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Early Warning System

Commercial Liability Statistical Plan

Anomaly Rule Business Descriptions

Version 1.2

November 2015

© General Insurance Statistical Agency / Agence Statistique D’assurance Générale 2015

Early Warning System CLSP Anomaly Rule Business Descriptions

2

This material is intended to provide orientation and guidance to users accessing GISA Early Warning System for data anomalies management.

All rights reserved. No part of this material may be reproduced in any material form or transmitted without the prior written permission of General Insurance Statistical Agency.

© General Insurance Statistical Agency / Agence Statistique D’assurance Générale 2015


3

Revision History

Version Date Changes 1.0 May 2012 Initial version, Changes to a few Rules : BCO4512002,

BCP4403001, BCP4404007,BCP4499001, BCP4499002, BXP4900001, BXP4900002 Appendix – Field Definition

1.1 June 2012 Update on no dependency for anomaly rule BCP4402002 BCC4512001 – the definition was changed to proper reflect the logic.

1.2 Nov. 2015 Document format and logo changes


4

Table of Contents

Revision History ............................................................................................................................................ 3 Table of Contents .......................................................................................................................................... 4 Chapter 1 – Introduction ............................................................................................................................... 6

General ................................................................................................................................................................... 6 Types of Rules ........................................................................................................................................................ 6 Rule Identification ................................................................................................................................................... 7 Company exceptions .............................................................................................................................................. 7 Province detail ........................................................................................................................................................ 7 Rule dependencies ................................................................................................................................................. 8 Rule conditions ....................................................................................................................................................... 8 Rule threshold ......................................................................................................................................................... 8

Chapter 2 - Benchmark Rules ........................................................................................................................ 9 BCC4304001 ........................................................................................................................................................ 10 BCP4304001 ......................................................................................................................................................... 11 BCC4304002 ........................................................................................................................................................ 12 BCP4304002 ......................................................................................................................................................... 13 BCC4402001 ........................................................................................................................................................ 14 BCP4402001 ......................................................................................................................................................... 15 BCP4402002 ......................................................................................................................................................... 16 BCP4403001 ......................................................................................................................................................... 17 BCP4404001 ......................................................................................................................................................... 18 BCP4404002 ......................................................................................................................................................... 19 BCP4404003 ......................................................................................................................................................... 20 BCP4404004 ......................................................................................................................................................... 21 BCP4404005 ......................................................................................................................................................... 22 BCP4404006 ......................................................................................................................................................... 23 BCP4404007 ......................................................................................................................................................... 24 BCP4407001 ......................................................................................................................................................... 25 BCP4407002 ......................................................................................................................................................... 26 BCP4499001 ......................................................................................................................................................... 27 BCP4499002-Suspended ..................................................................................................................................... 28 BCC4509001 ........................................................................................................................................................ 29 BCC4509002 ........................................................................................................................................................ 30 BCC4511001-Suspended ..................................................................................................................................... 31 BCC4512001 ........................................................................................................................................................ 32 BCO4512002 ........................................................................................................................................................ 33 BXP4900001 ......................................................................................................................................................... 34 BXP4900002 ......................................................................................................................................................... 35

Chapter 3 – Reference Rules ....................................................................................................................... 36 RCB4204001 ........................................................................................................................................................ 37 RCB4302001 ........................................................................................................................................................ 38 RCC4302001-Suspended ..................................................................................................................................... 39 Claims ................................................................................................................................................................... 39


5

RCP4302001 ........................................................................................................................................................ 40 RCB4401001 ........................................................................................................................................................ 41 RCP4401001 ........................................................................................................................................................ 42 RCB4407001 ........................................................................................................................................................ 43

Appendix A – Record segment/ data element name .................................................................................. 44 Appendix B – Field definitions used in Anomaly rules ................................................................................ 46


6

Chapter 1 – Introduction

General

Anomaly Rules are specific business conditions which have been identified as normal conditions expected in the data reported under the Commercial Liability Statistical Plan.

The anomaly rules are executed on a regular scheduled basis to test the reasonability of the reported data; issues identified by the anomaly rules trigger notification to a Data analyst. If the Data Analyst determined that the anomaly triggered constitutes a data reporting issue, they identify it as such and collaborate with the applicable insurer towards resolving the issue.

