
Claims Data - summarily for a selected EB-plan

by MIBAV Service

Through this information we can negotiate the future costs more precisely.

Client (HQ) *

Legal Entity (LE) *

Country *

Insurer *

----------------------------------------------------------------------------------------------------------------------------------------------------------------------- The claims data belong to the client. Therefore the insurer must guarantee that these data are correct. -----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Coverage *

Year *

Claims Handling Costs

----------------------------------------------------------------------------------------------------------------------------------------------------------------------- CLAIMS -----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Annuity Benefits

Lump Sum Benefits

Other Benefits

Pension Withdrawal

Projected Fund for Health

Health Care Benefits

----------------------------------------------------------------------------------------------------------------------------------------------------------------------- RESERVES -----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Technical Reserves - at begin

Technical Reserves - at end

IBNR Reserves - at begin

IBNR Reserves - at end

Claims Reserves - at begin

Claims Reserves - at end

Other Reserves - at begin

Other Reserves - at end

----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Signature -----------------------------------------------------------------------------------------------------------------------------------------------------------------------

Filled out by *

Position

Date *

Please enter the characters you see: