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UN/EDIFACT
UNITED NATIONS STANDARD MESSAGE (UNSM)

Insurance claim solicitor's instruction message

Version:D
Release:04A
Contr. Agency:UN
Revision:2
Date:2004-05-18
SOURCE:TBG8 Insurance

CONTENTS
Insurance claim solicitor's instruction message
  1. INTRODUCTION
  2. SCOPE
    1. Functional definition
    2. Field of application
    3. Principles
  3. REFERENCES
  4. TERMS AND DEFINITIONS
    1. Standard terms and definitions
    2. Message terms and definitions
  5. MESSAGE DEFINITION
    1. Segment clarification
      1. Header section
      2. Detail section
    2. Segment index (alphabetical sequence by tag)
    3. Message structure
      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


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

0. INTRODUCTION

This specification provides the definition of the Insurance claim solicitor's instruction message (ICSOLI) to be used in Electronic Data Interchange (EDI) between trading partners involved in administration, commerce and transport.


1. SCOPE


1.1. Functional definition

The Insurance claim solicitor's instruction message is exchanged between insurers and solicitors acting on behalf of the insurer during claim dispute resolution. It allows the insurer to provide claim details and instructions and the solicitor to report progress and resolution details.


1.2. Field of application

The Insurance claim solicitor's instruction 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

Each instance of the message contains information relating to one claim only.

The message may be used to exchange information of a claim dispute irrespective of the type of resolution being applied e.g. court settlement, independent arbitration, negotiation etc.

The message is used by insurers to provide policy and claim information to the solicitor and also to request a progress update.

It is used by the solicitor to request information from an insurer as well as to provide progress and resolution details.


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.


3.2. Message terms and definitions

Quantum - a legal term used by solicitors to mean "An estimate of the total amount that may be paid by one party to another in compensation for a loss"


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 Insurance claim solicitor's instruction message is ICSOLI.

Note: Insurance claim solicitor's instruction messages conforming to this document must contain the following data in segment UNH, composite S009:

Data element0065ICSOLI
0052D
005404A
0051UN

0020 BGM, Beginning of message

To identify the purpose and status of the Insurance claim solicitor's instruction message, such as instruction, progress report, resolution details.

0030 RFF, Reference

To identify the version of the message implementation guide being used in the application.

0040 SEQ, Sequence details

To identify the sequence number of the message in a series of messages relating to the same claim, incident or action.

0050 DTM, Date/time/period

Contains the creation date of the message.

0060 EFI, External file link identification

To enable cross reference to electronic files containing photographic or video files associated with this message.

0070 Segment Group 1: ICD-MOA-ATT-RFF-DTM-QRS-FTX

Contains details of one policy under which the claim was reported. Required when the message type is instruction.

0080 ICD, Insurance cover description

To identify the class of policy.

0090 MOA, Monetary amount

Contains monetary amounts relating to the policy excesses and indemnity limits.

0100 ATT, Attribute

Identifies the type of indemnity provided, and the area of jurisdiction specified by the policy.

0110 RFF, Reference

To specify reference numbers which are specific to the policy, e.g. policy number.

0120 DTM, Date/time/period

To specify the start and end dates for the cover under the policy.

0130 QRS, Query and response

Used to convey whether indemnity is unlimited and whether there was a previous policy in force.

0140 FTX, Free text

Contains a text description of the reason why policy cover is at issue and the legal venue specified in the policy.

0150 Segment Group 2: PNA-RFF-EMP-DTM-PCD-QRS-FTX-COM-ATT-SG3-SG4-

SG5 A group of segments used to identify all the parties involved in the transaction. The group will be used in all identified

0160 PNA, Party identification

Contains the name of the party in text or a coded identification of the name and address of the party together with the role of the party in the message.

0170 RFF, Reference

To specify those references which are specific to the party, e.g. national insurance number.

0180 EMP, Employment details

Contains a coded description of the occupation or business of the party.

0190 DTM, Date/time/period

Indicates dates which are relevant to the party, e.g. date of birth, date exposure commenced.

0200 PCD, Percentage details

To specify percentages applicable to the party, e.g. co-insurers proportion.

0210 QRS, Query and response

Used to convey whether the party is registered for value added tax or under a legal disability.

0220 FTX, Free text

Provides a textual description of the function of a party in a message.

0230 COM, Communication contact

Provides the communication number and channel for a contact party. Note: where the communication details are linked to an address they should be included in the address group.

0240 ATT, Attribute

Contains a coded identification or text description of an attribute of the party, e.g. title, gender, trading status.

