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 : RECLAM Version : D Release : 16B Contr. Agency: UN Revision : 3 Date : 2016-10-28 SOURCE: TBG8 Insurance 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 --------------------------------------------------------------------------- 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 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: 00010 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 16B 0051 UN 00020 Segment group 1: GEI-FTX A group of segments to transmit general processing indicators and to specify loss or event details. 00030 GEI, Processing information A segment to give a processing indicator relating to the whole message. 00040 FTX, Free text A segment to give free format text regarding type of participation, type of risk, cause of loss, consequence of loss. 00050 Segment group 2: NAD-PCD-CTA-COM-RFF-GEI-FTX-DTM A group of segments to specify relevant parties for the whole transaction. 00060 NAD, Name and address A segment to specify the name and address and the related function of the party involved. 00070 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. 00080 CTA, Contact information A segment to identify a person or department to whom the communication should be directed. 00090 COM, Communication contact A segment to identify a communication number of a department or a person to whom communication should be directed. 00100 RFF, Reference A segment to specify the references of the party identified in the leading NAD segment. 00110 GEI, Processing information A segment to give a processing indicator relating to the consequence of loss. 00120 FTX, Free text A segment to provide the ceding company details, leading reinsurer's comments, claimant information. 00130 DTM, Date/time/period A segment to give information dates regarding claimants in medical malpractice. 00140 UNS, Section control A segment placed at the start of the detail section to avoid segment collision. 00150 DTM, Date/time/period A segment to specify pertinent dates and periods relating to the RECLAM. 00160 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: 00170 Segment group 3: RFF-DTM-COM-FTX A group of segments to provide information concerning the loss or event, and the reinsurance contract. 00180 RFF, Reference A segment to provide references concerning the loss or event, reinsurance contract detail references, and for attached documents. 00190 DTM, Date/time/period A segment to specify the transaction date of the attached document or message. 00200 COM, Communication contact A segment to identify the means by which the attached document or message was transmitted. 00210 FTX, Free text A segment to provide free text regarding the document or message that is being referenced. 00220 LOC, Place/location identification A segment to identify the geographical scope to which the loss pertains. 00230 MOA, Monetary amount A segment to specify the possible maximum loss amount. 00240 PCD, Percentage details A segment to specify the possible maximum loss as a percentage. 00250 Segment group 4: GEI-RFF-LOC-DTM-FTX-PCD-SG5-SG7 A group of segments to specify the class, line or sub-line of business. 00260 GEI, Processing information A segment to give a processing indicator relating to the policy breakdown. 00270 RFF, Reference A segment to specify references of the original insurance policy contract. 00280 LOC, Place/location identification A segment to identify the geographical scope to which the risk pertains. 00290 DTM, Date/time/period A segment to give the original insurance policy effective period. 00300 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. 00310 PCD, Percentage details A segment used to give the percentage of the original insurance policy contract ceded to one or more reinsurance contract(s). 00320 Segment group 5: CUX-GEI-FTX-SG6-PCD A group of segments to specify the amounts of the original insurance policy contract in three non-equivalent currencies. 00330 CUX, Currencies A segment to specify the appropriate non-equivalent currency being used to report the amounts in the original insurance policy contract section. 00340 GEI, Processing information A segment to indicate whether the following amounts are annuities. 00350 FTX, Free text A segment to provide additional free text information regarding the annuities. 00360 Segment group 6: MOA-GEI-CUX-FTX A group of segments to provide all the information regarding amounts and converted amounts of the original insurance policy contract. 00370 MOA, Monetary amount A segment to specify the amounts of the original insurance policy contract. 00380 GEI, Processing information A segment to provide the entries expression flag. 00390 CUX, Currencies A segment to specify the reference and target currencies and the rate of exchange, in case a currency conversion is required. 