Types of Rules

Anomaly Rules are identified as either Benchmark rules which are testing certain expected business conditions in the reported data or Reference rules which are testing currently reported data against previously reported data.

The Anomaly rules are also identified as Company rules, which examine the rules against company specific data and Industry rules which run the rules against company data aggregated to an industry level.

Some rules are defined explicitly for Premium, some for Claims and other for both Premiums and Claims; the rules which are using both premiums and claims are those which examined certain measures which are a combination of premiums and claims information (e.g. Claims Frequency). Certain rules for Claim transactions are run against paid claims only, some against combined Paid and Outstanding claims and a few against Outstanding claims only.


7

Rule Identification The Anomaly rule identification is used to identify the situation described above; additionally, the rule identification can also be used to identify the primary field examined in the rule.

The following table describes the Anomaly Rules identification scheme:

Pos. Description Values 1 Rule Type Benchmark B

Reference R 2 Rule Level Company C

Industry I All Companies X 1

3 Record Kind Premium P Premium and Claims B Paid Claim C Outstanding Claims O Paid and Outstanding Claims I 4 Stat Plan CLSP, ASP 4, 8 5 Record Segment Submission Control 1

Policy 2 Classification 3 Coverage 4 Claims Detail 5 Special Rule Level X 9

6 - 7 Data Element Number Use 99, where multiple fields are used nn 2 Used in connection with Rule Level X 00

8 - 10 Sequential Number nnn

Company exceptions Some Anomaly rules are specific for certain companies or do not apply to certain companies; this is specified in the Company Exception and is user definable/ maintainable. This can, optionally be associated with a Policy Effective Start data and/ or a Policy Effective Stop date.

Province detail Some Anomaly rules conditions may be conditional on province details; this is specified in the Province detail and is user definable/ maintainable

1 Special Type of Anomaly Rules, used for testing domination criteria and assigned to Actuarial Analysts 2 Refer to Appendix – record layout


8

Rule dependencies Certain Anomaly rules make use of Dependant rules.

There are two types of dependencies:

INCLUSIVE, these are the types of rules which will be run if the corresponding rule raised an anomaly, and

EXCLUSIVE, these are rules which will not be run if the corresponding rule raised an anomaly

Rule conditions Conditions in the rule utilize Ranges or Tolerances; some conditions may use a tolerance while others may use a range, both of these can be expressed as percentage(s) or as actual value(s). The range or tolerance is user definable/ maintainable where the type (i.e. Range/ tolerance/percentage or actual value) is programmed a part of the condition and is user maintainable.

Range, is a lower and upper limit and may be expressed as 98% - 102%, as actual value it can be expressed as 0 – 0

Tolerance is a single number which is referenced in an equation and may be expressed as 5%, as actual value it may be expressed as 50,000.

Rule threshold Certain anomaly rules will utilize a threshold value to ensure that variations in the data are not the result of sparsity of data. The threshold standards are predetermined as follows:

Frequency # of Policies Claim Count Monthly 30 15

Qtrly 90 45 Semi Annual 180 90

Annual 360 180

Where both Claims and Premiums are used in an anomaly rules, threshold, if used, is applied to both measures; if more than one instance of a measure, threshold if used, is applied to each instance of the measure.


9

Chapter 2 - Benchmark Rules

The Benchmark Anomaly rules examines the reported data for certain expected business conditions; benchmark rules are frequently used where certain consistencies exist with between fields on an aggregated basis (Edit Rules may check field consistencies in an individual transaction basis). It is also used when new fields are being collected, or business conditions change, where a reliable historic reference set of data is not available.

In these types of rules, the Data analyst may use Company exceptions to manage situations where standard business conditions may be different for certain insurers. As experience is gathered with these anomaly rules it is expected that company exceptions will be modified using the Rule Maintenance module available for this purpose.

The following Anomaly Rules are arranged according to:

1. Company Rules and 2. Industry Rules and

Within each group of rules (e.g. Company), rules are sequenced by Record Segment and Data Element thereby providing easy reference and locating of anomaly rules associated with a specific field.


10

BCC4304001 Claims

The number of claims reported without Exposure should be less than 100% compared to all claims

Frequency: Quarterly Threshold: Yes

Edit Procedure

If Company Exception, Province and Policy Effective Date have the values shown in the table below, then the Condition must be TRUE.