0250 Segment Group 3: ADR-COM

Contains address details for the party and communication information related to that address. Note: if the address is included in the coded identification of the party it does not need to be repeated here.

0260 ADR, Address

Contains the address type and details for the party.

0270 COM, Communication contact

Contains a communication number and type of communication for the party at the address, e.g. telephone number.

0280 Segment Group 4: ROD-MOA-FTX

Contains details and amounts relating to quantum applicable to the party in respect of damage, loss or injury caused to the party by the insured risk.

0290 ROD, Risk object type

Contains the type of quantum in respect of the damage, injury or loss caused to the party by the insured risk.

0300 MOA, Monetary amount

Contains the monetary amount and status of the quantum.

0310 FTX, Free text

Contains the text description of the type of quantum, required if non-standard and no code available.

0320 Segment Group 5: COD-ATT-IDE-RFF-DTM-MOA-EQN-QRS

Contains details of convictions sustained by the party.

0330 COD, Component details

Identifies the group as containing conviction information.

0340 ATT, Attribute

Identifies the type of sentence.

0350 IDE, Identity

Makes reference to other parties related to the offence.

0360 RFF, Reference

Contains a reference which uniquely identifies the conviction.

0370 DTM, Date/time/period

Contains the date of the conviction and periods relating to the conviction, e.g. length of disqualification.

0380 MOA, Monetary amount

Contains the monetary amount of a fine resulting from the conviction.

0390 EQN, Number of units

Contains the number of penalty points relating to the conviction.

0400 QRS, Query and response

Advises whether the conviction is related to the claim which is the subject of the message.


4.1.2. Detail section

Information to be provided in the Detail section:

0410 UNS, Section control

A service segment placed at the start of the detail section to avoid segment collision.

0420 Segment Group 6: EVE-ADR-RFF-DTM-QRS-FTX-SG7

A group of segments containing details of the claim event.

0430 EVE, Event

Contains a qualifier identifying the segment as claim/loss.

0440 ADR, Address

Contains the location or addresses relevant to the claim event.

0450 RFF, Reference

Identifies the claim number.

0460 DTM, Date/time/period

Contains dates relating to the claim event, e.g. incident start and end date.

0470 QRS, Query and response

Used to convey information relevant to the claim such as whether the solicitor has delegated authority, whether aggregate indemnity/excess or indemnity is at issue, whether the claim is a recovery etc.

0480 FTX, Free text

Contains a text description of the claim. e.g. claim circumstances.

0490 Segment Group 7: ATT-MOA

Contains the type, status and amount of a recovery or the type and amount of reserve applicable to the claim.

0500 ATT, Attribute

Contains the type and status of a recovery or the type of reserve.

0510 MOA, Monetary amount

Contains the monetary amount of the reserve or recovery.

0520 Segment Group 8: PYT-MOA-PNA-FII-ATT-RFF

A group of segments containing information relating to payments in connection with the claim or dispute resolution.

0530 PYT, Payment terms

Contains a coded identification or textual description of the nature of the monetary value, also whether it is a payment or receipt.

0540 MOA, Monetary amount

Contains the payment/receipt amount.

0550 PNA, Party identification

Contains the full name of the payee.

0560 FII, Financial institution information

Contains the financial institution account number and sort code of the payee.

0570 ATT, Attribute

Contains a coded identification of the payment status, e.g. payment made, make payment etc.

0580 RFF, Reference

Contains the roll number, accounting reference of the payee and a coded identification of the party to whom the payment should be sent.

0590 Segment Group 9: COD-ATT-RFF-ADR-DTM-QRS-FTX-SG10

A group of segments containing information relating to a dispute resolution in connection with the claim.

0600 COD, Component details

Contains a coded identification of the method of dispute resolution, e.g. Crown Court, Civil County Court, mediation etc.

0610 ATT, Attribute

To specify coded attributes relating to the dispute resolution.

0620 RFF, Reference

Contains the reference of the dispute resolution.

0630 ADR, Address

Contains the address details or location where the dispute resolution is to be held. Note: this is used where the address or location is not related to a party, e.g. an inquest may be held at any suitable location such as a cinema or local hall.

0640 DTM, Date/time/period

Contains dates relevant to the dispute resolution e.g. proceedings issue date, dispute resolution date etc.

0650 QRS, Query and response

Used to request whether there are other proceedings in force.

0660 FTX, Free text

Contains a textual description of the dispute resolution or other proceedings.

