LRECLM Life reinsurance claims

TBG8 Insurance

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.

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Header

Position
Segment
Name
Max use

  1. 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 11B 0051 UN

    1. Data element S009/0057 is retained for upward compatibility. The use of
    S016 and/or S017 is encouraged in preference.
    2. The combination of the values carried in data elements 0062 and S009 shall
    be used to identify uniquely the message within its group (if used) or if
    not used, within its interchange, for the purpose of acknowledgement.

  2. A segment specifying the type of message contained in the transmission.

  3. A segment specifying the reporting period ending date.

  4. A segment identifying the default currency and its scaling factor for monetary amounts in this message.

  5. A segment identifying a person(s) or department(s), and their function(s), to whom communications should be directed.

  6. A segment with free text information, in coded or clear form, used when additional information is needed but cannot be accommodated within other segments.

Detail

Position
Segment
Name
Max use
  1. Segment group 1
    Repeat 999999

    1. A segment defining the type of claim.

    2. A segment providing attributes of the claim.

    3. A segment specifying general dates or durations related to the claim.

    4. A segment giving location information for the place of death or location where the onset of the disability occurred.

    5. A segment specifying the extent of loss and the interest rate to be used in calculating the claim payment.

    6. A segment specifying the claim numbers as assigned by the ceding company and the reinsurer.

    7. A segment identifying the default currency and its scaling factor for monetary amounts for the claim.

    8. A segment with free text information, in coded or clear form, used when additional information is needed regarding the claim.

    9. Segment group 2
      Repeat 9

      1. A segment specifying a monetary amount.

      2. A segment specifying the purpose of the monetary amount.

    10. Segment group 3
      Repeat 1

      1. A segment identifying the name of the person on claim.

      2. A segment specifying general date and durations associated with the person on claim.

      3. A segment giving location information for the place of residence of the person on claim at the time of loss.

      4. 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.

      5. Segment group 4
        Repeat 9

        1. A segment specifying a monetary amount.

        2. A segment specifying the purpose of the monetary amount.

    11. Segment group 5
      Repeat 99

      1. An indicator specifying whether this policy is the policy on claim or an associated policy.

      2. A segment specifying the policy number as assigned by the ceding company.

      3. A segment identifying the original issuer of the policy, in coded or clear form.

      4. A segment specifying general dates and durations associated with the policy on claim or related policy.

      5. Segment group 6
        Repeat 9

        1. A segment specifying a monetary amount.

        2. A segment specifying the purpose of the monetary amount.

      6. Segment group 7
        Repeat 99

        1. A segment identifying the party as the insured of record.

        2. A segment identifying the insured's name and universal identifier.

        3. A segment specifying the date of birth of the insured.

        4. Segment group 8
          Repeat 99

          1. A segment giving the insurance cover type associated with this coverage.

          2. A segment specifying general dates or durations related to this coverage.

          3. A segment specifying general references for this coverage.

          4. A segment providing attributes of the coverage.

          5. A segment specifying the percentages associated with the claim.

          6. A segment identifying the treaty as assigned by the ceding company.

          7. Segment group 9
            Repeat 9

            1. A segment specifying a monetary amount.

            2. A segment specifying the purpose of the monetary amount.

  2. 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.

    1. 0062, the value shall be identical to the value in 0062 in the
    corresponding UNH segment.
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