{"id":"F2021L00346","name":"Financial Sector (Collection of Data) (reporting standard) determination No. 2 of 2021","slug":"financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":101563,"registerId":"commonwealth-F2021L00346-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"Objective of this reporting standard","sectionType":"part","heading":"Objective of this reporting standard","content":"# Objective of this reporting standard\n\nThis Reporting Standard sets out requirements for the provision of information to APRA relating to claims made on insurers’ public liability, product liability and professional indemnity insurance policies, and facility business underwritten covering similar risks. \n\n\n\nIt includes Reporting Form GRF 800.2 Claim Data: Public and Product Liability and Professional Indemnity Insurance and the associated instructions.","sortOrder":0},{"sectionNumber":"Authority","sectionType":"part","heading":"Authority","content":"## Authority\n\n1. This Reporting Standard is made under section 13 of the Financial Sector (Collection of Data) Act 2001.","sortOrder":1},{"sectionNumber":"Purpose","sectionType":"part","heading":"Purpose","content":"## Purpose\n\n2. Information collected by Reporting Form GRF 800.2 Claim Data: Public and Product Liability and Professional Indemnity Insurance (GRF 800.2) is used by APRA for the purpose of prudential supervision and publication, including publication in the National Claims and Policies Database (NCPD).","sortOrder":2},{"sectionNumber":"Application","sectionType":"part","heading":"Application","content":"## Application\n\n3. This Reporting Standard applies to insurers.","sortOrder":3},{"sectionNumber":"Commencement","sectionType":"part","heading":"Commencement","content":"## Commencement\n\n4. This Reporting Standard applies for reporting periods ending on or after 31 December 2021.","sortOrder":4},{"sectionNumber":"Information required","sectionType":"part","heading":"Information required","content":"## Information required\n\n5. An insurer must provide APRA with the information required by GRF 800.2 for each reporting period and each reportable claim made on the insurer:\n\n(a) made during the reporting period; and\n\n(b) originally made before the start of the reporting period and that has not been settled, or was reopened, during the reporting period.","sortOrder":5},{"sectionNumber":"Reporting periods and due dates","sectionType":"part","heading":"Reporting periods and due dates","content":"## Reporting periods and due dates\n\n6. Subject to paragraph 7 of this Reporting Standard, an insurer to which this Reporting Standard applies must provide the information required by this Reporting Standard in respect of each calendar half-year (i.e. the periods ending 30 June and 31 December each year).\n\n7. APRA may, by notice in writing, change the reporting periods, or specify reporting periods, for a particular insurer to require it to provide the information required by this Reporting Standard more frequently, or less frequently, or in respect of reporting periods based upon the insurer’s own accounting financial year, having regard to:\n\n(a) the particular circumstances of the insurer; and\n\n(b) the extent to which the information is required for the purposes of the prudential supervision of the insurer.\n\n8. The information required by this Reporting Standard must be provided to APRA by no later than four months after the end of the reporting period.\n\n9. APRA may grant an insurer an extension of a due date in writing, in which case the new due date for the provision of the information will be the date on the notice of extension.","sortOrder":6},{"sectionNumber":"Method of submission","sectionType":"part","heading":"Method of submission","content":"## Method of submission\n\n10. Unless a method is notified by APRA, in writing, prior to submission, the information required by this Reporting Standard must be rendered in comma separated values (CSV) format in accordance with the instructions in GRF 800.2, and must be provided electronically through the web site www.ncpd.apra.gov.au, by logging on using the relevant customer identification number and password provided by Fujitsu Australia (as agent of APRA), and following the instructions on that web site.","sortOrder":7},{"sectionNumber":"Quality control","sectionType":"part","heading":"Quality control","content":"## Quality control\n\n11. The information provided by an insurer under this Reporting Standard must be subject to systems, processes and controls developed by the insurer for the internal review and authorisation of that information. It is the responsibility of the board and senior management of the insurer to ensure that an appropriate set of policies and procedures for the authorisation of data provided to APRA is in place.","sortOrder":8},{"sectionNumber":"Authorisation","sectionType":"part","heading":"Authorisation","content":"## Authorisation\n\n12. Fujitsu Australia (as agent of APRA) will provide each insurer with a customer identification number. If an insurer proposes to submit information required by this Reporting Standard using the method in paragraph 10 (i.e. via the website), the insurer must apply for a password by viewing the web page referred to in paragraph 10, quoting the insurer’s customer identification number and following the instructions for applying for a password on that page. Fujitsu Australia will advise the insurer’s Chief Financial Officer of the password for the insurer. When information is provided using the method in paragraph 10, the insurer will be required to quote its customer identification number and password. Upon successful validation of the customer identification and password a secure session between the insurer and Fujitsu Australia will be created and information will be encrypted before transmission.\n\n13. Despite paragraph 12, or where APRA has under paragraph 10 notified an alternate method of submission, APRA may also determine in writing that: \n\n(a) a specified person (who need not be the Principal Executive Officer or Chief Financial Officer of the insurer); \n\n(b) a person holding a specified position (which need not be the position of Principal Executive Officer or Chief Financial Officer of the insurer); or \n\n(c) a person authorised by the insurer to use the insurer’s customer identification number and password, \n\nmay, or must, authorise (in a manner specified) information provided by the insurer under this Reporting Standard.","sortOrder":9},{"sectionNumber":"Minor alterations to forms and instructi","sectionType":"part","heading":"Minor alterations to forms and instructions","content":"## Minor alterations to forms and instructions\n\n14. APRA may: \n\n(a) make minor variations to GRF 800.2 (either generally, or in relation to a class of insurers, or in relation to a particular insurer) to correct technical, programming or logical errors, inconsistencies or anomalies; or\n\n(b) vary, omit or substitute (either generally, or in relation to a class of insurers, or in relation to a particular insurer) a specification in a Table in GRF 800.2, if APRA forms the view that the specification is inappropriate having regard to the circumstances or business of each relevant insurer and any other relevant considerations.\n\n15. If APRA makes such a variation it must notify affected insurers in writing.","sortOrder":10},{"sectionNumber":"Transition","sectionType":"part","heading":"Transition","content":"## Transition\n\n16. An insurer must report under the old reporting standard in respect of a transitional reporting period. For these purposes:\n\nold reporting standard means the reporting standard revoked by the determination that makes this Reporting Standard (being the reporting standard that this Reporting Standard replaces); and\n\ntransitional reporting period means a reporting period under the old reporting standard:\n\n(a) that ended before the date of revocation of the old reporting standard; and \n\n(b) in relation to which the insurer was required, under the old reporting standard, to report by a date on or after the date of revocation of the old reporting standard.\n\nNote: For the avoidance of doubt, if an insurer was required to report under an old reporting standard, and the reporting documents were due before the date of revocation of the old reporting standard, the insurer is still required to provide any overdue reporting documents in accordance with the old reporting standard.","sortOrder":11},{"sectionNumber":"Interpretation","sectionType":"part","heading":"Interpretation","content":"## Interpretation\n\n17. In this Reporting Standard:\n\nagent of APRA means a person appointed under section 47 of the Australian Prudential Regulation Authority Act 1998 to receive data on behalf of APRA.