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UN/EDIFACT UNITED NATIONS STANDARD MESSAGE (UNSM)

Life reinsurance claims message

Version:	D
Release:	01B
Contr. Agency:	UN
Revision:	1
Date:	2001-05-15
SOURCE:	D9 Insurance (SWG)

CONTENTS Life reinsurance claims message

INTRODUCTION
SCOPE
REFERENCES
TERMS AND DEFINITIONS
1. Standard terms and definitions
MESSAGE DEFINITION

For general information on UN standard message types see UN Trade Data Interchange Directory, UNTDID, Part 4, Section 2.3, UN/ECE UNSM General Introduction

This message also occurs in the following versions of this standard:
D98B, D99A, D99B, D00A, D00B, D01A, D01B, D01C, D02A, D02B, D03A, D03B, D04A, D04B

0. INTRODUCTION

This specification provides the definition of the Life reinsurance claims message (LRECLM) to be used in Electronic Data Interchange (EDI) between trading partners involved in administration, commerce and transport.

1. SCOPE

1.1. Functional definition

The LRECLM message is used by companies to exchange information regarding a claim or claims on a policy or policies which have been reinsured. The message will be used for both ceded and assumed reinsurance.

The trading partners utilizing the Life reinsurance claims message will be direct companies, reinsurance companies, reinsurance intermediaries and retrocessionaires. The message will be used to transmit data required by ceding and assuming companies to communicate information for the orderly settlement of claims. It also facilitates the reconciliation of the reinsurance records in order to maintain the integrity of the data between the trading partners.

1.2. Field of application

The Life reinsurance claims message may be used for both national and international applications. It is based on universal practice related to administration, commerce and transport, and is not dependent on the type of business or industry.

1.3. Principles

The Life reinsurance claims message contains information about reinsured individual life insurance policies, reinsured disability insurance policies and reinsured annuity contracts administered under the terms and conditions of a reinsurance treaty.
This message contains specific reinsurance information about the base policy, the person on claim and the reinsured coverages associated with the claim.
The message is used to confirm the details of a claim and the person on claim under a specific reinsurance treaty and to communicate information regarding the status of the claim and the settlement of the claim.

The following guidelines apply to the whole message and are intended to facilitate the understanding and implementation of the message:

All specified dates should include the century unless all parties involved in the transaction agree that there is a functional requirement for an alternative format.
Where a choice of code or text is given, only the code element should be used wherever possible.

2. REFERENCES

See UNTDID, Part 4, Chapter 2.3 UN/ECE UNSM - General Introduction, Section 1.

3. TERMS AND DEFINITIONS

3.1. Standard terms and definitions

See UNTDID, Part 4, Chapter 2.3 UN/ECE UNSM - General Introduction, Section 2.

4. MESSAGE DEFINITION

4.1. Segment clarification

This section should be read in conjunction with the segment table which indicates mandatory, conditional and repeating requirements.

4.1.1. Header section

Information to be provided in the Header section:

0010 UNH, Message header

A service segment starting and uniquely identifying a message. The message type code for the Life reinsurance claims message is LRECLM.

Note: Life reinsurance claims messages conforming to this document must contain the following data in segment UNH, composite S009:

Data element	0065	LRECLM
	0052	D
	0054	01B
	0051	UN

0020 BGM, Beginning of message

A segment specifying the type of message contained in the transmission.

0030 DTM, Date/time/period

A segment specifying the reporting period ending date.

0040 CUX, Currencies

A segment identifying the default currency and its scaling factor for monetary amounts in this message.

0050 CTA, Contact information

A segment identifying a person(s) or department(s), and their function(s), to whom communications should be directed.

0060 FTX, Free text

A segment with free text information, in coded or clear form, used when additional information is needed but cannot be accommodated within other segments.

4.1.2. Detail section

Information to be provided in the Detail section:

0070 Segment group 1: IMD-ATT-DTM-LOC-PCD-RFF-CUX-FTX-SG2-SG3-SG5 A group of segments in which is detailed claim information.

0080 IMD, Item description

A segment defining the type of claim.

0090 ATT, Attribute

A segment providing attributes of the claim.

0100 DTM, Date/time/period

A segment specifying general dates or durations related to the claim.

0110 LOC, Place/location identification

A segment giving location information for the place of death or location where the onset of the disability occurred.

0120 PCD, Percentage details

A segment specifying the extent of loss and the interest rate to be used in calculating the claim payment.

0130 RFF, Reference

A segment specifying the claim numbers as assigned by the ceding company and the reinsurer.

0140 CUX, Currencies

A segment identifying the default currency and its scaling factor for monetary amounts for the claim.

0150 FTX, Free text

A segment with free text information, in coded or clear form, used when additional information is needed regarding the claim.

0160 Segment Group 2: MOA-ARD

A group of segments in which is detailed monetary amounts and their purpose for the claim.

0170 MOA, Monetary amount

A segment specifying a monetary amount.

0180 ARD, Monetary amount function

A segment specifying the purpose of the monetary amount.

0190 Segment Group 3: PNA-DTM-LOC-EMP-SG4

A group of segments in which is detailed information regarding the person for which this claim is being submitted.

0200 PNA, Party identification

A segment identifying the name of the person on claim.

0210 DTM, Date/time/period

A segment specifying general date and durations associated with the person on claim.

0220 LOC, Place/location identification

A segment giving location information for the place of residence of the person on claim at the time of loss.

0230 EMP, Employment details

A segment providing the occupation class of the person on claim at time of loss for purposes of this claim as defined by the issuing company.

0240 Segment Group 4: MOA-ARD

A group of segments in which is detailed monetary amounts and their purpose for this person on claim.

0250 MOA, Monetary amount

A segment specifying a monetary amount.

