cause(s) of loss being paid for this claim. For a list of the various Causes of Loss, see Appendix B. [35] Paid: The amount paid for that cause of loss. [36] Reserve: The reserve amount set aside for the cause of loss reported. [37] Deductible: The deductible paid by the claimant for this cause of loss. [38] Disposition: The current status of the claim for this cause of loss. [39] Total: This is the amount paid for this cause of loss, excluding the Deductible. This amount may change if the cause of loss disposition is not closed. Copyright 2012 LexisNexis. All rights reserved. 17

19 Additional Open Claims Section This section contains any additional open claims only if your company is setup to receive additional open claims. The summary will include all lines of business found and all claims found.the details will be reported following the summary. Claims will be reported from newest to oldest. Copyright 2012 LexisNexis. All rights reserved. 19

20 Appendix A: Policy Type The following policy type codes are returned in the Report Summary Claims Match Summary section and the Claims Detail section. The description is not returned in the result. Code Description Code Description AC Artisan Contractor GA Garage Liability BR Builders Risk GL General Liability BO Business Owners IM Inland Marine CA Commercial Auto MC Motor Carriers CM Commercial Multi-Peril PI Personal Injury Liability CP Commercial Property PL Professional Liability CR Crime TC Truckers Liability DO Director & Officer s Liability UA Umbrella Auto Liability EL Employer s Liability UE Umbrella Employers Liability EP Employment Practice Liability UL Umbrella Liability EO Errors & Omissions Liability UP Umbrella Package Liability FR Farm WC Workers Compensation Copyright 2012 LexisNexis. All rights reserved. 20

21 Appendix B: Cause of Loss The cause of loss codes are reported in the claims detail section. The cause of loss code can be from two to five bytes. The description is not returned in the result. Code Description Code Description ACCDL Accidental Discharge/Leakage FIREL Fire Legal Liability AIR Aircraft or Vehicles FLOOD Flood BI Bodily Injury Liability - Non Auto FORG Forgery BIA Bodily Injury - Auto FOROB Intake of Foreign Objects BOIL Boiler & Machinery FREEZ Freezing Water BURG Burglary GLASS Glass BUSIN Business Income HAIL Hail CFRAD Computer Fraud LAE Loss Adjustment Expense COLL Automobile Collision LIAB Liability (All Other) COMP Completed Operations Liability LIGHT Lightning CONTA Contamination/Pollution LIVES Livestock CRAFT Watercraft LOSS Loss Assessment DESTC Destruction LSCP Loss of Scheduled Property DISHO Employee Dishonesty MINE Mine Subsidence DISSA Disappearance MOVE Earth Movement DO Directors & Officers Liability MP Medical Payments - Non Auto EMBZL Embezzlement MPA Medical Payments - Auto EMPL Employer s Liability OTC Other than Collision EO Errors & Omissions Liability OTR All Other EP Employment Practice Liability PD Property Damage Liability - Non-Auto EXPLN Explosion PDA Property Damage Liability - Auto EXTEN Extended Coverage PI Personal Injury/Advertising Injury EXTOR Extortion PIP Personal Injury Protection - Auto FCOLL Collision, Upset, Overturn (Farm) PROD Products Liability FIRE Fire QUAKE Earthquake RENT Rental Reimbursement UIM Underinsured Motorists RIOT Riot & Civil Commotion UM Uninsured Motorist ROBBY Robbery VMM Vandalism & Malicious Mischief Copyright 2012 LexisNexis. All rights reserved. 21

22 Code Description Code Description SBURG Safe Burglary VOLC Volcanic Action SINK Sinkhole WATER Water SLIP Slip/Fall Liability WC Workers Compensation SMOKE Smoke WCMED Workers Compensation Medical SPRNK Sprinkler Leakage WCIND Workers' Compensation Indemnity THEFT Theft WEATH Weather Related Water TOW Towing & Labor WIND Wind Copyright 2012 LexisNexis. All rights reserved. 22