Company Exception Province

Policy Effective

Date Condition Range

Identification Start date

Stop date

∑(Number of Claims (Exposure

Type = 4 and Exposure Base Unit = 9 ) / ∑(Number of Claims) within Range

0 – 90%

Dependencies for this Anomaly INCLUSIVE; i.e. Execute these rules if this rule raised an anomaly:

EXCLUSIVE; i.e. Do not execute these rules if this rule raised an anomaly:

Dynamic C ExposureType '4' Dynamic C ExposureBaseUnit '9'


11

BCP4304001 Premiums

The number of policies reported without Exposure should be less than 100% compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date

Condition Range Identification Start

date Stop date

∑(Number of Policies (Exposure

Type = 4 and Exposure Base Unit = 9 ) / ∑(Number of Policies) within Range

0 – 90%



Dynamic P ExposureType '4' Dynamic P ExposureBaseUnit '9'


12

BCC4304002 Claims

The number of claims reported without Exposure (“Flat rated”) should be less than 100% compared to all claims


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number of Claims (Exposure

Type = 5 and Exposure Base Unit = 0 ) / ∑(Number of Claims) within Range

0 – 90%



Dynamic C ExposureType '5' Dynamic C ExposureBaseUnit '0'


13

BCP4304002 Premiums

The number of policies reported without Exposure (“Flat rated”) should be less than 100% compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number of Policies (Exposure

Type = 5 and Exposure Base Unit = 0 ) / ∑(Number of Policies) within Range

0 – 90%



Dynamic P ExposureType '5' Dynamic P ExposureBaseUnit '0'


14

BCC4402001 Claims

The Number of Claims reported for Extended Reporting Period (“ERP”) policies should be minimal compared to all claims


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number of Claims (Policy Type

= 8 ) / ∑(Number of Claims within Range

0 – 3%



Dynamic C PolicyType '8'


15

BCP4402001 Premiums

The Number of Policies reported for Extended Reporting Period (“ERP”) policies should be minimal compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number of Policies (Policy

Type = 8 ) / ∑(Number of Policies within Range

0 – 3%



BCC4402001

Dynamic P PolicyType '8'


16

BCP4402002 Premiums

The Number of Policies reported for Claims made policies are expected to be significant compared to all policies for Coverage / Policy Form 6x and 7x.


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For Coverage / Policy Form code 6x and 7x: ∑(Number of Policies (Policy

Type = 6 ) / ∑(Number of Policies within Range

90 - 100%



Dynamic P PolicyType '6' Static P CoveragePolicyFormCode '60','61','62','70','71'


17

BCP4403001 Premiums

The number of policies reported with Policy Limits less than $100,000 should be minimal compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date

Condition Tolerance Identification Start

date Stop date

For each Coverage: ∑(Number of Policies Policy Limit

< 100000 / ∑(Number of Policies) Within Range

0-10%



No filters.


18

BCP4404001 Premiums

The number of policies reported with Percent Participation other than 100% for Commercial General Liability should be minimal compared to all policies


Edit Procedure



Policy Effective



Stop date

For Coverage = 10 - 41: ∑(Number of Policies Percent

Participation <> 100 ) / ∑(Number of Policies) within Range

0 – 3 %



Dynamic P PercentParticipation '001','002','003','004','005','006','007','008','009',

'010','011','012','013','014','015','016','017','018', '019','020','021','022','023','024','025','026','027', '028','029','030','031','032','033','034','035','036', '037','038','039','040','041','042','043','044','045', '046','047','048','049','050','051','052','053','054', '055','056','057','058','059','060','061','062','063', '064','065','066','067','068','069','070','071','072', '073','074','075','076','077','078','079','080','081', '082','083','084','085','086','087','088','089','090', '091','092','093','094','095','096','097','098','099', 'Blank','Unknown'

Static P CoveragePolicyFormCode '10','20','30','40','41'


19

BCP4404002 Premiums

The number of policies reported with Percent Participation other than 100% for Automobile Policies should be minimal compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date



0 – 3 %




'010','011','012','013','014','015','016','017','018', '019','020','021','022','023','024','025','026','027', '028','029','030','031','032','033','034','035','036', '037','038','039','040','041','042','043','044','045', '046','047','048','049','050','051','052','053','054', '055','056','057','058','059','060','061','062','063', '064','065','066','067','068','069','070','071','072', '073','074','075','076','077','078','079','080','081', '082','083','084','085','086','087','088','089','090', '091','092','093','094','095','096','097','098','099', 'Blank','Unknown'

