Reinsurance claims message
| Version: | D |
|---|---|
| Release: | 99B |
| Contr. Agency: | UN |
| Revision: | 2 |
| Date: | 1999-09-11 |
| SOURCE: | Western European EDIFACT Board - MD7 |
|
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: D96A, D96B, D97A, D97B, D98A, D98B, D99A, D99B, D00A, D00B, D01A, D01B, D01C, D02A, D02B, D03A, D03B, D04A, D04B |
0. INTRODUCTION
This specification provides the definition of the Reinsurance claims message (RECLAM) to be used in Electronic Data Interchange (EDI) between trading partners involved in administration, commerce and transport.
1. SCOPE
1.1. Functional Definition
A reinsurance claims message is exchanged between insurers, professional intermediaries, reinsurers to send information concerning a loss and/or to request settlement (payment or refund) concerning the loss.
1.2. Field of Application
The 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 RECLAM message is a supporting message to the RETACC (Reinsurance technical account message), but can also stand on its own if for instance, only a loss reporting is done with no request for money, or if the result of the request for money equals zero. For each request for money, a RETACC message must be made to report the RECLAM result, be it a current billing or a refund.
The RECLAM message reports loss or event information, original insurance policy information and reinsurance contract information.
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 Reinsurance claims message is RECLAM.
Note: Reinsurance claims messages conforming to this document must contain the following data in segment UNH, composite S009:
| Data element | 0065 | RECLAM |
| 0052 | D | |
| 0054 | 99B | |
| 0051 | UN |
0020 Segment Group 1: GIS-FTX
A group of segments to transmit general processing indicators and to specify loss or event details.
0030 X GIS, General indicator
A segment to give a processing indicator relating to the whole message.
0040 FTX, Free text
A segment to give free format text regarding type of participation, type of risk, cause of loss, consequence of loss.
0050 Segment Group 2: NAD-PCD-CTA-COM-RFF-GIS-FTX-DTM
A group of segments to specify relevant parties for the whole transaction.
0060 NAD, Name and address
A segment to specify the name and address and the related function of the party involved.
0070 PCD, Percentage details
A segment to specify the producing or the placing intermediary's or broker's order percentage in the reinsurance, and to give the reinsurer's share in this intermediary's or broker's order.
0080 CTA, Contact information
A segment to identify a person or department to whom the communication should be directed.
0090 COM, Communication contact
A segment to identify a communication number of a department or a person to whom communication should be directed.
0100 RFF, Reference
A segment to specify the references of the party identified in the leading NAD segment.
0110 X GIS, General indicator
A segment to give a processing indicator relating to the consequence of loss.
0120 FTX, Free text
A segment to provide the ceding company details, leading reinsurer's comments, claimant information.
0130 DTM, Date/time/period
A segment to give information dates regarding claimants in medical malpractice.
0140 UNS, Section control
A segment placed at the start of the detail section to avoid segment collision.
0150 DTM, Date/time/period
A segment to specify pertinent dates and periods relating to the RECLAM.
0160 FTX, Free text
A segment to provide free format information regarding the loss, the risk or the reinsurance contract.
4.1.2. Detail section
Information to be provided in the Detail section:
0170 Segment group 3: RFF-DTM-COM-FTX A group of segments to provide information concerning the loss or event, and the reinsurance contract.
0180 RFF, Reference
A segment to provide references concerning the loss or event, reinsurance contract detail references, and for attached documents.
0190 DTM, Date/time/period
A segment to specify the transaction date of the attached document or message.
0200 COM, Communication contact
A segment to identify the means by which the attached document or message was transmitted.
0210 FTX, Free text
A segment to provide free text regarding the document or message that is being referenced.
0220 LOC, Place/location identification
A segment to identify the geographical scope to which the loss pertains.
0230 MOA, Monetary amount
A segment to specify the possible maximum loss amount.