\n\nAPRA means the Australian Prudential Regulation Authority established under the Australian Prudential Regulation Authority Act 1998.\n\nChief Financial Officer means the person having the function of chief financial officer of the insurer, by whatever name called, and whether or not he or she is a member of the governing board of the entity, and if there is no such person means a person who performs similar functions to those commonly performed by a chief financial officer. \n\nfacility business means business that is closed by bordereau and for which the insurer does not receive individual policy or claims data from the facility manager, and includes business undertaken through an underwriting pool or joint venture arrangement.\n\nFujitsu Australia means Fujitsu Australia Limited ABN 19 001 011 427.\n\ngeneral insurer has the same meaning as in the Insurance Act 1973. \n\ninsurer means general insurer.\n\nPrincipal Executive Officer means the principal executive officer of the insurer for the time being, by whatever name called, and whether or not he or she is a member of the governing board of the entity.\n\nproduct liability insurance includes policies that provide for compensation for loss and or injury caused by, or as a result of, the use of goods.\n\nprofessional indemnity insurance includes:\n\n(a) insurance that provides cover for a professional for actions taken against that professional in tort, contract or under statute law in respect of advice or services provided as part of their professional practice, including cover in respect of damages and legal expenses;\n\n(b) directors’ and officers’ liability insurance and legal expense insurance; and\n\n(c) medical indemnity insurance.\n\npublic liability insurance includes:\n\n(a) insurance covering legal liability to the public in respect of bodily injury or property damage arising out of the operation of the insured’s business; and\n\n(b) insurance in respect of environmental clean-up costs resulting from pollution where not covered by Fire and Industrial Special Risk policies.\n\nreportable claim means a claim made under a policy of product liability insurance, professional indemnity insurance or public liability insurance that was not finalised or settled by 1 January 2003, not being a claim that relates to:\n\n(a) reinsurance or retrocession cover;\n\n(b) marine insurance; \n\n(c) domestic householder’s or owner’s insurance, or tenant’s liability insurance, sold in conjunction with a building or contents policy; or\n\n(d) an event that could neither occur in Australia nor in relation to an insured resident of Australia.\n\n18. Unless the contrary intention appears, any reference to an Act, Regulation, Prudential Standard, Reporting Standard, Australian Accounting Standard or Auditing Standard is a reference to the instrument as in force or existing from time to time.\n\n19. Where this Reporting Standard provides for APRA to exercise a power or discretion, this power or discretion is to be exercised in writing.","sortOrder":12},{"sectionNumber":"Reporting Form GRF 800.2","sectionType":"part","heading":"Reporting Form GRF 800.2","content":"# Reporting Form GRF 800.2\n\nClaim Data: Public and Product Liability and Professional Indemnity Insurance","sortOrder":13},{"sectionNumber":"Instruction Guide","sectionType":"part","heading":"Instruction Guide","content":"# Instruction Guide\n\nThese instructions have been prepared for the purpose of defining the claim information required to be submitted by insurers in respect of public and product liability and professional indemnity insurance. This information will contribute to a National Claims and Policy Database (NCPD) in respect of these classes of insurance. The intention is to create a database that holds information in respect of claims and policies for public and product liability and professional indemnity on a national basis. State and Territory Government insurers will also contribute to the NCPD where possible.1 \n\n\n\nDetails of requirements in relation to reporting periods, method of submission and authorisation are set out in the Reporting Standard. The data submitted by each insurer will be validated by APRA at each reporting period. The data validation to be performed is outlined in Appendix A.","sortOrder":14},{"sectionNumber":"Record Layouts and Field Specifications","sectionType":"part","heading":"Record Layouts and Field Specifications","content":"# Reporting Form GRF 800.2\n\nClaim Data: Public and Product Liability and Professional Indemnity Insurance\n\n# Instruction Guide\n\nThese instructions have been prepared for the purpose of defining the claim information required to be submitted by insurers in respect of public and product liability and professional indemnity insurance. This information will contribute to a National Claims and Policy Database (NCPD) in respect of these classes of insurance. The intention is to create a database that holds information in respect of claims and policies for public and product liability and professional indemnity on a national basis. State and Territory Government insurers will also contribute to the NCPD where possible.1 \n\n\n\nDetails of requirements in relation to reporting periods, method of submission and authorisation are set out in the Reporting Standard. The data submitted by each insurer will be validated by APRA at each reporting period. The data validation to be performed is outlined in Appendix A.\n\n\n\n# Record Layouts and Field Specifications\n\n## Claim Data Specifications\n\n| Claims Data | Data Item | Public &
Products | Professional Risk | Field type[[1]](#_ftn1) |\n| --- | --- | --- | --- | --- |\n| 1* | Insurer code | M | M | 6a |\n| 2* | Record type | M | M | 1a |\n| 3 | Status at end of Reporting Period | M | M | 1a |\n| 4* | Month of End of Reporting Period | M | M | 8n |\n| 5.1* | Class of Business | M | M | 2a |\n| 5.2* | Product Type | M | M | 3a |\n| 6* | Policy Number | M | M | 30a/n |\n| 7* | Risk Number | M | M | 30a/n |\n| 8* | Claim Number | M | M | 30a/n |\n| 9 | Date of Loss | M | M | 8n |\n| 10 | Date of Report | M | M | 8n |\n| 11 | Date Finalised | M1 | M1 | 8n |\n| 12 | Jurisdiction of Claim | M1 | M1 | 3a |\n| 13 | Deductible/Excess | M | M | 12n |\n| 14 | General Nature of Loss | M1 | M1 | 1a |\n| 15 | Cause of Loss | M | M | 3a |\n| 16 | Body Functions or Structures Affected | M2 | O | 1a |\n| 17 | Severity of Loss | M2 | O | 1a&1n |\n| 18 | Litigation Status | M | M | 1a |\n| 19 | Gross Payments in the Reporting Period | M | M | 12n |\n| 20 | Gross Payments to Date | M | M | 12n |\n| 21 | Gross Case Estimate at Start of Reporting Period | M | M | 12n |\n| 22 | Gross Case Estimate at End of Reporting Period | M | M | 12n |\n| 23 | Gross Third Party Recoveries Received | M | O | 12n |\n| 24 | Gross Third Party Recoveries Outstanding | M | O | 12n |\n| 25.1 | Past economic loss | M | M | 12n |\n| 25.2 | Future economic loss | M | M | 12n |\n| 25.3 | Past medical, hospital, caring and related services | M | M | 12n |\n| 25.4 | Future medical, hospital and related services | M | M | 12n |\n| 25.5 | Future caring services | M | M | 12n |\n| 25.6 | General damages | M | M | 12n |\n| 25.7 | Interest | M | M | 12n |\n| 25.8 | Plaintiff legal costs | M | M | 12n |\n| 25.9 | Defendant legal costs | M | M | 12n |\n| 25.10 | Investigation costs | M | M | 12n |\n| 25.11 | Other | M | M | 12n |\n\n\n\n\n1Date must be DDMMYYYY, no delimiter.\n\nKey:\n\nM – mandatory field on all records from 1 July 2004.\n\nM1 – mandatory only if field 3 (Status at end of Reporting Period) = “F”. \n\nM2 – mandatory only if field 14 (General Nature of Loss) contains a bodily injury component.\n\nO – optional field.\n\na – alpha.\n\nn – numeric.\n\n* Fields so indicated, as a combination, must be unique. \n\n\n** A new claim is determined by the following process:\n\n\n\n\n\n\n\nClaims Record Data Field Definitions \n\n1. Insurer code\n\nA unique code assigned by APRA to each contributor.\n\n2. Record type \n\n• C = Claims Record\n\n## 3. Status at End of Reporting Period\n\n• C = Current\n\n• F = Finalised\n\n• R = Reopened\n\n• S = Structured Settlement\n\nA structured settlement occurs when a claim has been settled and payments are made as annuities over time, rather than in a single payment.\n\nIf a claim has been reopened and is closed again in the same period, the status should remain as finalised however there is a need to provide the updated finalised data for such a claim, such as $ paid etc. If a claim has been advised as finalised in a previous submission, has since been reopened AND is still open at the end of the current reporting period, the claim should be recorded as ‘Reopened’. \n\n## 4. Month of End of Reporting Period\n\nThe data for each submission will relate to a six month period. Enter as DDMMYYYY the last day of the period being reported, e.g. insert 30062004 for data relating to the six months ending 30 June 2004.\n\n### 5.1. Class of Business\n\n• PL = Public & Products Liability\n\n• PI = Professional Risk\n\n### 5.2. Product Type (Table 1)\n\n\n\n| Class | Public &
