Unified Template of Certificate of Claims Experience under Health Insurance Contracts and General ABI Policy on its Use

As of 7 April 2025, a general ABZ policy will enter into force introducing a standardized template for the presentation of data in certificates of claims experience under health insurance contracts. ABZ member companies have committed to applying this policy and to using the unified template.

The purpose of the unified form is to ensure consistency in the data on claims experience that is provided when negotiating a health insurance contract. In this way, underwriters will have clear and reliable information on the expenses incurred by a given insurance company under its contract. This will enable more objective risk assessment and pricing, with resulting benefits for the development of the market and for all participants – insurers, brokers, and clients.

For assistance in receiving the template in another format, please contact the ABI Secretariat at abz@abz.bg.


Unified Template of Certificate of Claims Experience under Health Insurance Contracts and Guidelines for Implementation of ABI’s General Policy

Structure and Content of the Unified Template

The data included are the minimum required to show the expenses incurred by an insurer in relation to a health insurance contract. The unified template is provided in a separate file attached to this communication.

Provision of Additional Information

Beyond the data contained in the unified template, insurers will continue to provide additional information depending on the specific needs and requirements of brokers, agents, and clients.

Issuance and Use

  • The general policy for the use of certificates of claims experience based on the unified template prepared by ABZ will take effect on 7 April 2025.
  • The certificate will be issued upon a request or assignment letter submitted to the insurer by an insurance broker or agent, within timeframes agreed between the parties.
  • The certificate will be signed electronically or issued with an outgoing reference number from the insurer’s document management system and personally signed.
  • The certificate will be prepared for group contracts with more than 20 insured persons.
  • ABI member insurers will require a signed certificate of claims experience when submitting a request for the preparation of offers for health insurance contracts.
  • The unified template has also been made available by ABI to non-member companies conducting health insurance business.

Feedback on Implementation

ABZ will collect feedback and suggestions from market participants, which will serve as a basis for further improvements to the general policy and the unified template.

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