0670 Segment Group 10: IMD-ATT-RFF-DTM-MOA-FTX

A group of segments containing information relating to progress in connection with a dispute resolution.

0680 IMD, Item description

Identifies the type of progress, e.g. trial, close of pleadings etc.

0690 ATT, Attribute

Contains a coded identification of the status of progress and/or coroner verdict.

0700 RFF, Reference

Contains the unique identifying reference of a party associated with the progress.

0710 DTM, Date/time/period

Contains dates relevant to the progress, e.g. response date progress as at date etc.

0720 MOA, Monetary amount

Contains details of a monetary amount related to the progress.

0730 FTX, Free text

Contains a textual description of progress.

0740 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)

ADR Address
ATT Attribute
BGM Beginning of message
COD Component details
COM Communication contact
DTM Date/time/period
EFI External file link identification
EMP Employment details
EQN Number of units
EVE Event
FII Financial institution information
FTX Free text
ICD Insurance cover description
IDE Identity
IMD Item description
MOA Monetary amount
PCD Percentage details
PNA Party identification
PYT Payment terms
QRS Query and response
RFF Reference
ROD Risk object type
SEQ Sequence details
UNH Message header
UNS Section control
UNT Message trailer

4.3. Message structure


4.3.1. Segment table

├─UNH Message header ×1 (M)
├─BGM Beginning of message ×1 (M)
├─RFF Reference ×9 (C)
├─SEQ Sequence details ×1 (C)
├─DTM Date/time/period ×9 (C)
├─EFI External file link identification ×9 (C)
├─Segment Group 1 ×1 (M)
├─ICD Insurance cover description ×1 (M)
├─MOA Monetary amount ×9 (C)
├─ATT Attribute ×9 (C)
├─RFF Reference ×9 (C)
├─DTM Date/time/period ×9 (C)
├─QRS Query and response ×9 (C)
└─FTX Free text ×9 (C)
├─Segment Group 2 ×9 (M)
├─PNA Party identification ×1 (M)
├─RFF Reference ×99 (C)
├─EMP Employment details ×9 (C)
├─DTM Date/time/period ×9 (C)
├─PCD Percentage details ×9 (C)
├─QRS Query and response ×9 (C)
├─FTX Free text ×1 (C)
├─COM Communication contact ×9 (C)
├─ATT Attribute ×9 (C)
├─Segment Group 3 ×9 (C)
├─ADR Address ×1 (M)
└─COM Communication contact ×9 (C)
├─Segment Group 4 ×9 (C)
├─ROD Risk object type ×1 (M)
├─MOA Monetary amount ×1 (M)
└─FTX Free text ×1 (C)
└─Segment Group 5 ×99 (C)
──├─COD Component details ×1 (M)
──├─ATT Attribute ×9 (C)
──├─IDE Identity ×1 (C)
──├─RFF Reference ×9 (C)
──├─DTM Date/time/period ×9 (C)
──├─MOA Monetary amount ×9 (C)
──├─EQN Number of units ×9 (C)
──└─QRS Query and response ×9 (C)
├─UNS Section control ×1 (M)
├─Segment Group 6 ×9 (C)
├─EVE Event ×1 (M)
├─ADR Address ×9 (C)
├─RFF Reference ×9 (C)
├─DTM Date/time/period ×9 (C)
├─QRS Query and response ×9 (C)
├─FTX Free text ×9 (C)
└─Segment Group 7 ×9 (C)
──├─ATT Attribute ×1 (M)
──└─MOA Monetary amount ×1 (C)
├─Segment Group 8 ×99 (C)
├─PYT Payment terms ×1 (M)
├─MOA Monetary amount ×9 (M)
├─PNA Party identification ×1 (C)
├─FII Financial institution information ×1 (C)
├─ATT Attribute ×9 (C)
└─RFF Reference ×9 (C)
├─Segment Group 9 ×99 (C)
├─COD Component details ×1 (M)
├─ATT Attribute ×9 (C)
├─RFF Reference ×9 (C)
├─ADR Address ×9 (C)
├─DTM Date/time/period ×9 (C)
├─QRS Query and response ×9 (C)
├─FTX Free text ×9 (C)
└─Segment Group 10 ×99 (C)
──├─IMD Item description ×1 (M)
──├─ATT Attribute ×9 (C)
──├─RFF Reference ×9 (C)
──├─DTM Date/time/period ×9 (C)
──├─MOA Monetary amount ×9 (C)
──└─FTX Free text ×9 (C)
└─UNT Message trailer ×1 (M)

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