Products | Professional Risk |\n| --- | --- | --- |\n| Public liability (pure) | PUB | |\n| Products liability (pure) and product recall | PRO | |\n| Mixed public/products cover ('Broadform' liability) | BRD | |\n| Construction liability | CON | |\n| Cyber Insurance | CYB | |\n| Environmental impairment liability | EIL | |\n| Excess Liability | EXL | |\n| Excess Umbrella | EXU | |\n| Umbrella covers | UMB | |\n| Other | PLO | |\n| Professional indemnity (not medical malpractice) and errors & omissions | | PII |\n| Association Liability | | ASN |\n| Directors' and Officers' liability | | D&O |\n| Defamation Insurance | | DFI |\n| Employment Practices | | EPL |\n| Financial Institutions Policy | | FIP |\n| Information & Communication Technology Insurance | | ICT |\n| Medical Indemnity/Malpractice | | MAL |\n| Management Liability | | MAN |\n| Superannuation Trustees | | STL |\n| Other | | PIO |\n\n\n\n\nNote: where business is written as part of a package policy, the “Product type” is to be based on the nature of the cover offered, as set out in the above table. The fact that cover is sold in conjunction with other types of insurance is not collected. \n\n## 6. Policy Number\n\nA unique policy identifier (which may relate to several separate risk records) by which the exposure and premium information on each individual record can be identified. Used for matching the policy data in force at date of claim to the claim record. This information is only used for cross-referencing by APRA – it will not be published except in any individual data reports prepared for the insurer concerned. \n\nWhere individual claims data is being provided but its associated policy data is being provided in aggregate form in the facility data file, the facility number should be used as the policy number for the claim.\n\n## 7. Risk Number\n\nA unique risk identifier (which may be the same as the policy number if the policy contains a single risk) by which the exposure and premium information on each individual record can be identified. Used for matching the policy data in force at date of claim to the claim record. This information is only used for cross-referencing by APRA – it will not be published except in any individual data reports prepared for the insurer concerned.\n\n## 8. Claim Number\n\nA unique identifier of a claim. This information is only used for cross-referencing by APRA – it will not be published except in any individual data reports prepared for the insurer concerned. \n\n## 9. Date of Loss\n\nEnter as DDMMYYYY the date on which the incident giving rise to the claim is believed to have occurred. \n\nFor claims made policies where an actual date of loss is not available, code this field as the date that the claim is notified to the insurer. For losses incurred based (or occurrence based) policies, the Date of Loss should be the date of the event that gave rise to the claim, or the best estimate of the date of that event(s). \n\n## 10. Date of Report\n\nEnter as DDMMYYYY the date on which the claim was reported (not processed) to the agent or insurer. \n\n## 11. Date Finalised\n\nEnter as DDMMYYYY the date on which the finalised. This field should only be completed when all payments to the claimant(s) and any third party suppliers are believed to have been made and all recoveries expected from third parties (ignoring reinsurers) have been received. Note that a claim may be recorded as finalised even if recoveries from reinsurers have not been received. \n\nReopened claims that are still open at the end of the reporting period must not have a “date finalised”.\n\n## 12. Jurisdiction of Claim\n\nThis is the state (ACT, NSW, NT, QLD, SA, TAS, VIC or WA) where the claim has been decided by a court judgement. If the claim is decided in a federal court, input the state where the claim was heard. However, if the claim is settled out of court, then input the state where the claim was settled, this would usually be the State or Territory in which the claimant resides.\n\nA claim that never reaches the stage of a writ is an out of court claim.\n\nWhere an insurer has multiple claimants under the one claim and payments are made to each claimant, but in different jurisdictions, the jurisdiction of the principle claimant should be used. \n\nIf the claim was settled overseas, code the jurisdiction as that of the policy holder's principle address.\n\nThis field is mandatory for finalised claims only.\n\n## 13. Deductible/Excess\n\nTotal of all deductibles or excesses applied to this claim in whole dollars. This may differ from the amount shown in field 20 on the related exposure record.\n\nFor Liability XOL policies, the relevant attachment point should be reported.\n\n## 14. General Nature of Loss (Table 3)\n\n| General Nature of Loss | Code |\n| --- | --- |\n| Bodily injury or death | B |\n| Property damage only | P |\n| Financial loss only (no physical damage or bodily injury) | F |\n| Both property damage and bodily injury | L |\n| Both bodily injury and financial loss | X |\n| Both property damage and financial loss | Y |\n| Property damage, bodily injury and financial loss | Z |\n\n\n\n\nIf a claim is comprised of more than one general nature of loss field type (i.e. P (property damage) and B (bodily injury)), then a claim may only be coded as L, X, Y or Z if the relevant component is greater than 15% of the claim amount. \n\n## 15. Cause of loss (Tables 4 & 5)\n\nCode one of the causes shown in the following tables (for appropriate class of business). The most significant contributing factor should be identified. Where a suitable cause of loss was not recorded in respect of a claim that occurred before 30 June 2004, report a hyphen (“-“). \n\n\n\n| APRA Code | Claim Type – Public & Products Liability (Table 4) | Current ISA Code(s) (for information only) |\n| --- | --- | --- |\n| ABM | Abuse/molestation | L12 |\n| ANM | Animal bite/attack/impact | L88,L16, L62 |\n| ASB | Asbestos/Dust Diseases | L14 |\n| CAT | Catastrophe, e.g. Cyclone, earthquake | |\n| CUS | Care/custody/control | L50 |\n| COL | Collapse of building/structure/subsidence/landslide/weakening and or removal of supports/rusting/oxidation/discoloration including concrete cancer | L18, L42, L86, L40 |\n| CYF | Cyber – 1st party loss | |\n| CYT | Cyber – 3rd party loss | |\n| DFM | Defamation/slander | L53 |\n| DSC | Discrimination/harassment | L54 |\n| ELC | Electrocution | L21 |\n| ENV | Environmental contamination or pollution/spray/drift/other contamination/exposure to or contact with substance/ Not mould or asbestos | L72, L80, L19, L24 |\n| APRA Code | Claim Type – Public & Products Liability (Table 4) | Current ISA Code(s) (for information only) |\n| EQB | Equipment breakdown and accidental breakage | L22, L11 |\n| EXP | Explosion and/or vibration/exposure to sudden or long-term sound or noise/excavation/drilling damage | L23, L56, L43, L65 |\n| NEG | Failed or injurious treatment by practitioner or consultant, or negligent advice | L29, L69 |\n| FLL | Fall including from height and slip & fall | L25, L41 |\n| FPW | Faulty product/faulty workmanship | L51, L59 |\n| FIR | Fire including welding | L27, L87 |\n| IMP | Impact or damage by object/vehicle/person, including physical assault/trapped by machinery or equipment | L30, L44, L66, L37, L83 |\n| LSL | Lease liabilities | L64 |\n| LFT | Lifting, carrying or putting down objects/machinery use/repetitive or overuse injury | L63, L66, L77
|\n| MLD | Mould | L89 |\n| OTH | Other non financial loss i.e. losses with no tangible value attached such as 'Pain and Suffering' | L48 |\n| OFN | Other financial loss i.e. losses that are tangible | L26 |\n| WTR | Water | L46 |\n| WKR | Worker to worker injury | L47 |\n\n\n\n\n| APRA
