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 14A 0051 UN

  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.

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