Appendix B Workers Compensation Glossary of Terms
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New Hampshire EDI Implementation Guide Appendix B Workers Compensation Glossary of Terms This section of terms is taken from The Workers Compensation Insurance Organizations a voluntary association of authorized or licensed rating, advisory, or data service organizations that collect workers compensation insurance information in one or more states. GLOSSARY OF TERMS GLOSSARY New Hampshire EDI Implementation Guide Appendix B INTRODUCTION TO THE GLOSSARY This glossary defines terms that are not all insurance related, but are commonly used in the business and data reporting environment. The terms have been defined in a simplified and nontechnical manner. The definitions are not intended to and should not be used as the "legal" definitions of the terms. For example: Permanent Partial – this definition may vary by state. The purpose of the glossary is to acquaint the reader with easy-to-understand definitions of workers' compensation terms. Acronyms and abbreviations found in the Acronyms and Abbreviations section of this manual are defined in this glossary. In an effort to keep the definitions simple, many of the terms in this glossary have been defined in greater detail throughout this manual; e.g., unit reports. January, 2012 AppB-2 New Hampshire EDI Implementation Guide Appendix B GLOSSARY code indicates that the correction is being done to A add (A), change (C) or delete (D) exposure or claim information on unit stat data. The use of A, C, or D AAA – is not allowed in all jurisdictions. see definition for American Academy of Actuaries Address Record – AAI – a portion of data that identifies the address see definition for Alliance of American Insurers information of the insured. AASCIF – Adjusting and Other – see definition for American Association of State a new term for Unallocated Loss Adjustment Compensation Insurance Funds Expense. See definition for Unallocated Loss Adjustment Expense. ACAS – see definition for Associate of Casualty Actuarial Adjuster – an individual representing the insurance company in Society discussions to reach agreement on the loss amount. (Sometimes called a claim representative or claim ACCCT – adjuster.) see definition for American Cooperative Council on Compensation Technology Admiralty – refers to the laws governing shipping, transportation, ™ ACORD – and fishing. see definition for Association for Cooperative Operations Research & Development ADQIP – see definition for Aggregate Data Quality Incentive Accident Date Program (NCCI’s) the month, day and year on which the injury occurred. For commulative injuries or disease Advisory Organization – injuries there may not be an actual accident date. In an organization that provides advisory rules and rates these cases the accident date may be the last date of for the Insurance Industry. exposure or last day of policy. Advisory Statistical Work Group (ASWG) – Accident Year – Originally, ASWG referred to the group analyzing the year in which the injury occurred workers’ comp statistical data collection. (See section on ASWG). ‘ASWG’ is now used to describe: Accident State – a state or foreign location that identifies where the - 250-byte unit report format accident took place or where a disease was first contracted. - 250-byte unit report requirements - unit report form Accredited Standards Committee (ASC) – - the Advisory Statistical Work Group see definition for National Committee for Information Technology Standards Agent – an independent business person engaged in the Actuary – activity of soliciting insurance coverage for one or an individual who computes statistics relating to more insurance companies. insurance, such as pricing and reserving. Aggregate Data Quality Incentive Program (ADQIP) – an NCCI program that rewards companies for filing Add (A)/Change (C)/Delete (D) – aggregate (financial) data early, or fines for late or a correction procedure in which an update type erroneous filings. January, 2012 AppB-1 New Hampshire EDI Implementation Guide Appendix B Aggregate Financial Data – see Financial data. Alphanumeric (AN) – a field that contains alphabetic and numeric characters. Data field is to be left-justified and right Aggregate Limit – blank-filled. the maximum amount an insurer will pay for all claims covered by a policy during a policy period. ‘Alternative workers’ compensation coverage’ – this is commercial insurance purchased on the Aggregate Reports – voluntary market. The policy may consist of any reports that aggregate data for all insurers reporting to a combination of life, disability, accident, health or statistical agent in a state. There are three types of other insurance, provided that the coverage insures statistical data that may be aggregated: without limitation or exclusion any of the workers' 1. Financial Data compensation benefits as defined in the law of the 2. Unit Report Data state. 