Code | Claim Type – Professional Risk (Table 5) |\n| --- | --- |\n| | Non performance or improper, inappropriate, inadequate, incorrect, incomplete, inaccurate, untimely provision of : |\n| AA | Advice |\n| AB | Assault /abuse / mistreatment |\n| AE | Anaesthetic |\n| BC | Breach of confidentiality |\n| BL | Blood Products |\n| BT | Breach of trust / fiduciary duties |\n| CI | Conflict of interest |\n| CO | Consent (incl. no valid consent, failure to warn, acting against patient’s wishes) |\n| DA | Documentation/ administration |\n| DE | Defamation |\n| DI | Diagnosis |\n| DS | Design / specification |\n| EQ | Faulty and/or inadequate / inappropriate / inaccurate / contaminated equipment and/or premises |\n| FR | Fraud & dishonesty. Fidelity |\n| HA | Harassment / discrimination |\n| IC | Infection control / prevention |\n| IN | Insolvency |\n| IP | Breach of intellectual property rights |\n| IT | Improper trading / collusive practices /unconscionable conduct |\n| LD | Loss of documents |\n| LE | Legal expense coverage (disciplinary enquiries, investigations, inquests and the like) |\n| ME | Medication |\n| MI | Misleading and/or deceptive advice/conduct (specifically section(s) of federal Trade Practices Act, state Fair Trading Acts and the like) |\n| OR | Other |\n| PM | Project management |\n| PR | Procedural |\n| SE | Services other than specified above |\n| SH | Sexual harassment |\n| SI | Supervision / inspection |\n| APRA
Code | Claim Type – Professional Risk (Table 5) |\n| TE | Testing |\n| TR | Treatment |\n| UD | Unfair dismissal |\n\n\n\n\n## 16. Body Functions or Structures Affected (Table 6)\n\nCode the most significant body function or structure affecting the claimant as known at the end of the reporting period, for all claims involving bodily injury where claim item 14 (General Nature of Loss) contains a bodily injury component i.e. B, L, X or Z.\n\n| APRA Code | Body Functions or Structures Affected |\n| --- | --- |\n| C | Cardiovascular, Haematological, Immunological and Respiratory |\n| D | Death |\n| E | Digestive, Metabolic and Endocrine Systems |\n| G | Genitourinary and Reproductive |\n| M | Mental or Nervous System |\n| N | Neuro-musculoskeletal and Movement-Related |\n| P | Sensory, Pain, Eye, Ear and Related Structures |\n| S | Skin and Related Structures |\n| V | Voice and Speech |\n\n\n \n\n## 17. Severity of loss (Table 7)\n\nCode the severity of the loss underlying the claim for all claims involving bodily injury where claim item 14 (General Nature of Loss) contains a bodily injury component i.e. B, L, X or Z.\n\n| APRA
code | Severity of loss |\n| --- | --- |\n| L1 | Minor or mild injury to soft tissue; minor lacerations; bruising; minor psychological harm |\n| L2 | Minor or simple fractures; larger lacerations |\n| M1 | Moderate injury usually involving nerve or tissue damage; major psychological harm |\n| M2 | Serious injury involving loss of tissue, internal bleeding, ruptured tissue or organs; serious and permanent psychological damage |\n| S1 | Major injury involving brain injury likely to lead to permanent impairment |\n| S2 | Major injury involving spinal cord injury likely to lead to permanent impairment |\n| S3 | Quadriplegia |\n| S4 | Paraplegia |\n| S5 | Other major injury leading to a disability that is likely to permanently reduce the earning capacity or activity in the community of the claimant |\n\n\n\n\n## 18. Litigation Status (Table 8)\n\nExtent to which case has proceeded through the legal system.\n\n| APRA
Code | Litigation Status |\n| --- | --- |\n| O | Claim is not litigated |\n| N | Plaintiff does not have legal representation |\n| U | Plaintiff has legal representation but the claim has not been resolved. |\n| L | Plaintiff has obtained legal advice but settlement was reached by negotiation (whether court proceedings were commenced or subsequent to a judgement but before an appeal court determination) |\n| V | Case was settled by court judgement (whether lower court or appeal court) and defendant |\n| | paid judgement amount (i.e. either case was not appealed or appeal was not upheld) |\n| W | Plaintiff has legal representation and elects to withdraw the claim. |\n| X | Plaintiff has legal representation, but the case is not awarded in plaintiff’s favour |\n\n\n\n\n## 19. Gross Payments in the Reporting Period\n\nThe amount of payments made since the last reporting period, net of GST in whole dollars, no decimal point. Includes payments made to claimant and to third-party service providers (medical, legal, investigation) that are attributed to the claim. \n\nNote: \n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST. \n\n## 20. Gross Payments to Date\n\nThe amount of payments made on this claim since the claim was first reported, net of GST in whole dollars, no decimal point. Includes payments made to claimant and to third-party service providers (medical, legal, investigation) that are attributed to the claim. \n\n## 21. Gross Case Estimate at Start of Reporting Period\n\nTotal of all payments expected to be made in future to the claimant(s) and third party providers at the start of the reporting period, net of GST in whole dollars, no decimal point. Equals field 22 on the corresponding claim record that was submitted for the previous reporting period. Will be zero if this claim was first reported in the current reporting period. \n\nNote: \n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST. \n\n## 22. Gross Case Estimate at End of Reporting Period\n\nTotal of all payments expected to be made in future to the claimant(s) and third party providers at the end of the reporting period, net of GST in whole dollars, no decimal point. Will be zero if the claim is finalised.\n\nNote: \n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST. \n\n## 23. Gross Third Party Recoveries Received\n\nTotal of all amounts that have been received to date from third parties in respect of the claim, net of GST in whole dollars, no decimal point. Excludes any amounts that have been received under reinsurance contracts. \n\nSalvage should be reported as a third party recovery. \n\nNote: Data should be provided based on your share only. \n\n## 24. Gross Third Party Recoveries Outstanding\n\nTotal of all amounts that are expected to be received after the end of the reporting period from third parties in respect of the claim, net of GST in whole dollars, no decimal point. Excludes any amounts expected to be received under reinsurance contracts. Will be zero if the claim is finalised.\n\nSalvage should be reported as a third party recovery. \n\nNote: Data should be provided based on your share only. \n\n## 25. Gross Claim Payments by Head of Damage before Third Party Recoveries (This field is not used)\n\nA breakdown of the total settlement amount into the following heads of damage is required for finalised claims only. The total of items 25.1 to 25.11 must equal item 20\n\n– Gross Payments to Date, with any rounding difference included in item 25.11 (Other). \n\nNote:\n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST. \n\nA finalised claim is one where field 11 (date finalised) has been recorded and field 22 (gross case estimate at end of reporting period) is zero.\n\nWhere a claim is settled out of court, contributors should provide a reasonable estimate as to how the total claim is distributed between the Heads of Damages categories.\n\n25.1. Past economic loss\n\n25.2. Future economic loss\n\n25.3. Past medical, hospital, caring and related services\n\n25.4. Future medical, hospital and related services 25.5. Future caring services\n\n25.6. General damages\n\n25.7. Interest\n\n25.8. Plaintiff legal costs\n\n25.9. Defendant legal costs\n\n25.10. Investigation costs\n\n25.11. Other\n\n\n\n\n\n\n# Appendix A: Data Validation\n\nAs well as unit record validation, overall reasonability checks will be carried out on each insurer’s data.\n\n## With each half-yearly data submission\n\n Various comparisons between the current reporting period and the previous period will be carried out in order to monitor data reasonability and consistency. These may include:\n\n• Change in the aggregate Gross Earned Premium, split by two digit ANZSIC code or single character occupation code;\n\n• Changes in the total numbers of policies and claims;\n\n• Counts of claims by various measures; causes of loss, severity or litigation status; and\n\n• Changes in the average and total claims paid.\n\nAs well, various reasonability checks will be carried out within each period submission, including;\n\n• Overuse of the various ‘Other’ categories and codes; and\n\n• Comparison of the various premium fields against each other.\n\nOther reasonability checks may be carried out on an ad hoc basis.","sortOrder":15},{"sectionNumber":"Claim Data Specifications","sectionType":"part","heading":"Claim Data Specifications","content":"## Claim Data Specifications\n\n| Claims Data | Data Item | Public &
