United Nations Directories
for Electronic Data Interchange for
Administration, Commerce and Transport
UN/EDIFACT
| United Nations Directories for Electronic Data Interchange for Administration, Commerce and Transport UN/EDIFACT |
Message Type : LRECLM Version : D Release : 11A Contr. Agency: UN Revision : 2 Date : 2011-06-29 SOURCE: TBG8 Insurance CONTENTS Life 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 4.2 Segment index (alphabetical sequence by tag) 4.3 Message structure 4.3.1 Segment table --------------------------------------------------------------------------- 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 --------------------------------------------------------------------------- 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 11A 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: GEI-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 GEI, Processing information 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 GEI Processing information 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 Pos Tag Name S R HEADER SECTION 0010 UNH Message header M 1 0020 BGM Beginning of message M 1 0030 DTM Date/time/period M 1 0040 CUX Currencies C 1 0050 CTA Contact information C 9 0060 FTX Free text C 1 DETAIL SECTION 0070 ----- Segment group 1 ------------------ M 999999-----------+ 0080 IMD Item description M 1 | 0090 ATT Attribute M 99 | 0100 DTM Date/time/period C 9 | 0110 LOC Place/location identification C 1 | 0120 PCD Percentage details C 9 | 0130 RFF Reference C 9 | 0140 CUX Currencies C 1 | 0150 FTX Free text C 1 | | 0160 ----- Segment group 2 ------------------ C 9---------------+| 0170 MOA Monetary amount M 1 || 0180 ARD Monetary amount function M 1---------------+| | 0190 ----- Segment group 3 ------------------ M 1---------------+| 0200 PNA Party identification M 1 || 0210 DTM Date/time/period M 9 || 0220 LOC Place/location identification C 1 || 0230 EMP Employment details C 1 || || 0240 ----- Segment group 4 ------------------ C 9--------------+|| 0250 MOA Monetary amount M 1 ||| 0260 ARD Monetary amount function M 1--------------++| | 0270 ----- Segment group 5 ------------------ M 99--------------+| 0280 GEI Processing information M 1 || 0290 RFF Reference M 9 || 0300 PNA Party identification C 1 || 0310 DTM Date/time/period C 99 || || 0320 ----- Segment group 6 ------------------ C 9--------------+|| 0330 MOA Monetary amount M 1 ||| 0340 ARD Monetary amount function M 1--------------+|| || 0350 ----- Segment group 7 ------------------ C 99-------------+|| 0360 IDE Identity M 1 ||| 0370 PNA Party identification M 1 ||| 0380 DTM Date/time/period M 1 ||| ||| 0390 ----- Segment group 8 ------------------ C 99------------+||| 0400 ICD Insurance cover description M 1 |||| 0410 DTM Date/time/period C 99 |||| 0420 RFF Reference C 9 |||| 0430 ATT Attribute C 9 |||| 0440 PCD Percentage details C 1 |||| 0450 AGR Agreement identification C 1 |||| |||| 0460 ----- Segment group 9 ------------------ C 9------------+|||| 0470 MOA Monetary amount M 1 ||||| 0480 ARD Monetary amount function M 1------------+++++ 0490 UNT Message trailer M 1