23 Glossary Account Number The account number used to place the order. Additional Line of Business Included This can result in two conditions. 1) When Business Insurance line was requested (no Small Business indicated), a search for Small Business claims is always done. If Small Business claims were found, Small Business will be shown here. 2) If Small Business was requested (no Business Insurance indicated) and Business Insurance claims were found, Business Insurance will be shown here. NOTE: Condition number one is always searched. Condition number two is an account set up option. Contact your LexisNexis National Account Manger or Customer Manager if you have questions. Additional Open Claim(s) This section shows when additional open claims were requested for a period greater than the five years preceding the reporting period requested. If open claims were found prior to the reporting period, the claim summary for those claim(s) will be reported here. AMB The AM Best number for the carrier that contributed the claim. Carrier Name The name of the carrier that contributed the claim. The name reported is the name associated with the AM Best number. Catastrophe Indicates whether the claim was the result of a catastrophe. If contributed, a catastrophe code may also be reported. Cause of Loss The cause(s) of loss being paid for this claim. For a list of the various Causes of Loss, see Appendix B. Claim Amount The first line will be the total amount of claims found for that policy period for the line of business shown. If no claims were found, a -0- will be reported. Claim Count The total number of claims included in the claim amount shown. If no claims were found in the reporting period, a (-0-) will be reported. Claim Date The date the claim occurred Claim Disposition The disposition of the entire claim. Either Open or Closed will be reported. For example, if a property claim due to a fire has two components - contents damage which has been paid and closed, a business interruption component that is still open, the entire claim will be reported as Open. Claim Number The claim number for this claim. Claimant/Vehicle Operator Name For Business Insurance policies, Small Business policies and Workers Compensation policies the name shown is the Claimant Name. For Commercial Auto policies, the name reported is the Vehicle Operator. Deductible The deductible paid by the claimant for this cause of loss. Copyright 2012 LexisNexis. All rights reserved. 23

24 Disposition The current status of the claim for this cause of loss. The Dispositions include Open (O), Closed (C), Subrogation (S), Under Deductible (D), Peril Not Covered (P), and Withdrawn (W). Incident Location The location at which the claim occurred. Some carriers do not collect this data element. Others collect it, but report it in the claim description field. Inquiry Result Additional details for the results. Lines of Business Each line of business searched will be reported here along with a Y for claims found or a N for no claims found. Line of Business Requested Only the line(s) of business that were searched on the order will be reported. Up to four lines of business can be shown: Business Insurance, Small Business, Commercial Auto, and Workers Compensation. Named Insured The named insured listing contributed by the carrier. Often, this is a text field that may contain multiple names as shown on the insured s policy name field. Number of Claims() The total number of claims included in the claim amount shown. If no claims for the reporting period were found, a (-0-) will be reported. Open The number of claims that are reported as being in an Open vs Closed status. Order Date and Time The time and date the order was received by LexisNexis. Paid The amount paid by the policy number/carrier shown for that reporting period. If no claims were found for a policy period, it will be blank. Policy Number & Carrier The policy number and carrier name for all the claims found for each line of business. If more than one claim was found for a policy number for a line of business, the policy number will only be listed once. Policy Period Policy periods will be reported in increments of 12 months and will be based on the reporting period you requested on the order inquiry. Policy Type The type of policy for claims reported. See Appendix A for the complete list of policy types. Quoteback The quoteback is entered when you order a C.L.U.E. Commercial report. It is used so you can match the report back to your quote submission or policy.often the quoteback used is the quote/policy number. Because you may need to match one C.L.U.E. Commercial report to multiple lines of business up to five quotebacks can be entered. Reference Number This number is created by LexisNexis and uniquely identifies the C.L.U.E. Commercial report provided. Refer to this number when you call the LexisNexis Support Center with questions regarding a report. Copyright 2012 LexisNexis. All rights reserved. 24

25 Requestor This is the name of the requestor for the account number ordered. The requestor name may not be your name, but rather something like ABC Insurance Western Region. Reporting Period This is the date entered on the C.L.U.E. Commercial inquiry form on which all data is organized for reporting purposes in the C.L.U.E. Commercial report. For example, if you entered 7/1/2011 for the reporting period, you would receive losses from 7/ 1/2006 to 7/1/2011. Claims are only provided on the reporting period. In the 7/1/2011 example, if a claim occurred on 7/2/ 2011, it would not be shown. If you have requested to receive additional open claims over the reporting threshold, a message will be reported if claims were or were not found. NOTE: Additional years can be searched for both open and/or closed claims up to ten years at a nominal additional investment. Contact your LexisNexis National Account Manager. Reserve The reserve amount set aside for the cause of loss reported. Reserves If a dollar amount reserve was reported for a claim it will be included in the claim amount paid and a -R- will be reported. If a carrier only reports reserves in dollar ranges no reserve amount is included in the Total Incurred Amount. These are identified with a -X-. If more than one claim is reported in the policy period there is a possibility both a -R- and a -X- can be reported. See the Claim Detail section for dollar amount reserves and/or reserve range. Search Addresses The addresses that were sent on the order and inquiry form. Search Names The names that were sent on the order and inquiry form. Search Policy Numbers/Effective Date The policy number(s) and effective date(s) that were sent on the inquiry. Search Type One of three search types can be requested. The type of search you requested will have a check mark. Special Billing ID This is a number and/or name entered by you and is included on the billing invoice. System Messages A message indicating the status of the search. The report request processed successfully. The Report request resulted in an error. Total This is the total amount of money associated with this cause of loss. Total All Lines This is a grand total for all lines of business for the reporting period. Total Incurred This is the sum total from all of the cause of loss amounts. The total incurred includes dollar amount reserves, but does not include the deductible or the LAE. Copyright 2012 LexisNexis. All rights reserved. 25