Products | Professional Risk | Field type[[1]](#_ftn1) |\n| --- | --- | --- | --- | --- |\n| 1* | Insurer code | M | M | 6a |\n| 2* | Record type | M | M | 1a |\n| 3 | Status at end of Reporting Period | M | M | 1a |\n| 4* | Month of End of Reporting Period | M | M | 8n |\n| 5.1* | Class of Business | M | M | 2a |\n| 5.2* | Product Type | M | M | 3a |\n| 6* | Policy Number | M | M | 30a/n |\n| 7* | Risk Number | M | M | 30a/n |\n| 8* | Claim Number | M | M | 30a/n |\n| 9 | Date of Loss | M | M | 8n |\n| 10 | Date of Report | M | M | 8n |\n| 11 | Date Finalised | M1 | M1 | 8n |\n| 12 | Jurisdiction of Claim | M1 | M1 | 3a |\n| 13 | Deductible/Excess | M | M | 12n |\n| 14 | General Nature of Loss | M1 | M1 | 1a |\n| 15 | Cause of Loss | M | M | 3a |\n| 16 | Body Functions or Structures Affected | M2 | O | 1a |\n| 17 | Severity of Loss | M2 | O | 1a&1n |\n| 18 | Litigation Status | M | M | 1a |\n| 19 | Gross Payments in the Reporting Period | M | M | 12n |\n| 20 | Gross Payments to Date | M | M | 12n |\n| 21 | Gross Case Estimate at Start of Reporting Period | M | M | 12n |\n| 22 | Gross Case Estimate at End of Reporting Period | M | M | 12n |\n| 23 | Gross Third Party Recoveries Received | M | O | 12n |\n| 24 | Gross Third Party Recoveries Outstanding | M | O | 12n |\n| 25.1 | Past economic loss | M | M | 12n |\n| 25.2 | Future economic loss | M | M | 12n |\n| 25.3 | Past medical, hospital, caring and related services | M | M | 12n |\n| 25.4 | Future medical, hospital and related services | M | M | 12n |\n| 25.5 | Future caring services | M | M | 12n |\n| 25.6 | General damages | M | M | 12n |\n| 25.7 | Interest | M | M | 12n |\n| 25.8 | Plaintiff legal costs | M | M | 12n |\n| 25.9 | Defendant legal costs | M | M | 12n |\n| 25.10 | Investigation costs | M | M | 12n |\n| 25.11 | Other | M | M | 12n |\n\n\n\n\n1Date must be DDMMYYYY, no delimiter.\n\nKey:\n\nM – mandatory field on all records from 1 July 2004.\n\nM1 – mandatory only if field 3 (Status at end of Reporting Period) = “F”. \n\nM2 – mandatory only if field 14 (General Nature of Loss) contains a bodily injury component.\n\nO – optional field.\n\na – alpha.\n\nn – numeric.\n\n* Fields so indicated, as a combination, must be unique. \n\n\n** A new claim is determined by the following process:\n\n\n\n\n\n\n\nClaims Record Data Field Definitions \n\n1. Insurer code\n\nA unique code assigned by APRA to each contributor.\n\n2. Record type \n\n• C = Claims Record","sortOrder":16},{"sectionNumber":"3. Status at End of Reporting Period","sectionType":"part","heading":"3. Status at End of Reporting Period","content":"## 3. Status at End of Reporting Period\n\n• C = Current\n\n• F = Finalised\n\n• R = Reopened\n\n• S = Structured Settlement\n\nA structured settlement occurs when a claim has been settled and payments are made as annuities over time, rather than in a single payment.\n\nIf a claim has been reopened and is closed again in the same period, the status should remain as finalised however there is a need to provide the updated finalised data for such a claim, such as $ paid etc. If a claim has been advised as finalised in a previous submission, has since been reopened AND is still open at the end of the current reporting period, the claim should be recorded as ‘Reopened’.","sortOrder":17},{"sectionNumber":"4. Month of End of Reporting Period","sectionType":"part","heading":"4. Month of End of Reporting Period","content":"## 4. Month of End of Reporting Period\n\nThe data for each submission will relate to a six month period. Enter as DDMMYYYY the last day of the period being reported, e.g. insert 30062004 for data relating to the six months ending 30 June 2004.","sortOrder":18},{"sectionNumber":"5.1. Class of Business","sectionType":"division","heading":"5.1. Class of Business","content":"### 5.1. Class of Business\n\n• PL = Public & Products Liability\n\n• PI = Professional Risk","sortOrder":19},{"sectionNumber":"5.2. Product Type (Table 1)","sectionType":"division","heading":"5.2. Product Type (Table 1)","content":"### 5.2. Product Type (Table 1)\n\n\n\n| Class | Public &
Products | Professional Risk |\n| --- | --- | --- |\n| Public liability (pure) | PUB | |\n| Products liability (pure) and product recall | PRO | |\n| Mixed public/products cover ('Broadform' liability) | BRD | |\n| Construction liability | CON | |\n| Cyber Insurance | CYB | |\n| Environmental impairment liability | EIL | |\n| Excess Liability | EXL | |\n| Excess Umbrella | EXU | |\n| Umbrella covers | UMB | |\n| Other | PLO | |\n| Professional indemnity (not medical malpractice) and errors & omissions | | PII |\n| Association Liability | | ASN |\n| Directors' and Officers' liability | | D&O |\n| Defamation Insurance | | DFI |\n| Employment Practices | | EPL |\n| Financial Institutions Policy | | FIP |\n| Information & Communication Technology Insurance | | ICT |\n| Medical Indemnity/Malpractice | | MAL |\n| Management Liability | | MAN |\n| Superannuation Trustees | | STL |\n| Other | | PIO |\n\n\n\n\nNote: where business is written as part of a package policy, the “Product type” is to be based on the nature of the cover offered, as set out in the above table. The fact that cover is sold in conjunction with other types of insurance is not collected.","sortOrder":20},{"sectionNumber":"6. Policy Number","sectionType":"part","heading":"6. Policy Number","content":"## 6. Policy Number\n\nA unique policy identifier (which may relate to several separate risk records) by which the exposure and premium information on each individual record can be identified. Used for matching the policy data in force at date of claim to the claim record. This information is only used for cross-referencing by APRA – it will not be published except in any individual data reports prepared for the insurer concerned. \n\nWhere individual claims data is being provided but its associated policy data is being provided in aggregate form in the facility data file, the facility number should be used as the policy number for the claim.","sortOrder":21},{"sectionNumber":"7. Risk Number","sectionType":"part","heading":"7. Risk Number","content":"## 7. Risk Number\n\nA unique risk identifier (which may be the same as the policy number if the policy contains a single risk) by which the exposure and premium information on each individual record can be identified. Used for matching the policy data in force at date of claim to the claim record. This information is only used for cross-referencing by APRA – it will not be published except in any individual data reports prepared for the insurer concerned.","sortOrder":22},{"sectionNumber":"8. Claim Number","sectionType":"part","heading":"8. Claim Number","content":"## 8. Claim Number\n\nA unique identifier of a claim. This information is only used for cross-referencing by APRA – it will not be published except in any individual data reports prepared for the insurer concerned.","sortOrder":23},{"sectionNumber":"9. Date of Loss","sectionType":"part","heading":"9. Date of Loss","content":"## 9. Date of Loss\n\nEnter as DDMMYYYY the date on which the incident giving rise to the claim is believed to have occurred. \n\nFor claims made policies where an actual date of loss is not available, code this field as the date that the claim is notified to the insurer. For losses incurred based (or occurrence based) policies, the Date of Loss should be the date of the event that gave rise to the claim, or the best estimate of the date of that event(s).","sortOrder":24},{"sectionNumber":"10. Date of Report","sectionType":"part","heading":"10. Date of Report","content":"## 10. Date of Report\n\nEnter as DDMMYYYY the date on which the claim was reported (not processed) to the agent or insurer.","sortOrder":25},{"sectionNumber":"11. Date Finalised","sectionType":"part","heading":"11. Date Finalised","content":"## 11. Date Finalised\n\nEnter as DDMMYYYY the date on which the finalised. This field should only be completed when all payments to the claimant(s) and any third party suppliers are believed to have been made and all recoveries expected from third parties (ignoring reinsurers) have been received. Note that a claim may be recorded as finalised even if recoveries from reinsurers have not been received. \n\nReopened claims that are still open at the end of the reporting period must not have a “date finalised”.","sortOrder":26},{"sectionNumber":"12. Jurisdiction of Claim","sectionType":"part","heading":"12. Jurisdiction of Claim","content":"## 12. Jurisdiction of Claim\n\nThis is the state (ACT, NSW, NT, QLD, SA, TAS, VIC or WA) where the claim has been decided by a court judgement. If the claim is decided in a federal court, input the state where the claim was heard. However, if the claim is settled out of court, then input the state where the claim was settled, this would usually be the State or Territory in which the claimant resides.