0260 ARD, Monetary amount function

A segment specifying the purpose of the monetary amount.

0270 Segment Group 5: GIS-RFF-PNA-DTM-SG6-SG7

A group of segments in which is detailed information regarding the policy on claim and other policies related to the claim.

0280 X GIS, General indicator

An indicator specifying whether this policy is the policy on claim or an associated policy.

0290 RFF, Reference

A segment specifying the policy number as assigned by the ceding company.

0300 PNA, Party identification

A segment identifying the original issuer of the policy, in coded or clear form.

0310 DTM, Date/time/period

A segment specifying general dates and durations associated with the policy on claim or related policy.

0320 Segment Group 6: MOA-ARD

A group of segments in which is detailed monetary amounts and their purpose for this policy.

0330 MOA, Monetary amount

A segment specifying a monetary amount.

0340 ARD, Monetary amount function

A segment specifying the purpose of the monetary amount.

0350 Segment Group 7: IDE-PNA-DTM-SG8

A group of segments in which is detailed information regarding the insureds on this policy.

0360 IDE, Identity

A segment identifying the party as the insured of record.

0370 PNA, Party identification

A segment identifying the insured's name and universal identifier.

0380 DTM, Date/time/period

A segment specifying the date of birth of the insured.

0390 Segment Group 8: ICD-DTM-RFF-ATT-PCD-AGR-SG9

A group of segments in which is detailed coverage information regarding the insured.

0400 ICD, Insurance cover description

A segment giving the insurance cover type associated with this coverage.

0410 DTM, Date/time/period

A segment specifying general dates or durations related to this coverage.

0420 RFF, Reference

A segment specifying general references for this coverage.

0430 ATT, Attribute

A segment providing attributes of the coverage.

0440 PCD, Percentage details

A segment specifying the percentages associated with the claim.

0450 AGR, Agreement identification

A segment identifying the treaty as assigned by the ceding company.

0460 Segment Group 9: MOA-ARD

A group of segments in which is detailed monetary amounts and their purpose for the coverage.

0470 MOA, Monetary amount

A segment specifying a monetary amount.

0480 ARD, Monetary amount function

A segment specifying the purpose of the monetary amount.

0490 UNT, Message trailer

A service segment ending a message, giving the total number of segments in the message (including the UNH & UNT) and the control reference number of the message.

4.2. Segment index (alphabetical sequence by tag)

	AGR	Agreement identification
	ARD	Monetary amount function
	ATT	Attribute
	BGM	Beginning of message
	CTA	Contact information
	CUX	Currencies
	DTM	Date/time/period
	EMP	Employment details
	FTX	Free text
	GIS	General indicator
	ICD	Insurance cover description
	IDE	Identity
	IMD	Item description
	LOC	Place/location identification
	MOA	Monetary amount
	PCD	Percentage details
	PNA	Party identification
	RFF	Reference
	UNH	Message header
	UNT	Message trailer

4.3. Message structure

4.3.1. Segment table

├─UNH Message header	×1	(M)
├─BGM Beginning of message	×1	(M)
├─DTM Date/time/period	×1	(M)
├─CUX Currencies	×1	(C)
├─CTA Contact information	×9	(C)
├─FTX Free text	×1	(C)
├─Segment Group 1	×99999	(M)
│─├─IMD Item description	×1	(M)
│─├─ATT Attribute	×99	(M)
│─├─DTM Date/time/period	×9	(C)
│─├─LOC Place/location identification	×1	(C)
│─├─PCD Percentage details	×9	(C)
│─├─RFF Reference	×9	(C)
│─├─CUX Currencies	×1	(C)
│─├─FTX Free text	×1	(C)
│─├─Segment Group 2	×9	(C)
│─│─├─MOA Monetary amount	×1	(M)
│─│─└─ARD Monetary amount function	×1	(M)
│─├─Segment Group 3	×1	(M)
│─│─├─PNA Party identification	×1	(M)
│─│─├─DTM Date/time/period	×9	(M)
│─│─├─LOC Place/location identification	×1	(C)
│─│─├─EMP Employment details	×1	(C)
│─│─└─Segment Group 4	×9	(C)
│─│───├─MOA Monetary amount	×1	(M)
│─│───└─ARD Monetary amount function	×1	(M)
│─└─Segment Group 5	×99	(M)
│───├─GIS General indicator	×1	(M)
│───├─RFF Reference	×9	(M)
│───├─PNA Party identification	×1	(C)
│───├─DTM Date/time/period	×99	(C)
│───├─Segment Group 6	×9	(C)
│───│─├─MOA Monetary amount	×1	(M)
│───│─└─ARD Monetary amount function	×1	(M)
│───└─Segment Group 7	×99	(C)
│─────├─IDE Identity	×1	(M)
│─────├─PNA Party identification	×1	(M)
│─────├─DTM Date/time/period	×1	(M)
│─────└─Segment Group 8	×99	(C)
│───────├─ICD Insurance cover description	×1	(M)
│───────├─DTM Date/time/period	×99	(C)
│───────├─RFF Reference	×9	(C)
│───────├─ATT Attribute	×9	(C)
│───────├─PCD Percentage details	×1	(C)
│───────├─AGR Agreement identification	×1	(C)
│───────└─Segment Group 9	×9	(C)
│─────────├─MOA Monetary amount	×1	(M)
│─────────└─ARD Monetary amount function	×1	(M)
└─UNT Message trailer	×1	(M)

Change indicators
plus sign		An addition.
asterisk		Addition/substraction/change to a code entry for a particular data element.
hash or pound sign		Changes to names.
vertical bar		Changes to text for descriptions, notes and functions.
minus sign		A deletion.
letter X		Marked for deletion.

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