EDI 272 Property and Casualty Loss Notification

Functional Group LN

X12N Insurance Subcommittee

This Draft Standard for Trial Use contains the format and establishes the data contents of the Property and Casualty Loss Notification Transaction Set (272) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to provide loss information flow between property and casualty (P & C) insurance companies, agents, service providers, and industry bureaus. Expected users are property and casualty insurance companies, agents, service providers (e.g., adjusters or glaziers), and industry bureaus (e.g., National Insurance Crime Bureau (NICB) or the Index System). Business functions consist of loss notification, work assignments and reporting.

Heading

Position
Segment
Name
Max use
  1. To indicate the start of a transaction set and to assign a control number

  2. To indicate the beginning of a transaction set.

  3. To specify any or all of a date, a time, or a time period

  4. 1000 Loop Optional
    Repeat >1
    1. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

    2. To provide a free form format that would allow the transmission of text information.

  5. 1100 Loop Optional
    Repeat 15
    1. To supply the full name of an individual or organizational entity

    2. To specify additional names or those longer than 35 characters in length

    3. To specify the location of the named party

    4. To specify the geographic place of the named party

    5. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

    6. To identify a person or office to whom administrative communications should be directed

Detail

Position
Segment
Name
Max use
  1. 2000 Loop Mandatory
    Repeat >1
    1. To provide details on a specific insurance claim

    2. To specify any or all of a date, a time, or a time period

    3. To identify information basic to the processing of any claims transaction

      This occurrence of the Basic Claim Information (BCI) segment is required for Loss Notification and Reporting purposes. If the effective date range is specified, it applies to all coverages on the policy unless otherwise specified within the appropriate coverage loop (LQ).
    4. To specify service characteristic data

    5. 2100 Loop Optional
      Repeat 1
      1. To provide an accurate description of where an individual was located or an event took place

        This occurrence of the Individual or Event Location (LIE) segment is used to specify the location of the loss.
      2. To specify the location of the named party

      3. To specify the geographic place of the named party

    6. 2200 Loop Optional
      Repeat >1
      1. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

      2. To provide a free form format that would allow the transmission of text information.

    7. 2300 Loop Optional
      Repeat >1
      1. To identify the type and transmission of paperwork or supporting information

      2. To specify any or all of a date, a time, or a time period

      3. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

      4. To specify the geographic place of the named party

      5. To supply the full name of an individual or organizational entity

      6. To identify a person or office to whom administrative communications should be directed

    8. To indicate that the next segment begins a loop

    9. 2400 Loop Optional
      Repeat 10
      1. To supply the full name of an individual or organizational entity

        This loop is used to specify witness information or administrative persons associated with the loss (i.e., claim handler, etc.).
      2. To specify additional names or those longer than 35 characters in length

      3. To specify the location of the named party

      4. To specify the geographic place of the named party

      5. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

      6. To identify a person or office to whom administrative communications should be directed

      7. 2410 Loop Optional
        Repeat 1
        1. To provide an accurate description of where an individual was located or an event took place

        2. To specify the location of the named party

        3. To specify the geographic place of the named party

    10. To indicate that the loop immediately preceding this segment is complete

    11. 2500 Loop Optional
      Repeat >1
      1. To reference a line number in a transaction set.

        This Assigned Number (LX) loop is used to specify information about a loss exposure.
      2. To provide descriptions that identify a specific vehicle

      3. Identifies attributes associated with a vehicle

      4. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

      5. To provide dynamic information pertaining to a vehicle

      6. To provide information about the recovery of a vehicle

      7. To identify the part of the vehicle that was damaged

      8. 2510 Loop Optional
        Repeat 1
        1. To provide an accurate description of where an individual was located or an event took place

          This occurrence of the Individual or Event Location (LIE) segment is used to specify the recovery location.
        2. To specify the location of the named party

        3. To specify the geographic place of the named party

      9. 2520 Loop Optional
        Repeat >1
        1. To define the attributes of a property or an entity

          This NX1 loop is used to specify information pertinent to an involved party.
        2. To supply the full name of an individual or organizational entity

        3. To specify additional names or those longer than 35 characters in length

        4. To specify the location of the named party

        5. To specify the geographic place of the named party

        6. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

        7. To identify a person or office to whom administrative communications should be directed

        8. To provide personal information on an individual

        9. To supply information on conditions

        10. To identify information basic to the processing of any claims transaction

        11. 2525 Loop Optional
          Repeat >1
          1. Code to transmit standard industry codes

          2. To specify any or all of a date, a time, or a time period

          3. To indicate the total monetary amount.

          4. To qualify percent amounts, and supply percent amounts

          5. To indicate that the next segment begins a loop

          6. 2528 Loop Optional
            Repeat >1
            1. Code to transmit standard industry codes

            2. To indicate the total monetary amount.

            3. To qualify percent amounts, and supply percent amounts

          7. To indicate that the loop immediately preceding this segment is complete

          8. 2600 Loop Optional
            Repeat >1
            1. To supply the full name of an individual or organizational entity

              This occurrence of the Individual or Organizational Name (NM1) loop is ued to specify associated party information.
            2. To specify additional names or those longer than 35 characters in length

            3. To specify the location of the named party

            4. To specify the geographic place of the named party

            5. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

            6. To identify a person or office to whom administrative communications should be directed

            7. To provide personal information on an individual

            8. To supply information on conditions

            9. To identify information basic to the processing of any claims transaction

            10. 2610 Loop Optional
              Repeat >1
              1. To report optionally codified information

              2. To specify any or all of a date, a time, or a time period

              3. To indicate the total monetary amount.

              4. To qualify percent amounts, and supply percent amounts

              5. To indicate that the next segment begins a loop

              6. 2615 Loop Optional
                Repeat >1
                1. Code to transmit standard industry codes

                2. To indicate the total monetary amount.

                3. To qualify percent amounts, and supply percent amounts

            11. To indicate that the loop immediately preceding this segment is complete

      10. 2700 Loop Optional
        Repeat 5
        1. To identify details of previous insurance losses

        2. To identify information basic to the processing of any claims transaction

        3. To specify the location of the named party

        4. To specify the geographic place of the named party

        5. 2710 Loop Optional
          Repeat >1
          1. To identify the type and transmission of paperwork or supporting information

          2. To specify any or all of a date, a time, or a time period

          3. To transmit identifying numbers and descriptive information as specified by the reference number qualifier

          4. To specify the geographic place of the named party

          5. To supply the full name of an individual or organizational entity

          6. To identify a person or office to whom administrative communications should be directed

  2. To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments).

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