IPFCF Data Layout

Last Updated: April 14, 2016

​The data layout for the submission of medical malpractice insurance certificates follows.


Header Record

Field NameStarting
Position
LengthDescription
record type11 (Note: the value here will always be 1.)This field differentiates the header record (type 1 insurance company information) from the detail record (type 2 insured specific information)
carrier name245Name of insurer​
addr_text14730First line of insurer street address
addr_text7730Second line of insurer street address
city_text10728Insurer city
state_code1352Insurer state
postal_code13710Insurer Zip code
naic_company_code1478Insurer NAIC code
irs_id_number1559Insurer tax indentification number
company_type_ind1641Licensed/authorized insurer use "1." Self insurer use "2."
run_date1658Provide date filed created

Detail Record

Field NameStarting
Position
LengthDescription
record type11 (Note: the value here will always be 2.)This field differentiates the header record (type 1 insurance company information) from the detail record (type 2 insured specific information)
policy_id_number222Insured policy number
policy_form_nbr2425OCI approved medical maplractice policy form number
eff_ins_date498Effective date of coverage
expir_ins_date578Expiration date of coverage
rev_eff_date658For revision provide effective date of change. For new/renew or termination leave blank.
canc_ins_date738For termination provide effective date of termination. For new/renew or revision leave blank.
retoa_ins_date818For clains-made policies provide retroactive date
malp_cov_code891For claims-made policies use "1."  For occurrence policies use "2."
policy_occur_lim909Per occurence limit
policy_aggr_lim999Annual aggregate limit
prvd_license_nbr1087For people provide license number (MD, OD, or RN)
name_data11545For entities provide full name.  For people leave blank
last_name16025Person last name.  For entities leave blank
1st_name18515Person first name.  For entities leave blank
midl_name20015Person middle name.  For entities leave blank
name_sufx2153For example: Sr. Jr., III
addr_text121830Insured address line 1
addr_​text224830Insured address line 2
city_text27828​Insured city
state_text3062Insured state
postal_code30810Insured Zip code
irs_id_number318​9For entities provide tax id.  For people leave blank.
iso_class_code3275ISO code
prvd_type_ind3322Fund provider type - see Fees page for current fee grid.
coverage_limit_ind3341 (Note: This column can be one of the following: "Y", "N" or blank.)Leave blank.  This indicator is not currently used.
processing_type3351 (Note: This value can only be one of the following: 1 = new certificate, 2 = revise certificate, 3 = terminate certificate. Revised date, ISO code, provider type are required for revising a certificate. Termination date is required for terminating a certificate.)​See description in column C.​


​​

​​​Questions? Contact the Fund at 608-266-6830 or ociipfcf@wisconsin.gov​