0240 PCD, Percentage details
A segment to specify the possible maximum loss as a percentage.
0250 Segment Group 4: GIS-RFF-LOC-DTM-FTX-PCD-SG5-SG7
A group of segments to specify the class, line or sub-line of business.
0260 X GIS, General indicator
A segment to give a processing indicator relating to the policy breakdown.
0270 RFF, Reference
A segment to specify references of the original insurance policy contract.
0280 LOC, Place/location identification
A segment to identify the geographical scope to which the risk pertains.
0290 DTM, Date/time/period
A segment to give the original insurance policy effective period.
0300 FTX, Free text
A segment used to provide additional free text information about the policy effective period, the whole policy contract and the class or line of business.
0310 PCD, Percentage details
A segment used to give the percentage of the original insurance policy contract ceded to one or more reinsurance contract(s).
0320 Segment Group 5: CUX-GIS-FTX-SG6-PCD
A group of segments to specify the amounts of the original insurance policy contract in three non-equivalent currencies.
0330 CUX, Currencies
A segment to specify the appropriate non-equivalent currency being used to report the amounts in the original insurance policy contract section.
0340 X GIS, General indicator
A segment to indicate whether the following amounts are annuities.
0350 FTX, Free text
A segment to provide additional free text information regarding the annuities.
0360 Segment Group 6: MOA-GIS-CUX-FTX
A group of segments to provide all the information regarding amounts and converted amounts of the original insurance policy contract.
0370 MOA, Monetary amount
A segment to specify the amounts of the original insurance policy contract.
0380 X GIS, General indicator
A segment to provide the entries expression flag.
0390 CUX, Currencies
A segment to specify the reference and target currencies and the rate of exchange, in case a currency conversion is required.
0400 FTX, Free text
A segment to provide free text information regarding policy contract amounts.
0410 PCD, Percentage details
A segment to specify the cedent's share percentage.
0420 Segment Group 7: NAD-PCD
A group of segments to identify the parties involved in the original insurance policy section.
0430 NAD, Name and address
A segment to specify the name and address and the related function of the party involved.
0440 PCD, Percentage details
A segment to give the percentage in the original insurance policy of the party identified in the leading NAD segment.
0450 UNS, Section control
A segment used to prevent collision between the detail and the summary sections of the message.
4.1.3. Summary section
Information to be provided in the Summary section:
0460 Segment group 8: CUX-SG9 A group of segments to specify the amounts of the reinsurance contract in three non-equivalent currencies.
0470 CUX, Currencies
A segment to specify the appropriate non-equivalent currency used to report the amounts in the reinsurance contract section.
0480 Segment Group 9: MOA-PCD-CUX-FTX-SG10-GIS
A group of segments to provide all the information related to the amounts and their currency conversion for the reinsurance contract.
0490 MOA, Monetary amount
A segment to specify the amounts of the reinsurance contract.
0500 PCD, Percentage details
A segment to specify the reinsurer's share percentage or the applicable reinsurance contract retention.
0510 CUX, Currencies
A segment to specify the reference and target currencies and the rate of exchange, in case a currency conversion is required.
0520 FTX, Free text
A segment to provide free text information regarding the reinsurance contract amounts.
0530 Segment Group 10: RFF-DTM-COM-FTX
A group of segments to make reference to previous loss notifications in case an aggregate deductible is applicable.
0540 RFF, Reference
A segment to specify the reference number of the previous loss notification.
0550 DTM, Date/time/period
A segment to specify the date of transaction of the supporting document or message.
0560 COM, Communication contact
A segment to identify the means by which the referenced document or message was transmitted.
0570 FTX, Free text
A segment to provide free text regarding the referenced document or message.
0580 X GIS, General indicator
A segment to provide the entries expression flag at reinsurance contract level.