\n\nA claim that never reaches the stage of a writ is an out of court claim.\n\nWhere an insurer has multiple claimants under the one claim and payments are made to each claimant, but in different jurisdictions, the jurisdiction of the principle claimant should be used. \n\nIf the claim was settled overseas, code the jurisdiction as that of the policy holder's principle address.\n\nThis field is mandatory for finalised claims only.","sortOrder":27},{"sectionNumber":"13. Deductible/Excess","sectionType":"part","heading":"13. Deductible/Excess","content":"## 13. Deductible/Excess\n\nTotal of all deductibles or excesses applied to this claim in whole dollars. This may differ from the amount shown in field 20 on the related exposure record.\n\nFor Liability XOL policies, the relevant attachment point should be reported.","sortOrder":28},{"sectionNumber":"14. General Nature of Loss (Table 3)","sectionType":"part","heading":"14. General Nature of Loss (Table 3)","content":"## 14. General Nature of Loss (Table 3)\n\n| General Nature of Loss | Code |\n| --- | --- |\n| Bodily injury or death | B |\n| Property damage only | P |\n| Financial loss only (no physical damage or bodily injury) | F |\n| Both property damage and bodily injury | L |\n| Both bodily injury and financial loss | X |\n| Both property damage and financial loss | Y |\n| Property damage, bodily injury and financial loss | Z |\n\n\n\n\nIf a claim is comprised of more than one general nature of loss field type (i.e. P (property damage) and B (bodily injury)), then a claim may only be coded as L, X, Y or Z if the relevant component is greater than 15% of the claim amount.","sortOrder":29},{"sectionNumber":"15. Cause of loss (Tables 4 & 5)","sectionType":"part","heading":"15. Cause of loss (Tables 4 & 5)","content":"## 15. Cause of loss (Tables 4 & 5)\n\nCode one of the causes shown in the following tables (for appropriate class of business). The most significant contributing factor should be identified. Where a suitable cause of loss was not recorded in respect of a claim that occurred before 30 June 2004, report a hyphen (“-“). \n\n\n\n| APRA Code | Claim Type – Public & Products Liability (Table 4) | Current ISA Code(s) (for information only) |\n| --- | --- | --- |\n| ABM | Abuse/molestation | L12 |\n| ANM | Animal bite/attack/impact | L88,L16, L62 |\n| ASB | Asbestos/Dust Diseases | L14 |\n| CAT | Catastrophe, e.g. Cyclone, earthquake | |\n| CUS | Care/custody/control | L50 |\n| COL | Collapse of building/structure/subsidence/landslide/weakening and or removal of supports/rusting/oxidation/discoloration including concrete cancer | L18, L42, L86, L40 |\n| CYF | Cyber – 1st party loss | |\n| CYT | Cyber – 3rd party loss | |\n| DFM | Defamation/slander | L53 |\n| DSC | Discrimination/harassment | L54 |\n| ELC | Electrocution | L21 |\n| ENV | Environmental contamination or pollution/spray/drift/other contamination/exposure to or contact with substance/ Not mould or asbestos | L72, L80, L19, L24 |\n| APRA Code | Claim Type – Public & Products Liability (Table 4) | Current ISA Code(s) (for information only) |\n| EQB | Equipment breakdown and accidental breakage | L22, L11 |\n| EXP | Explosion and/or vibration/exposure to sudden or long-term sound or noise/excavation/drilling damage | L23, L56, L43, L65 |\n| NEG | Failed or injurious treatment by practitioner or consultant, or negligent advice | L29, L69 |\n| FLL | Fall including from height and slip & fall | L25, L41 |\n| FPW | Faulty product/faulty workmanship | L51, L59 |\n| FIR | Fire including welding | L27, L87 |\n| IMP | Impact or damage by object/vehicle/person, including physical assault/trapped by machinery or equipment | L30, L44, L66, L37, L83 |\n| LSL | Lease liabilities | L64 |\n| LFT | Lifting, carrying or putting down objects/machinery use/repetitive or overuse injury | L63, L66, L77
|\n| MLD | Mould | L89 |\n| OTH | Other non financial loss i.e. losses with no tangible value attached such as 'Pain and Suffering' | L48 |\n| OFN | Other financial loss i.e. losses that are tangible | L26 |\n| WTR | Water | L46 |\n| WKR | Worker to worker injury | L47 |\n\n\n\n\n| APRA
Code | Claim Type – Professional Risk (Table 5) |\n| --- | --- |\n| | Non performance or improper, inappropriate, inadequate, incorrect, incomplete, inaccurate, untimely provision of : |\n| AA | Advice |\n| AB | Assault /abuse / mistreatment |\n| AE | Anaesthetic |\n| BC | Breach of confidentiality |\n| BL | Blood Products |\n| BT | Breach of trust / fiduciary duties |\n| CI | Conflict of interest |\n| CO | Consent (incl. no valid consent, failure to warn, acting against patient’s wishes) |\n| DA | Documentation/ administration |\n| DE | Defamation |\n| DI | Diagnosis |\n| DS | Design / specification |\n| EQ | Faulty and/or inadequate / inappropriate / inaccurate / contaminated equipment and/or premises |\n| FR | Fraud & dishonesty. Fidelity |\n| HA | Harassment / discrimination |\n| IC | Infection control / prevention |\n| IN | Insolvency |\n| IP | Breach of intellectual property rights |\n| IT | Improper trading / collusive practices /unconscionable conduct |\n| LD | Loss of documents |\n| LE | Legal expense coverage (disciplinary enquiries, investigations, inquests and the like) |\n| ME | Medication |\n| MI | Misleading and/or deceptive advice/conduct (specifically section(s) of federal Trade Practices Act, state Fair Trading Acts and the like) |\n| OR | Other |\n| PM | Project management |\n| PR | Procedural |\n| SE | Services other than specified above |\n| SH | Sexual harassment |\n| SI | Supervision / inspection |\n| APRA
Code | Claim Type – Professional Risk (Table 5) |\n| TE | Testing |\n| TR | Treatment |\n| UD | Unfair dismissal |","sortOrder":30},{"sectionNumber":"16. Body Functions or Structures Affecte","sectionType":"part","heading":"16. Body Functions or Structures Affected (Table 6)","content":"## 16. Body Functions or Structures Affected (Table 6)\n\nCode the most significant body function or structure affecting the claimant as known at the end of the reporting period, for all claims involving bodily injury where claim item 14 (General Nature of Loss) contains a bodily injury component i.e. B, L, X or Z.\n\n| APRA Code | Body Functions or Structures Affected |\n| --- | --- |\n| C | Cardiovascular, Haematological, Immunological and Respiratory |\n| D | Death |\n| E | Digestive, Metabolic and Endocrine Systems |\n| G | Genitourinary and Reproductive |\n| M | Mental or Nervous System |\n| N | Neuro-musculoskeletal and Movement-Related |\n| P | Sensory, Pain, Eye, Ear and Related Structures |\n| S | Skin and Related Structures |\n| V | Voice and Speech |","sortOrder":31},{"sectionNumber":"17. Severity of loss (Table 7)","sectionType":"part","heading":"17. Severity of loss (Table 7)","content":"## 17. Severity of loss (Table 7)\n\nCode the severity of the loss underlying the claim for all claims involving bodily injury where claim item 14 (General Nature of Loss) contains a bodily injury component i.e. B, L, X or Z.\n\n| APRA
code | Severity of loss |\n| --- | --- |\n| L1 | Minor or mild injury to soft tissue; minor lacerations; bruising; minor psychological harm |\n| L2 | Minor or simple fractures; larger lacerations |\n| M1 | Moderate injury usually involving nerve or tissue damage; major psychological harm |\n| M2 | Serious injury involving loss of tissue, internal bleeding, ruptured tissue or organs; serious and permanent psychological damage |\n| S1 | Major injury involving brain injury likely to lead to permanent impairment |\n| S2 | Major injury involving spinal cord injury likely to lead to permanent impairment |\n| S3 | Quadriplegia |\n| S4 | Paraplegia |\n| S5 | Other major injury leading to a disability that is likely to permanently reduce the earning capacity or activity in the community of the claimant |","sortOrder":32},{"sectionNumber":"18. Litigation Status (Table 8)","sectionType":"part","heading":"18. Litigation Status (Table 8)","content":"## 18. Litigation Status (Table 8)\n\nExtent to which case has proceeded through the legal system.\n\n| APRA