00400 FTX, Free text A segment to provide free text information regarding policy contract amounts. 00410 PCD, Percentage details A segment to specify the cedent's share percentage. 00420 Segment group 7: NAD-PCD A group of segments to identify the parties involved in the original insurance policy section. 00430 NAD, Name and address A segment to specify the name and address and the related function of the party involved. 00440 PCD, Percentage details A segment to give the percentage in the original insurance policy of the party identified in the leading NAD segment. 00450 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: 00460 Segment group 8: CUX-SG9 A group of segments to specify the amounts of the reinsurance contract in three non-equivalent currencies. 00470 CUX, Currencies A segment to specify the appropriate non-equivalent currency used to report the amounts in the reinsurance contract section. 00480 Segment group 9: MOA-PCD-CUX-FTX-SG10-GEI A group of segments to provide all the information related to the amounts and their currency conversion for the reinsurance contract. 00490 MOA, Monetary amount A segment to specify the amounts of the reinsurance contract. 00500 PCD, Percentage details A segment to specify the reinsurer's share percentage or the applicable reinsurance contract retention. 00510 CUX, Currencies A segment to specify the reference and target currencies and the rate of exchange, in case a currency conversion is required. 00520 FTX, Free text A segment to provide free text information regarding the reinsurance contract amounts. 00530 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. 00540 RFF, Reference A segment to specify the reference number of the previous loss notification. 00550 DTM, Date/time/period A segment to specify the date of transaction of the supporting document or message. 00560 COM, Communication contact A segment to identify the means by which the referenced document or message was transmitted. 00570 FTX, Free text A segment to provide free text regarding the referenced document or message. 00580 GEI, Processing information A segment to provide the entries expression flag at reinsurance contract level. 00590 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 GEI Processing information 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 00010 UNH Message header M 1 00020 ---- Segment group 1 ------------------ M 99---------------+ 00030 GEI Processing information M 1 | 00040 FTX Free text C 1----------------+ 00050 ---- Segment group 2 ------------------ M 999--------------+ 00060 NAD Name and address M 1 | 00070 PCD Percentage details C 1 | 00080 CTA Contact information C 1 | 00090 COM Communication contact C 5 | 00100 RFF Reference C 5 | 00110 GEI Processing information C 2 | 00120 FTX Free text C 2 | 00130 DTM Date/time/period C 9----------------+ 00140 UNS Section control M 1 00150 DTM Date/time/period M 8 00160 FTX Free text C 999 DETAIL SECTION 00170 ---- Segment group 3 ------------------ C 9----------------+ 00180 RFF Reference M 1 | 00190 DTM Date/time/period C 1 | 00200 COM Communication contact C 1 | 00210 FTX Free text C 1----------------+ 00220 LOC Place/location identification C 1 00230 MOA Monetary amount C 1 00240 PCD Percentage details C 1 00250 ---- Segment group 4 ------------------ C 99---------------+ 00260 GEI Processing information M 1 | 00270 RFF Reference C 8 | 00280 LOC Place/location identification C 9 | 00290 DTM Date/time/period C 1 | 00300 FTX Free text C 3 | 00310 PCD Percentage details C 2 | | 00320 ---- Segment group 5 ------------------ C 3---------------+| 00330 CUX Currencies M 1 || 00340 GEI Processing information C 1 || 00350 FTX Free text C 1 || || 00360 ---- Segment group 6 ------------------ M 99-------------+|| 00370 MOA Monetary amount M 1 ||| 00380 GEI Processing information M 3 ||| 00390 CUX Currencies C 1 ||| 00400 FTX Free text C 2--------------+|| 00410 PCD Percentage details M 1---------------+| | 00420 ---- Segment group 7 ------------------ C 99--------------+| 00430 NAD Name and address M 1 || 00440 PCD Percentage details C 1---------------++ 00450 UNS Section control M 1 SUMMARY SECTION 00460 ---- Segment group 8 ------------------ C 3----------------+ 00470 CUX Currencies M 1 | | 00480 ---- Segment group 9 ------------------ M 999-------------+| 00490 MOA Monetary amount M 1 || 00500 PCD Percentage details C 2 || 00510 CUX Currencies C 1 || 00520 FTX Free text C 10 || || 00530 ---- Segment group 10 ------------------ C 99-------------+|| 00540 RFF Reference M 1 ||| 00550 DTM Date/time/period C 1 ||| 00560 COM Communication contact C 1 ||| 00570 FTX Free text C 1--------------+|| 00580 GEI Processing information M 99--------------++ 00590 UNT Message trailer M 1