...
Coverholder Name
Agreement No
Unique Market Reference (UMR)
Binding authority or coverholder appointment agreement inception date
Binding authority or coverholder appointment agreement expiry date
Class of Business
Original Currency
Settlement Currency
Product
Certificate Reference
Claim Reference / Number
Insured Full Name or Company Name
Insured Country
Loss Description
Date Claim First Advised/Date Claim Made
Claim Status
Claimant Name
Type of Insurance (Direct, or Type of RI)
Location of loss Address
Date Claim Opened
Claim First Notification Acknowledgement Date
Date First Reserve Established
Date of Loss
Paid this month - Indemnity
Paid this month - Fees
Previously Paid - Indemnity
Previously Paid - Fees
Reserve - Indemnity
Reserve - Fees
Total Incurred - Indemnity
Total Incurred - Fees