0590 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)
| COM | Communication contact | |
| CTA | Contact information | |
| CUX | Currencies | |
| DTM | Date/time/period | |
| FTX | Free text | |
 |
GIS | General indicator |
| LOC | Place/location identification | |
| MOA | Monetary amount | |
| NAD | Name and address | |
| PCD | Percentage details | |
| RFF | Reference | |
| UNH | Message header | |
| UNS | Section control | |
| UNT | Message trailer |
4.3. Message structure
4.3.1. Segment table
| ├─UNH Message header | ×1 | (M) |
| ├─Segment Group 1 | ×99 | (M) |
| │─├─GIS General indicator | ×1 | (M) |
| │─└─FTX Free text | ×1 | (C) |
| ├─Segment Group 2 | ×999 | (M) |
| │─├─NAD Name and address | ×1 | (M) |
| │─├─PCD Percentage details | ×1 | (C) |
| │─├─CTA Contact information | ×1 | (C) |
| │─├─COM Communication contact | ×5 | (C) |
| │─├─RFF Reference | ×5 | (C) |
| │─├─GIS General indicator | ×2 | (C) |
| │─├─FTX Free text | ×2 | (C) |
| │─└─DTM Date/time/period | ×9 | (C) |
| ├─UNS Section control | ×1 | (M) |
| ├─DTM Date/time/period | ×8 | (M) |
| ├─FTX Free text | ×999 | (C) |
| ├─Segment Group 3 | ×9 | (C) |
| │─├─RFF Reference | ×1 | (M) |
| │─├─DTM Date/time/period | ×1 | (C) |
| │─├─COM Communication contact | ×1 | (C) |
| │─└─FTX Free text | ×1 | (C) |
| ├─LOC Place/location identification | ×1 | (C) |
| ├─MOA Monetary amount | ×1 | (C) |
| ├─PCD Percentage details | ×1 | (C) |
| ├─Segment Group 4 | ×99 | (C) |
| │─├─GIS General indicator | ×1 | (M) |
| │─├─RFF Reference | ×8 | (C) |
| │─├─LOC Place/location identification | ×9 | (C) |
| │─├─DTM Date/time/period | ×1 | (C) |
| │─├─FTX Free text | ×3 | (C) |
| │─├─PCD Percentage details | ×2 | (C) |
| │─├─Segment Group 5 | ×3 | (C) |
| │─│─├─CUX Currencies | ×1 | (M) |
| │─│─├─GIS General indicator | ×1 | (C) |
| │─│─├─FTX Free text | ×1 | (C) |
| │─│─├─Segment Group 6 | ×99 | (M) |
| │─│─│─├─MOA Monetary amount | ×1 | (M) |
| │─│─│─├─GIS General indicator | ×3 | (M) |
| │─│─│─├─CUX Currencies | ×1 | (C) |
| │─│─│─└─FTX Free text | ×2 | (C) |
| │─│─└─PCD Percentage details | ×1 | (M) |
| │─└─Segment Group 7 | ×99 | (C) |
| │───├─NAD Name and address | ×1 | (M) |
| │───└─PCD Percentage details | ×1 | (C) |
| ├─UNS Section control | ×1 | (M) |
| ├─Segment Group 8 | ×3 | (C) |
| │─├─CUX Currencies | ×1 | (M) |
| │─└─Segment Group 9 | ×999 | (M) |
| │───├─MOA Monetary amount | ×1 | (M) |
| │───├─PCD Percentage details | ×2 | (C) |
| │───├─CUX Currencies | ×1 | (C) |
| │───├─FTX Free text | ×10 | (C) |
| │───├─Segment Group 10 | ×99 | (C) |
| │───│─├─RFF Reference | ×1 | (M) |
| │───│─├─DTM Date/time/period | ×1 | (C) |
| │───│─├─COM Communication contact | ×1 | (C) |
| │───│─└─FTX Free text | ×1 | (C) |
| │───└─GIS General indicator | ×99 | (M) |
| └─UNT Message trailer | ×1 | (M) |
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