Code | Litigation Status |\n| --- | --- |\n| O | Claim is not litigated |\n| N | Plaintiff does not have legal representation |\n| U | Plaintiff has legal representation but the claim has not been resolved. |\n| L | Plaintiff has obtained legal advice but settlement was reached by negotiation (whether court proceedings were commenced or subsequent to a judgement but before an appeal court determination) |\n| V | Case was settled by court judgement (whether lower court or appeal court) and defendant |\n| | paid judgement amount (i.e. either case was not appealed or appeal was not upheld) |\n| W | Plaintiff has legal representation and elects to withdraw the claim. |\n| X | Plaintiff has legal representation, but the case is not awarded in plaintiff’s favour |","sortOrder":33},{"sectionNumber":"19. Gross Payments in the Reporting Peri","sectionType":"part","heading":"19. Gross Payments in the Reporting Period","content":"## 19. Gross Payments in the Reporting Period\n\nThe amount of payments made since the last reporting period, net of GST in whole dollars, no decimal point. Includes payments made to claimant and to third-party service providers (medical, legal, investigation) that are attributed to the claim. \n\nNote: \n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST.","sortOrder":34},{"sectionNumber":"20. Gross Payments to Date","sectionType":"part","heading":"20. Gross Payments to Date","content":"## 20. Gross Payments to Date\n\nThe amount of payments made on this claim since the claim was first reported, net of GST in whole dollars, no decimal point. Includes payments made to claimant and to third-party service providers (medical, legal, investigation) that are attributed to the claim.","sortOrder":35},{"sectionNumber":"21. Gross Case Estimate at Start of Repo","sectionType":"part","heading":"21. Gross Case Estimate at Start of Reporting Period","content":"## 21. Gross Case Estimate at Start of Reporting Period\n\nTotal of all payments expected to be made in future to the claimant(s) and third party providers at the start of the reporting period, net of GST in whole dollars, no decimal point. Equals field 22 on the corresponding claim record that was submitted for the previous reporting period. Will be zero if this claim was first reported in the current reporting period. \n\nNote: \n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST.","sortOrder":36},{"sectionNumber":"22. Gross Case Estimate at End of Report","sectionType":"part","heading":"22. Gross Case Estimate at End of Reporting Period","content":"## 22. Gross Case Estimate at End of Reporting Period\n\nTotal of all payments expected to be made in future to the claimant(s) and third party providers at the end of the reporting period, net of GST in whole dollars, no decimal point. Will be zero if the claim is finalised.\n\nNote: \n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST.","sortOrder":37},{"sectionNumber":"23. Gross Third Party Recoveries Receive","sectionType":"part","heading":"23. Gross Third Party Recoveries Received","content":"## 23. Gross Third Party Recoveries Received\n\nTotal of all amounts that have been received to date from third parties in respect of the claim, net of GST in whole dollars, no decimal point. Excludes any amounts that have been received under reinsurance contracts. \n\nSalvage should be reported as a third party recovery. \n\nNote: Data should be provided based on your share only.","sortOrder":38},{"sectionNumber":"24. Gross Third Party Recoveries Outstan","sectionType":"part","heading":"24. Gross Third Party Recoveries Outstanding","content":"## 24. Gross Third Party Recoveries Outstanding\n\nTotal of all amounts that are expected to be received after the end of the reporting period from third parties in respect of the claim, net of GST in whole dollars, no decimal point. Excludes any amounts expected to be received under reinsurance contracts. Will be zero if the claim is finalised.\n\nSalvage should be reported as a third party recovery. \n\nNote: Data should be provided based on your share only.","sortOrder":39},{"sectionNumber":"25. Gross Claim Payments by Head of Dama","sectionType":"part","heading":"25. Gross Claim Payments by Head of Damage before Third Party Recoveries (This field is not used)","content":"## 25. Gross Claim Payments by Head of Damage before Third Party Recoveries (This field is not used)\n\nA breakdown of the total settlement amount into the following heads of damage is required for finalised claims only. The total of items 25.1 to 25.11 must equal item 20\n\n– Gross Payments to Date, with any rounding difference included in item 25.11 (Other). \n\nNote:\n\n1) Data should be provided based on your share only.\n\n2) Income Tax Credits are excluded.\n\n3) The values reported should represent the cost to the insurer however the standard assumes that GST paid out on a claim will be recovered by the insurer. If no recovery is available, then the full value should be reported including GST. \n\nA finalised claim is one where field 11 (date finalised) has been recorded and field 22 (gross case estimate at end of reporting period) is zero.\n\nWhere a claim is settled out of court, contributors should provide a reasonable estimate as to how the total claim is distributed between the Heads of Damages categories.\n\n25.1. Past economic loss\n\n25.2. Future economic loss\n\n25.3. Past medical, hospital, caring and related services\n\n25.4. Future medical, hospital and related services 25.5. Future caring services\n\n25.6. General damages\n\n25.7. Interest\n\n25.8. Plaintiff legal costs\n\n25.9. Defendant legal costs\n\n25.10. Investigation costs\n\n25.11. Other","sortOrder":40},{"sectionNumber":"Appendix A: Data Validation","sectionType":"part","heading":"Appendix A: Data Validation","content":"# Appendix A: Data Validation\n\nAs well as unit record validation, overall reasonability checks will be carried out on each insurer’s data.","sortOrder":41},{"sectionNumber":"With each half-yearly data submission","sectionType":"part","heading":"With each half-yearly data submission","content":"## With each half-yearly data submission\n\n Various comparisons between the current reporting period and the previous period will be carried out in order to monitor data reasonability and consistency. These may include:\n\n• Change in the aggregate Gross Earned Premium, split by two digit ANZSIC code or single character occupation code;\n\n• Changes in the total numbers of policies and claims;\n\n• Counts of claims by various measures; causes of loss, severity or litigation status; and\n\n• Changes in the average and total claims paid.\n\nAs well, various reasonability checks will be carried out within each period submission, including;\n\n• Overuse of the various ‘Other’ categories and codes; and\n\n• Comparison of the various premium fields against each other.\n\nOther reasonability checks may be carried out on an ad hoc basis.","sortOrder":42}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":false,"description":"This Reporting Standard continues the existing policy objective of collecting claim‑level data for public/product liability and professional indemnity insurance for APRA’s prudential supervision and publication in the NCPD (s.1–2). It does not materially expand the classes of business required to report beyond those stated; rather it specifies the data fields, file formats, validation rules and operational arrangements. The instrument preserves transitional arrangements for the previous standard (s.16) and gives APRA operational discretion to vary technical specifications (s.14–15), but these are administrative refinements rather than an expansion of substantive scope."