Static P CoveragePolicyFormCode ‘42’,’43’,’44’


20

BCP4404003 Premiums

The number of policies reported with Percent Participation other than 100% for Wrap-Up Policies should be minimal compared to all policies


Edit Procedure



Policy Effective



Stop date

For Coverage = 50: ∑(Number of Policies Percent


0 – 3 %



Dynamic P PercentParticipation '001','002','003','004','005','006','007','008','009', '010','011','012','013','014','015','016','017','018', '019','020','021','022','023','024','025','026','027', '028','029','030','031','032','033','034','035','036', '037','038','039','040','041','042','043','044','045', '046','047','048','049','050','051','052','053','054', '055','056','057','058','059','060','061','062','063', '064','065','066','067','068','069','070','071','072', '073','074','075','076','077','078','079','080','081', '082','083','084','085','086','087','088','089','090', '091','092','093','094','095','096','097','098','099', 'Blank','Unknown'

Static P CoveragePolicyFormCode ‘50’


21

BCP4404004 Premiums

The number of policies reported with Percent Participation other than 100% for Professional Liability Policies should be minimal compared to all policies


Edit Procedure



Policy Effective



Stop date



0 – 20 %




'010','011','012','013','014','015','016','017','018', '019','020','021','022','023','024','025','026','027', '028','029','030','031','032','033','034','035','036', '037','038','039','040','041','042','043','044','045', '046','047','048','049','050','051','052','053','054', '055','056','057','058','059','060','061','062','063', '064','065','066','067','068','069','070','071','072', '073','074','075','076','077','078','079','080','081', '082','083','084','085','086','087','088','089','090', '091','092','093','094','095','096','097','098','099', 'Blank','Unknown'

Static P CoveragePolicyFormCode ‘60’,’61’,’62’


22

BCP4404005 Premiums

The number of policies reported with Percent Participation other than 100% for Pollution Liability Policies should be significant compared to all policies


Edit Procedure



Policy Effective



Stop date



0 – 90%




'010','011','012','013','014','015','016','017','018', '019','020','021','022','023','024','025','026','027', '028','029','030','031','032','033','034','035','036', '037','038','039','040','041','042','043','044','045', '046','047','048','049','050','051','052','053','054', '055','056','057','058','059','060','061','062','063', '064','065','066','067','068','069','070','071','072', '073','074','075','076','077','078','079','080','081', '082','083','084','085','086','087','088','089','090', '091','092','093','094','095','096','097','098','099', 'Blank','Unknown'

Static P CoveragePolicyFormCode ‘70’,’71’


23

BCP4404006 Premiums

The number of policies reported with Percent Participation other than 100% for Employers’ Liability Policies should be minimal compared to all policies


Edit Procedure



Policy Effective



Stop date

For Coverage = 80: ∑(Number of Policies Percent


0 – 10%




'010','011','012','013','014','015','016','017','018', '019','020','021','022','023','024','025','026','027', '028','029','030','031','032','033','034','035','036', '037','038','039','040','041','042','043','044','045', '046','047','048','049','050','051','052','053','054', '055','056','057','058','059','060','061','062','063', '064','065','066','067','068','069','070','071','072', '073','074','075','076','077','078','079','080','081', '082','083','084','085','086','087','088','089','090', '091','092','093','094','095','096','097','098','099', 'Blank','Unknown'

Static P CoveragePolicyFormCode ‘80’


24

BCP4404007 Premiums

The number of policies reported with Aggregate Premium Amount greater than $100,000 should be minimal for each Coverage/Policy Form compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Coverage / Policy Form code: ∑(Number of Policies (Premium

Amount/ percent Participation) > 100000 ) / ∑(Number of Policies) within Range

0 – 3%



No filters.


