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UN/EDIFACT
UNITED NATIONS STANDARD MESSAGE (UNSM)

Reinsurance claims message

Version:D
Release:98A
Contr. Agency:UN
Revision:1
Date:98-02-23
SOURCE:Western European EDIFACT Board - MD7

CONTENTS
Reinsurance claims 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
  5. MESSAGE DEFINITION
    1. Data segment clarification
      1. Header section
      2. Detail section
      3. Summary section
    2. Data segment index (alphabetical sequence)
    3. Message structure
      1. Segment table

For general information on UN standard message types see UN Trade Data Interchange Directory, UNTDID, Part 4, Section 2.6, 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 2.6 UN/ECE UNSM - General Introduction, Section 1.


3. TERMS AND DEFINITIONS


3.1. Standard terms and definitions

See UNTDID, Part 4, Chapter 2.6 UN/ECE UNSM - General Introduction, Section 2.


4. MESSAGE DEFINITION


4.1. Data 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 element0065RECLAM
0052D
005498A
0051UN

0020 Segment Group 1: GIS-FTX

A group of segments to transmit general processing indicators and to specify loss or event details.

0030 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

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 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 specify pertinent dates and periods relating to the RECLAM.

0140 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:

0150 Segment group 3: RFF-DTM-COM-FTX A group of segments to provide information concerning the loss or event, and the reinsurance contract.

0160 RFF, Reference

A segment to provide references concerning the loss or event, reinsurance contract detail references, and for attached documents.

0170 DTM, Date/time/period

A segment to specify the transaction date of the attached document or message.

0180 COM, Communication contact

A segment to identify the means by which the attached document or message was transmitted.

0190 FTX, Free text

A segment to provide free text regarding the document or message that is being referenced.

0200 LOC, Place/location identification

A segment to identify the geographical scope to which the loss pertains.

0210 MOA, Monetary amount

A segment to specify the possible maximum loss amount.

0220 PCD, Percentage details

A segment to specify the possible maximum loss as a percentage.

0230 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.

0240 GIS, General indicator

A segment to give a processing indicator relating to the policy breakdown.

0250 RFF, Reference

A segment to specify references of the original insurance policy contract.

0260 LOC, Place/location identification

A segment to identify the geographical scope to which the risk pertains.

0270 DTM, Date/time/period

A segment to give the original insurance policy effective period.

0280 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.

0290 PCD, Percentage details

A segment used to give the percentage of the original insurance policy contract ceded to one or more reinsurance contract(s).

0300 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.

0310 CUX, Currencies

A segment to specify the appropriate non-equivalent currency being used to report the amounts in the original insurance policy contract section.

0320 GIS, General indicator

A segment to indicate whether the following amounts are annuities.

0330 FTX, Free text

A segment to provide additional free text information regarding the annuities.

0340 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.

0350 MOA, Monetary amount

A segment to specify the amounts of the original insurance policy contract.

0360 GIS, General indicator

A segment to provide the entries expression flag.

0370 CUX, Currencies

A segment to specify the reference and target currencies and the rate of exchange, in case a currency conversion is required.

0380 FTX, Free text

A segment to provide free text information regarding policy contract amounts.

0390 PCD, Percentage details

A segment to specify the cedent's share percentage.

0400 Segment Group 7: NAD-PCD

A group of segments to identify the parties involved in the original insurance policy section.

0410 NAD, Name and address

A segment to specify the name and address and the related function of the party involved.

0420 PCD, Percentage details

A segment to give the percentage in the original insurance policy of the party identified in the leading NAD segment.

0430 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:

0440 Segment group 8: CUX-SG9 A group of segments to specify the amounts of the reinsurance contract in three non-equivalent currencies.

0450 CUX, Currencies

A segment to specify the appropriate non-equivalent currency used to report the amounts in the reinsurance contract section.

0460 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.

0470 MOA, Monetary amount

A segment to specify the amounts of the reinsurance contract.

0480 PCD, Percentage details

A segment to specify the reinsurer's share percentage or the applicable reinsurance contract retention.

0490 CUX, Currencies

A segment to specify the reference and target currencies and the rate of exchange, in case a currency conversion is required.

0500 FTX, Free text

A segment to provide free text information regarding the reinsurance contract amounts.

0510 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.

0520 RFF, Reference

A segment to specify the reference number of the previous loss notification.

0530 DTM, Date/time/period

A segment to specify the date of transaction of the supporting document or message.

0540 COM, Communication contact

A segment to identify the means by which the referenced document or message was transmitted.

0550 FTX, Free text

A segment to provide free text regarding the referenced document or message.

0560 GIS, General indicator

A segment to provide the entries expression flag at reinsurance contract level.

0570 UNT, Message trailer

A service segment ending a message, giving the total number of segments in the message and the control reference number of the message.


4.2. Data 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 ×14 (M)
├─GIS General indicator ×1 (M)
└─FTX Free text ×1 (C)
├─Segment Group 2 ×212 (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 ×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 ×90 (C)
├─GIS General indicator ×1 (M)
├─RFF Reference ×8 (C)
├─LOC Place/location identification ×1 (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 ×13 (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 ×11 (M)
└─UNT Message trailer ×1 (M)

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