3. Claim Information Data A.M. Best Company – AIA – a company that rates insurance companies based on see definition for American Insurance Association their financial condition and operating performance AIDM – AMCOMP – see definition for Associate Insurance Data Manager see definition for The American Society of Workers’ Compensation Professionals, Inc. ALAE – see definition for Allocated Loss Adjustment Expense American (National) Standard Code for Information Interchange (ASCII) – Alliance of American Insurers (AAI) – a table of values used for data transmission by a National Insurance Trade Association of minicomputers and personal computers. Property and Casualty member companies. Provides input on critical legislative and regulatory issues. American Academy of Actuaries (AAA) – is the organization representing the entire U.S. actuarial profession. It serves the public and the actuarial Allocated Loss Adjustment Expense (ALAE) – profession both nationally and internationally through: an accumulation of expenses incurred in (1) establishing, maintaining, and enforcing high investigating and settling claims that are directly professional standards of actuarial qualification, assignable to specific claims. Examples include: practice and conduct; (2) assisting in the formation of legal fees, adjusting fees, court costs, medical costs public policy by providing independent and objective containment expenses, services required by law or information, analysis, and education; (3) advancing the insurance regulation. actuarial profession with other organizations representing actuaries; and (4) increasing the public’s Allocated Loss Adjustment Expense – Incurred – recognition of the actuarial profession’s value. a specific expense in whole dollars incurred, including paid and outstanding by an insurance company, when American Association of State Compensation handling a claim that can be directly allocated to that Insurance Funds (AASCIF) – particular claim. an organization whose members are the state compensation insurance funds and the Workers’ Allocated Loss Adjustment Expense – Paid – Compensation Boards and Commissions of Canada. a specific expense in whole dollars paid by an insurance company when handling a claim that can be directly American Cooperative Council on Compensation allocated to that particular claim. Technology (ACCCT) – a workers' compensation joint venture that shares ideas Alpha (A) – and technology and, jointly develops software a field that contains only alphabetical characters. programs and systems with the goal of operating more Data field is to be left-justified and right blank- effectively and efficiently. filled. January, 2012 AppB-4 New Hampshire EDI Implementation Guide Appendix B American Insurance Association (AIA) – modification factor, used in states to adjust a property and casualty insurance trade premium for assigned risk policies. organization. Provides constructive solutions to issues facing the insurance industry. ARP – see definition for Assigned Risk Plan American National Standards Institute (ANSI) – encourages the use of US standards ASC (Accredited Standards Committee) – internationally and the adoption of see definition for National Committee for Information international standards as national standards. Technology Standards American Society of Workers’ Comp Professionals, ASCII – Inc. (AMCOMP) – see definition for American Standard Code for a not-for-profit corporation dedicated to the Information Interchange improvement of professional excellence in the multi- disciplined field of workers’ compensation. Assigned Risk – an insured who is unable to acquire coverage in the Anniversary Rating Date (ARD) – regular (voluntary) market, and has been assigned to a a term used in the experience rating process. In company that will provide coverage. general terms, the anniversary rating date is normally Assigned Risk Plan (ARP) – the effective date of the policy. an involuntary plan where a risk obtains insurance that is not available on the voluntary Annual Statement – insurance market. Insurance is handled by a a detailed financial statement required to be reported pool (Assigned Risk Pools) or assigned to by each insurer to the insurance department in its insurers for which participation is mandatory. state of domicile. The annual statement includes a Under an assigned risk plan, the Plan balance sheet, income statement, reinsurance Administrator assigns the account to licensed information, and a breakdown of loss payments and insurers and the insurers issue their own policies reserves by line of business and accident year. and retain the experience of the risk as direct business. ANSI – see