},"complexity_factors":["Approximately 12 defined terms in the Interpretation section (s.17)","Long record layout with 25+ numeric and coded fields (Record Layouts and Field Specifications / GRF 800.2)","Conditional mandatory fields (M1 mandatory if status = 'F'; M2 mandatory if bodily injury component)","Numerous code tables to map to (product type table, cause of loss tables, body part codes, severity codes, litigation status, heads of damage)","Cross‑references to external regimes and instruments (Financial Sector (Collection of Data) Act 2001 authority; APRA/NCPD processes)","APRA discretion to change reporting periods, frequency or method for individual insurers (s.7)","APRA power to make minor variations to forms/tables for all insurers or particular insurers (s.14–15)","Detailed validation and reasonability checks (Appendix A) that may produce iterative queries and rework","Technical ICT/operational requirements (CSV format, portal upload, encryption via Fujitsu agent) (s.10–12)","Transition rules requiring reporting under the old standard for certain transitional reporting periods (s.16)"],"plain_english_summary":"**What this instrument does (mechanics)**\n\n- This Reporting Standard requires insurers to submit detailed, claim-level data to the Australian Prudential Regulation Authority (APRA) about claims under public liability, product liability and professional indemnity insurance, and facility business written on similar risks (see Objective and Application) (s.1; s.3). The required data fields and file format are set out in Reporting Form GRF 800.2 and its Instruction Guide (Record layouts and Field Specifications). \n\n- Insurers must report every reportable claim that was either made during the reporting period or that was originally made earlier but remained open, was reopened, or was settled during the period (s.5). The standard applies to reporting periods ending on or after 31 December 2021 (s.4).\n\n- Default reporting frequency is every half‑year (periods ending 30 June and 31 December) and data must be supplied no later than four months after the end of the reporting period (s.6; s.8). APRA may require a particular insurer to report more or less frequently, or on a different accounting period, taking account of the insurer’s circumstances and the needs of prudential supervision (s.7).\n\n- The standard prescribes submission method and format: unless APRA notifies otherwise, data must be rendered in CSV and uploaded electronically through APRA’s NCPD portal operated by Fujitsu Australia (as APRA’s agent) using an APRA‑issued customer ID and password (s.10; s.12). APRA may specify a different method of submission in writing (s.10).\n\n- The form GRF 800.2 defines a long list of mandatory and conditional fields (policy and risk identifiers, dates, cause and nature of loss, amounts paid and estimates, recoveries, heads of damage for finalised claims, litigation status, injury severity and body part codes, product type codes, etc.). Some fields are mandatory only for finalised claims or where bodily injury is involved (see instruction tables and field keys). The Instruction Guide and Appendix A set out validation checks and reasonability tests that APRA will apply to each submission.\n\n- Insurers must have internal systems, processes and controls for review and authorisation of data submitted to APRA; the board and senior management are responsible for ensuring appropriate policies and procedures are in place (s.11). APRA may make minor variations to the form or certain table specifications (for all insurers, a class of insurers, or a particular insurer) to correct technical or business‑specific anomalies; affected insurers must be notified in writing (s.14–15).\n\n**Why APRA says it matters (stated purpose)**\n\n- APRA states the information will be used for prudential supervision and for publication, including publication in the National Claims and Policies Database (NCPD) (s.2). The Instruction Guide repeats that the data will feed the NCPD to hold national claims and policy information for these insurance classes.\n\n**Who pays, who decides, and what behaviour changes (plain statements with sections cited)**\n\n- Who pays / provides data: licensed general insurers (the instrument defines insurer = general insurer) must collect and supply the data to APRA as prescribed (s.3; s.17 definitions).\n\n- Who decides: APRA decides the reporting timetable and may change reporting periods or the submission method in writing; APRA also has discretion to make minor alterations to the form and table specifications (s.7; s.10; s.14–15). Fujitsu Australia (as APRA’s appointed agent) operates the submission portal and issues customer IDs and passwords; APRA may authorise other persons to sign off submissions (s.12–13).\n\n- Behaviour changes required of insurers: implement or adapt IT and claims systems to produce GRF 800.2 output (CSV) on the required fields; institute internal review and authorisation controls overseen by board and senior management; ensure timely uploads to the APRA/NCPD portal (s.10; s.11; s.12). Insurers must also map their product and claim classifications to APRA’s code lists (product types, cause of loss, litigation status, injury severity and body part codes) and perform any reconciliations and validations required (Instruction Guide and Appendix A).\n\n**Costs, incentives and trade‑offs (mechanical risks and incentives)**\n\n- Compliance costs: insurers will incur direct costs to adapt claims management and reporting systems, to code legacy claims to APRA’s tables, and to run the internal controls and validation checks required (s.11; Instruction Guide). Smaller insurers or those using facility arrangements (bordereau reporting) may face fixed‑cost burdens to meet the field and format requirements.\n\n- Operational risk and implementation: conditional mandatory fields and numerous code lists (many itemised tables) create a moderate risk of inconsistent interpretation across insurers. APRA’s ability to make minor variations (s.14) reduces the need for formal legislative amendment but can impose recurring adaptation costs.\n\n- Data governance and confidentiality trade‑offs: APRA will use the data for supervision and publication in the NCPD (s.2). While the reporting standard states certain identifiers are for APRA cross‑referencing only and “will not be published except in any individual data reports prepared for the insurer” (Instruction Guide: policy/risk/claim numbers), publication of aggregated or selected outputs creates trade‑offs between transparency for market participants and confidentiality for claimants and commercial counterparties.\n\n- Incentives for insurers: richer reporting gives APRA higher‑resolution supervision capability (s.2), which may lead to more granular regulatory scrutiny of underwriting, reserving and pricing. That in turn may influence insurers’ reserving policies, product design and pricing if APRA’s published outputs change market expectations.\n\n- Competitive effects: standardized national data can improve market information (benefit to entrants and incumbents alike) but also raises regulatory compliance costs that are relatively heavier for smaller players, potentially affecting market structure and scale economies.\n\n**Implementation risk and administrative discretion**\n\n- APRA’s discretions (changing reporting frequency, varying form fields, authorising who may sign off submissions) concentrate operational decision‑making with the regulator (s.7; s.13; s.14). That centralised discretion allows responsiveness but requires insurers to monitor APRA notices and adjust systems, increasing recurring compliance overhead.\n\n**Summary of the concrete mechanics insurers must meet (with key sections)**\n\n- Provide GRF 800.2 data each relevant reporting period for each reportable claim (s.5; GRF 800.2 specifications).\n- Submit half‑yearly unless APRA specifies otherwise, and meet the four‑month deadline (s.6; s.8).\n- Use CSV format and the NCPD portal unless APRA notifies a different method (s.10).\n- Maintain board‑approved systems and controls for data authorisation (s.11).\n- Accept that APRA may vary form fields or timing and will validate submissions using rules in Appendix A (s.14–15; Appendix A).\n\n(Primary references to sections are as indicated: s.1–19, Instruction Guide and Appendix A.)"}},"importantCases":[],"_links":{"self":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021","history":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021/history","analysis":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021/analysis","conflicts":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021/conflicts","importantCases":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021/important-cases","documents":"/api/acts/financial-sector-collection-of-data-reporting-standard-determination-no-2-of-2021/documents"}}