RECLAM Reinsurance claims

TBG8 Insurance

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.

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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 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 13A 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. Segment group 1
    Repeat 99

    1. A segment to give a processing indicator relating to the whole message.

    2. A segment to give free format text regarding type of participation, type of risk, cause of loss, consequence of loss.

  3. Segment group 2
    Repeat 999

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

    2. 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.

    3. A segment to identify a person or department to whom the communication should be directed.

    4. A segment to identify a communication number of a department or a person to whom communication should be directed.

    5. A segment to specify the references of the party identified in the leading NAD segment.

    6. A segment to give a processing indicator relating to the consequence of loss.

    7. A segment to provide the ceding company details, leading reinsurer's comments, claimant information.

    8. A segment to give information dates regarding claimants in medical malpractice.

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

  5. A segment to specify pertinent dates and periods relating to the RECLAM.

  6. A segment to provide free format information regarding the loss, the risk or the reinsurance contract.

Detail

Position
Segment
Name
Max use
  1. Segment group 3
    Repeat 9

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

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

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

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

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

  3. A segment to specify the possible maximum loss amount.

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

  5. Segment group 4
    Repeat 99

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

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

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

    4. A segment to give the original insurance policy effective period.

    5. 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.

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

    7. Segment group 5
      Repeat 3

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

      2. A segment to indicate whether the following amounts are annuities.

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

      4. Segment group 6
        Repeat 99

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

        2. A segment to provide the entries expression flag.

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

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

      5. A segment to specify the cedent's share percentage.

    8. Segment group 7
      Repeat 99

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

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

  6. A segment used to prevent collision between the detail and the summary sections of the message.

Summary

Position
Segment
Name
Max use
  1. Segment group 8
    Repeat 3

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

    2. Segment group 9
      Repeat 999

      1. A segment to specify the amounts of the reinsurance contract.

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

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

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

      5. Segment group 10
        Repeat 99

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

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

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

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

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

  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.

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