Section II - Indemnity Data Call Structure
A. Record Descriptions
The Indemnity Data Call includes the following four separate record layouts:
- File Control Record—The File Control Record identifies the carrier, the quarter that the data represents, and the number of Transactional or Quarterly records being submitted. The File Control Record contains nine data elements. The File Control Record Data Elements are provided in Section III—Record Layouts and in Section IV—Data Dictionary.
Note: A separate file and File Control Record are required for transactional records and a separate file and File Control Record are required for quarterly records.
- Transactional Record—The Transactional record provides the details of each indemnity payment transaction and includes five key fields, four processing data elements, and nine Transactional claim data elements. These records are to be created for each payment transaction and are due by the end of the following quarter. The Transactional data elements are provided in Section III—Record Layouts and in Section IV—Data Dictionary.
- Quarterly Record—The Quarterly record provides the inception-to-date aggregated details of each indemnity claim and includes five key fields, two Processing data elements, and thirty Quarterly claim data elements. These records are to be valued as of the end of each quarter (3/31, 6/30, 9/30, and 12/31) and are due to be reported by the end of the following quarter. The Quarterly record data elements are provided in Section III—Record Layouts and in Section IV—Data Dictionary.
- Key Field Change Record—The Key Field Change record provides the necessary data to make key field changes to one or all previously reported impacted records. Key fields are listed in Part B of this Section, and the Key Field Change record data elements are provided in Section III—Record Layouts and in Section IV—Data Dictionary.
B. Key Fields and Processing Data Elements (Transactional and Quarterly)
Key fields identify unique claims. These elements are required to be reported the same for all records related to a claim (refer to Section V—Reporting Rules in this manual for details regarding deleting and changing records or making key field changes).
Key fields of the Indemnity Data Call include:
- Carrier Code
- Policy Number Identifier
- Policy Effective Date
- Claim Number Identifier
- Accident Date
The key fields are also used to link the cancellation or replacement Transactional record to the original Transactional record. If a record is reported with one or more of the key fields either missing or invalid, the record would be deemed unusable.
Consistent Reporting of Multi-Data Type Fields
Consistently reporting the field values that DCRB uses for linking within each data type and across all data types enables DCRB to use all data elements for the same policy and associated claims. Below are the fields by data type:
Data Type
| Data Element | Policy Data | Unit Statistical Data | Financial Call #4 | Medical Data Call | Indemnity Data Call |
| Carrier Code | X | X | X | X | X |
| Policy Number | X | X | X | X | X |
| Policy Effective Date | X | X | X | X | X |
| Exposure State Code | X | X | X | X | |
| Claim Number | X | X | X | X | |
| Accident Date | X | X | X | X | |
| Jurisdiction State Code | X | X | X | ||
| Accident State Code | X |
Note: An “X” denotes that the data element is applicable for the data type.
The field values that DCRB uses for linking within each data type and across all data types must be reported in accordance with their reporting rules and be consistent across data types for the life of the policy and the life of the claim. Claim numbers and accident dates must be reported consistently from one valuation to the next.
The data types are:
- Policy Data
- Unit Statistical Data
- Financial Call #4
- Medical Data Call
- Indemnity Data Call
Note: DCRB recognizes that some data providers (or their TPA/service providers) may report a different carrier code for related entities under their established statistical group, financial group, or pool group. The difference in carrier codes may be reported for these exceptions.
Subsequent Changes in Multi-Data Type Fields
When data linking fields are updated through Key Field Changes (KFCs), corrections or replacements based on their appropriate data type, similar updates may be needed to other data types. This ensures the continued accurate linking of policy fields and unique identification of claims.
Definition of Data Elements
Below are the data elements and their definitions in accordance with DCRB’s Statistical Plan Manual and related guidebooks.
| Data Elements | Definitions |
| Carrier Code | The numeric code assigned to the data provider (insurer) by NCCI. |
| Policy Number | The alphanumeric code that uniquely identifies the policy under which the experience occurred, excluding blanks, punctuation marks, and special characters. This number must be identical to the number set forth on the policy Information Page including prefixes or suffixes, if used. |
| Policy Effective Date | The date the Policy became effective that corresponds exactly to the date shown on the policy Information Page or to endorsements attached. In cases where an interstate policy was endorsed after the effective date to provide coverage for an additional state, report the effective date of the policy. |
| Exposure State Code* | The state in which coverage has been provided. |
| Claim Number | The alphanumeric code that uniquely identifies the specific claim and that will make it possible to location the claim records in the company files. The claim number must be reported consistently throughout the life of the claim. |
| Accident Date | For all claims where the accident date is known, report the date on which the claim occurred. This date must be with the policy period. For Occupational Disease and Cumulative Injury Other Than Disease claims where the accident date is not known, report the claimant's last date of exposure to the conditions causing or aggravating the injury as the accident date. The accident date must be reported consistently throughout the life of the claim. |
| Jurisdiction State Code | The code that corresponds to the governing jurisdiction that will administer the claim and whose statutes will apply to the claim adjustment process. |
| Accident State Code* | The code that corresponds to the state or foreign location where the claimant was injured or contracted an occupational disease. |
Processing data elements are used to ensure the proper handling of the transactions.
Indemnity Data Call Processing Data Elements
Indemnity Data Call processing data elements include:
- Record Type Code
- Transaction Code*
- Transaction Date
- Transaction Identifier*
Correctly reporting the processing data elements ensures the accurate processing of the record. If a record is reported with one or more of the processing data elements either missing or invalid, the record could be deemed unusable.
*Only applicable to the Transactional Record
C. Submission Types
The Indemnity Data call includes the following two separate file types:
- Original File—The original file type, identified by an “O” in the Submission File Type Code field in the File Control Record (as described in above), is used for the regular submission of records each quarter.
- Replacement File—the replacement file, identified by an “R” in the Submission File Type Code field in the File Control Record (as described in above), is used when the data provider has records that have been previously submitted and that need to be removed from {database}. A replacement file first removes all of the records from the previously submitted file that are identified by the Submission File Identifier in the File Control Record, and then submits the records found in the replacement file.