25

BCP4407001 Premiums

The number of policies reported with Deductible Amount higher than $100,000 should be minimal for each Coverage/Policy Form compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Coverage / Policy Form code ∑(Number of Policies Deductible

> 100000 ) / ∑(Number of Policies) within Range

0 – 10 %



Dynamic P DeductibleAmount '125000','150000','175000','200000','250000',

'300000','350000','400000','450000','500000', '600000','700000','800000','900000','1000000', '1250000','1500000','1750000','2000000','2500000', '3000000','3500000','4000000','4500000','5000000', '6000000','7000000','8000000','9000000','10000000', '999999999'


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BCP4407002 Premiums

The number of policies reported with Deductible Amount higher than Policy Limit should be minimal for each Coverage / Policy Form compared to all policies


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Coverage / Policy Form code: ∑(Number of Policies Deductible

amount > Policy limit ) / ∑(Number of Policies) within Range

0 – 3 %



No filters.


27

BCP4499001 Premiums

The number of policies reported with Policy Limits less than Aggregate Premium Amount should be minimal for each Coverage/Policy Form


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Coverage / Policy Form Code: ∑(Number of Policies Policy Limit

< (Premium Amount / Percent Participation ) within Range

0 – 0 %



No filters.


28

BCP4499002-Suspended Premiums

The number of policies reported with Policy Limit less than Deductible should be minimal for each Coverage/Policy Form.

Frequency: Threshold:

Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Coverage / Policy Form code: ∑(Number of Policies Policy Limit

< Deductible ) within Range

0 – 0 %



No filters.


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BCC4509001 Claims

The number of claims reported with Claims Location = Ontario must be significant compared to all claims.


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number Claims Claims Location

= “07”) / ∑(Number of Claims) within Range

90 – 100 %



Dynamic C ClaimLocationCode '07'


30

BCC4509002 Claims

The Loss and Expense Amounts reported with Claims Location = Ontario must be significant compared to loss and expense amounts reported in all claims location.

Frequency: Monthly Threshold: No

Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Loss & Expense Amount Claims Location = “07”) / ∑(Loss & Expense Amount) within Range

90 – 100 %



Dynamic C ClaimLocationCode '07'


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BCC4511001-Suspended Claims

The Number of Claims reported without expense should be minimal for each Kind of Loss.


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Kind of Loss and Loss Amount > 0: ∑(Number of Claims (Expense

Amount = 0 ) / ∑(Number of Claims) within Range

0 – 3%



No filters.


32

BCC4512001 Claims

The Number of Claims reported with amount exceeding a certain threshold should be minimal compared to all claims

Frequency: On request Threshold: No

Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number Claims (Aggregate

loss amount > Tolerance

must be 0

5,000,000



No filters.


33

BCO4512002 Claims

The Number of Outstanding Claims transactions reported with small loss amount should be minimal compared to all Outstanding Claims transactions

Frequency: Monthly Threshold: No

Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

∑(Number Outstanding Claims transactions (Loss

Amount < 100 / ∑(Number of Outstanding Claims transactions must be within range

0 – 2 %



No filters.


34

BXP4900001 Premium

The total amount of Premium for each company should be less than 70% when compared to all companies for each Industry Classification code.


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Industry Classification code and Policy Effective Date with total premium amount > $250,000: ∑(Premium amount (Company

Identification / ∑(Premium amount

0 – 70%



BXP4900002

No filters.


35

BXP4900002 Premium

The total amount of Premium for each company should be less than 70% when compared to all companies for each Industry Classification code.


Edit Procedure


Company Exception

Province Policy

Effective Date


date Stop date

For each Industry Classification code and Policy Effective Date with total premium amount > $250,000: ∑(Premium amount (Company Identification / ∑(Premium amount

0 – 15%



No filters.


36

Chapter 3 – Reference Rules

The Reference Anomaly rules examines the reported data for against a similar set of data reported in a previous period; these rules are generally used in stable business conditions, where the reported data is expected to be similar to the data reported in a previous period.

Although the Data analyst may use Company exceptions to manage situations where standard business conditions may be different for certain insurers, this is expected to be used less for Reference rules. In scheduling the rules, the Data analyst has a capability to group certain companies to manage situations such as portfolio transfers of business.

The following Anomaly Rules are arranged according to:

1. Company Rules and 2. Industry Rules

Within each group of rules (e.g. Company), rules are sequenced by Record Segment and Data Element thereby providing easy reference and locating of anomaly rules associated with a specific field.


