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Insured Information
This section should be
completed about the insured or defendant in the claim. If more than one
insured is named, a separate entry is required for each insured defendant.
All of the information in this section is required with the exception of the
Board Certified/Eligible Date. Please remember to update your specialty
table with the PIAA as specialty codes could changes or be added and
subsequently rejected if they have not been entered into the PIAA master
database. All information regarding the insured must reflect the insured's
status at the time of the incident.
| Field
No. |
Field
Name |
Entry |
Description |
| 12 |
Specialty |
Required |
Enter the
primary medical specialty in which the defendant is rated. Use the
code utilized by your company. Corporate files are to be
identified by a unique specialty code. |
|
|
|
|
| 13 |
Board
Certified |
Optional |
Enter the
claimant's board status from the following table. |
| Code |
Board
Status |
| c |
Certified |
| n |
Not
certified |
| u |
Unknown |
|
Table
4-A |
| Field
No. |
Field
Name |
Entry |
Description |
| 14 |
Limits |
Required |
Optional for
corporate files. Enter the code for the insured's limits of
liability from the following Policy Limits table. Use the total
amount of limits the insured is carrying, including any excess coverage
for which you will be reporting payments. If that amount is
unknown, report the limit carried from your company. |
| Code |
Policy
Limit |
Code |
Policy
Limit |
| 05 |
$25,000 |
35 |
$1,400,000 |
| 06 |
$30,000 |
19 |
$1,500,000 |
| 07 |
$40,000 |
20 |
$2,000,000 |
| 08 |
$50,000 |
21 |
$2,500,000 |
| 09 |
$75,000 |
22 |
$3,000,000 |
| 10 |
$100,000 |
36 |
$4,000,000 |
| 11 |
$150,000 |
23 |
$5,000,000 |
| 12 |
$200,000 |
30 |
$6,000,000 |
| 13 |
$250,000 |
34 |
$7,000,000 |
| 14 |
$300,000 |
24 |
$7,500,000 |
| 15 |
$400,000 |
38 |
$8,000,000 |
| 16 |
$500,000 |
39 |
$9,000,000 |
| 17 |
$750,000 |
25 |
$10,000,000 |
| 18 |
$1,000,000 |
26 |
$15,000,000 |
| 31 |
$1,100,000 |
27 |
$20,000,000 |
| 32 |
$1,150,000 |
28 |
$30,000,000 |
| 33 |
$1,200,000 |
29 |
$50,000,000 |
| 37 |
$1,300,000 |
99 |
Other |
|
Table
4-B |
| Field
No. |
Field
Name |
Entry |
Description |
| 15 |
Type
Practice |
Required |
Not
required for paraprofessional or corporate files. Enter code for
the type of practice in which the insured is engaged from the following
Practice Type table. |
| Code |
Type
Practice |
Description |
|
1 |
Institutional Practice |
Usually
employed by the institution, this physician has most of his or her
practice centered around a hospital, medical school, drug company, or
similar organization. He or she may see some private patients, but
the majority of the practice is dedicated to the institution. |
|
2 |
Group Practice |
Two or more
physicians practicing together; it need not be a formal corporation. |
|
3 |
Solo Practice |
Single
practitioner or private practice. |
|
Table
4-C |
| Field
No. |
Field
Name |
Entry |
Description |
| 16 |
Medical
School |
Required |
Do not
complete for paraprofessional and corporate files. Enter the
insured's medical school from the following table. |
| Code |
Medical
School |
| 05999 |
U.S.
medical/dental school |
| 99998 |
International
medical/dental school |
| 99999 |
Medical
school not included in the AMA listing |
|
Table
4-D |
| Field
No. |
Field
Name |
Entry |
Description |
| 17 |
Full/Part
Time |
Required |
Do not
complete for corporate files. Enter the insured's work status from
the following table. |
| Code |
Status |
| f |
Full
Time |
| p |
Part
Time |
|
Table
4-E |
| Field
No. |
Field
Name |
Entry |
Description |
| 18 |
Age |
Required |
Do not
complete for corporate files. Enter the age of the insured at the
time the claim occurred. Use -1 for unknown age or non-person
type (as in corporate files). |
|
|
|
|
| 19 |
Sex |
Required |
Do not
complete for corporate files. Enter the sex of the insured from
the following table. |
| Code |
Sex |
| f |
Female |
| m |
Male |
| u |
Unknown |
|
Table
4-F |
|
