United Nations Directories for Electronic Data Interchange for
Administration, Commerce and Transport
UN/EDIFACT
United Nations Directories for Electronic Data Interchange for |
Message Type : RECLAM
Version : D
Release : 01C
Contr. Agency: UN
Revision : 2
Date : 2001-11-07
SOURCE: D9 Insurance (SWG)
CONTENTS
Reinsurance claims message
0. INTRODUCTION
1. SCOPE
1.1 Functional definition
1.2 Field of application
1.3 Principles
2. REFERENCES
3. TERMS AND DEFINITIONS
3.1 Standard terms and definitions
4. MESSAGE DEFINITION
4.1 Segment clarification
4.1.1 Header section
4.1.2 Detail section
4.1.3 Summary section
4.2 Segment index (alphabetical sequence by tag)
4.3 Message structure
4.3.1 Segment table
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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
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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 01C
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
X 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
Pos Tag Name S R
HEADER SECTION
0010 UNH Message header M 1
0020 ----- Segment group 1 ------------------ M 99----------+
0030 X GIS General indicator M 1 |
0040 FTX Free text C 1-----------+
0050 ----- Segment group 2 ------------------ M 999---------+
0060 NAD Name and address M 1 |
0070 PCD Percentage details C 1 |
0080 CTA Contact information C 1 |
0090 COM Communication contact C 5 |
0100 RFF Reference C 5 |
0110 X GIS General indicator C 2 |
0120 FTX Free text C 2 |
0130 DTM Date/time/period C 9-----------+
0140 UNS Section control M 1
0150 DTM Date/time/period M 8
0160 FTX Free text C 999
DETAIL SECTION
0170 ----- Segment group 3 ------------------ C 9-----------+
0180 RFF Reference M 1 |
0190 DTM Date/time/period C 1 |
0200 COM Communication contact C 1 |
0210 FTX Free text C 1-----------+
0220 LOC Place/location identification C 1
0230 MOA Monetary amount C 1
0240 PCD Percentage details C 1
0250 ----- Segment group 4 ------------------ C 99----------+
0260 X GIS General indicator M 1 |
0270 RFF Reference C 8 |
0280 LOC Place/location identification C 9 |
0290 DTM Date/time/period C 1 |
0300 FTX Free text C 3 |
0310 PCD Percentage details C 2 |
|
0320 ----- Segment group 5 ------------------ C 3----------+|
0330 CUX Currencies M 1 ||
0340 X GIS General indicator C 1 ||
0350 FTX Free text C 1 ||
||
0360 ----- Segment group 6 ------------------ M 99--------+||
0370 MOA Monetary amount M 1 |||
0380 X GIS General indicator M 3 |||
0390 CUX Currencies C 1 |||
0400 FTX Free text C 2---------+||
0410 PCD Percentage details M 1----------+|
|
0420 ----- Segment group 7 ------------------ C 99---------+|
0430 NAD Name and address M 1 ||
0440 PCD Percentage details C 1----------++
0450 UNS Section control M 1
SUMMARY SECTION
0460 ----- Segment group 8 ------------------ C 3-----------+
0470 CUX Currencies M 1 |
|
0480 ----- Segment group 9 ------------------ M 999--------+|
0490 MOA Monetary amount M 1 ||
0500 PCD Percentage details C 2 ||
0510 CUX Currencies C 1 ||
0520 FTX Free text C 10 ||
||
0530 ----- Segment group 10 ------------------ C 99--------+||
0540 RFF Reference M 1 |||
0550 DTM Date/time/period C 1 |||
0560 COM Communication contact C 1 |||
0570 FTX Free text C 1---------+||
0580 X GIS General indicator M 99---------++
0590 UNT Message trailer M 1
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