37

RCB4204001 Premiums/Claims

The Claims frequency for Commercial General Liability must be equal to historical reported information for each Policy Year


Edit Procedure


Company Exception

Province Policy Effective Date Condition Range


Stop date

For Coverage = 10 - 41: (Claims Frequency Policy Year)

= (Claims Frequency Policy

Year.HIST1) Within Range

90 – 110%



Static C CoveragePolicyFormCode '10','20','30','40','41' Static P CoveragePolicyFormCode '10','20','30','40','41'

1 HIST refers to historic reference information


38


The Claims Frequency must be equal to historical reported information for each Major Category of Industry Classification


Edit Procedure


Company Exception



Stop date

For each Major Category: Claims Frequency = Claims Frequency.HIST1) Within Range

90 – 110%



No filters.



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RCC4302001-Suspended Claims The Claims Severity must be equal to historical reported information for each Major Category of Industry Classification

Edit Procedure


Company Exception



Stop date

For each Major Category: Claims Severity = Claims Severity.HIST1) Within Range

90 – 110%



No filters.



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RCP4302001 Premiums

The Number of Policies must be equal to historical reported information for each Major Category of Industry Classification.


Edit Procedure


Company Exception



Stop date

For each Major Category : ∑(Number of Policies) = ∑(Number of

Policies.HIST1) Within Range

90 – 110%



No filters.



41


The Claims Frequency must be equal to historical reported information for each Coverage / Policy Form

Frequency: Yearly Threshold: Yes

Edit Procedure


Company Exception



Stop date

For each Coverage / Policy Form: Claims Frequency = Claims Frequency.HIST1) Within Range

90 – 110%



No filters.



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RCP4401001 Premiums

The Number of Policies must be equal to historical reported information for each Coverage / Policy Form


Edit Procedure


Company Exception



Stop date

For each Coverage / Policy Form: ∑(Number of Policies) = ∑(Number of

Policies.HIST1) Within Range

90 – 110%



No filters.



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The Claims frequency for each Coverage by Deductible amount must be equal to historical reported information


Edit Procedure


Company Exception



Stop date

For each Coverage: ( Claims Frequency Deductible

Group) = (Claims Frequency Deductible

Group.HIST1) Within Range

90 – 110%



No filters.



44

Appendix A – Record segment/ data element name Both the Record Segment and Data Element Number are used in the composition of the Anomaly Rule Identification.

Record Segment Data Element

Number Name

1 - Submission Control 01 Record Format Version Number

02 Company Identification

03 Entry Date

04 Statistical Plan

05 Transaction Type Code

2 - Policy 01 Policy Control ID

02 Policy Identification Digit

03 Policy Identification

04 Policy Effective Date

05 Retroactive Date

06 Transaction Effective Date

07 Policy Expiry Date

3 - Classification 01 Premium Location code

02 Industry Classification code

03 Line code

04 Exposure Type

05 Exposure Base unit

06 Exposure Amount

4 - Coverage 01 Coverage / Policy Form code

02 Policy type

03 Policy limit

04 Percent participation

05 Premium amount


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Record Segment Data Element

Number Name

06 Deductible type

07 Deductible amount

5 – Claim Detail 01 Claims Control ID

02 Claim Identification Digit

03 Claim Identification

04 Accident Date

05 Notice of Occurrence date

06 Basis of Claim

07 Notice of Claim date

08 Event Category

09 Claim Location code

10 Claim count

11 Kind of Loss

12 Loss Amount

13 Expense Type

14 Expense Amount


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Appendix B – Field definitions used in Anomaly rules

Field definitions are frequently used in Anomaly Rules to identify subsets of data for the particular condition; unless specifically identified in the Anomaly Rules, all fields have their regular meaning set out in the Commercial Liability Statistical Plan with the following additions/ modifications:

Field Meaning Aggregate Loss Amount (Loss Amount + Expense Amount) for each

combination of • Company Number, • Policy Identification, • Claims Identification, • Claim Location Code • Policy Effective Date and • Accident Date Regardless of Entry Date

Claims Frequency Number of Claims / Number of Policies

Claims Severity (Loss Amount + Expense Amount) / Number of Claims

Deductible Group Grouping of Deductible Amounts as per definitions for Cube.

Major Category Refer to Commercial Lines Statistical Plan – Appendix A for a definition of Major Category

Number of Claims Sum of Claim Count Number of Policies 1 (Transaction Type = 1), -1 (Transaction Type = J

or M) for each combination of: • Company Number, • Policy Identification, • Policy Effective Date and Policy Expiry

Date • Industry Classification Code • Coverage / Policy Form code

Premium Sum of Premium amount

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