ICASRP Insurance claim assessment and reporting

TBG8 Insurance

The Insurance claim assessment and reporting message is exchanged between all parties involved in the claims handling process. Claims handling parties include insurers, intermediaries, assessors and repairers. The claims handling process includes the functions, claim notification, assessment request, assessment report, repair estimate, repair authorisation, claim progress reporting.

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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 Insurance claim assessment and reporting message is ICASRP. Note: Insurance claim assessment and reporting messages conforming to this document must contain the following data in segment UNH, composite S009: Data element 0065 ICASRP 0052 D 0054 15B 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. To specify the function of the message, such as claim notification, assessment request, assessment report.

  3. To specify the type of transaction within the specified message function.

  4. To specify the currency of the transaction.

  5. To specify dates related to the transaction, such as the date processed.

  6. To provide the response to coded questions related to the transaction.

  7. To provide additional text information related to the transaction, such as transaction description.

  8. Segment group 1
    Repeat 9

    1. To specify one party related to the business transaction, such as message originator, ultimate recipient and software supplier.

    2. Segment group 2
      Repeat 9

      1. To provide a reference that identifies one software component provided by the software supplier together with the version of the software.

      2. To specify dates related to the software component, such as effective date and date applied to system.

  9. Segment group 3
    Repeat 99

    1. To identify and describe one event or incident related to the claim.

    2. To provide identification numbers for the incident which may be used to link the incident to specific items of damage.

    3. To specify coded attributes relating to the incident, such as incident scale.

    4. To specify dates relating to the incident, such as incident date or start and end date when the incident occurred over a period of time.

    5. To specify references relating to the incident such as intermediary's claim reference, insurer's claim number.

    6. To specify percentages relating to the incident such as percentage of responsibility.

    7. To specify the response to coded questions about the incident.

    8. To specify quantities relating to the incident, such as number of injured parties, number of witnesses.

    9. To provide text information about the incident, such as incident description.

    10. Segment group 4
      Repeat 9

      1. To specify one type of cost or charge relating to the incident.

      2. To specify one type of cost or charge relating to the incident.

      3. To specify coded attributes relating to the cost charge, such as method of calculation.

      4. To specify monetary amounts for the cost or charge, such as amount including tax, discount amount.

      5. To specify percentages relating to the cost or charge, such as tax percentage.

      6. To provide text information about the cost or charge, such as explanation of cost or charge.

      7. Segment group 5
        Repeat 99

        1. To identify one contribution or recovery relating to the cost or charge.

        2. To specify the identity number of a party to whom this contribution or recovery applies.

        3. To provide coded attributes relating to the contribution or recovery, such as contribution or recovery status.

        4. To specify monetary amounts relating to the contribution or recovery, such as amount of contribution to the cost charge.

        5. To specify percentages relating to the contribution or recovery, such as percentage of contribution to the cost charge.

        6. To specify references for the contribution or recovery.

        7. To provide text information about the contribution or recovery.

    11. Segment group 6
      Repeat 99

      1. Provides a coded identification of one type of claim or incident component, such as policy cover, addresses.

      2. To reference the object or party to which the cover applies.

      3. To specify a geographic limit on a policy cover, which may be expressed as a location, an address or a country or the address(es) of the incident.

      4. To specify coded attributes related to the cover component, such as cover type, usage.

      5. To specify communication numbers for the address.

      6. To specify dates related to the cover, such as cover inception date, end date.

      7. To specify monetary amounts related to the cover, such as cover limit.

      8. To specify percentages related to the cover, such as cover index.

      9. To specify the response to coded questions concerning the cover.

      10. To specify quantities related to the cover, such as number of claims allowed.

      11. To specify references related to the cover.

      12. To specify text information about the cover, such as cover description, usage description.

      13. Segment group 7
        Repeat 999

        1. To specify one type of component used in the claim calculation, such as excess, cover condition.

        2. To specify coded attributes related to the claim calculation component, such as claim calculated by code.

        3. To specify dates relating to the claim calculation, such as condition valid date.

        4. To specify monetary amounts relating to the claim calculation, such as excess amount.

        5. To specify percentages related to the claim calculation component, such as excess percentage.

        6. To specify the response to coded questions about the claim calculation component.

        7. To specify quantities relating to the claim calculation component.

        8. To provide text information about the claim calculation component, such as condition wording.

        9. Segment group 8
          Repeat 99

          1. To specify one type of cost or charge relating to the cover.

          2. To reference the object or party that the cost or charge applies to.

          3. To specify coded attributes relating to the claim calculation, such as method of calculation.

          4. To specify monetary amounts for the claim calculation component, such as cost or charge amount, discount amount.

          5. To specify percentages relating to the claim calculation component, such as cost or charge discount percentage.

          6. To provide text information about the claim calculation component, such as explanation of cost or charge.

          7. Segment group 9
            Repeat 99

            1. To identify one contribution or recovery relating to the claim calculation.

            2. To reference a party to whom this contribution or recovery relates.

            3. To provide coded attributes related to the contribution or recovery, such as contribution or recovery status.

            4. To specify monetary amounts related to the contribution or recovery, such as amount of contribution to the cost charge.

            5. To specify percentages relating to the contribution or recovery, such as percentage of contribution to the cost charge.

            6. To specify references relating to the contribution or recovery.

            7. To provide text information about the contribution or recovery.

  10. Segment group 10
    Repeat 999

    1. To identify the insurance product specified in the policy.

    2. To provide identification numbers for the policy as specified by the intermediary, insurer and client.

    3. To specify coded attributes related to the policy, such as policy product code, scheme code.

    4. To specify dates related to the policy, such as inception date, expiry date.

    5. To specify monetary amounts related to the policy, such as indemnity limit.

    6. To specify references related to the policy, such as policy number, policy wording version number.

    7. To provide the response to coded questions relating to the policy.

    8. To provide text information related to the policy.

  11. Segment group 11
    Repeat 99

    1. To specify one type of document which is external to the message.

    2. To reference a party or object to which the document relates.

    3. To specify coded attributes relating to the document, such as document status code.

    4. To specify addresses relating to the document, such as place of issue.

    5. To specify a link to an external file that is related to the document.

    6. To specify references relating to the document, such as document reference, previous document reference.

    7. To specify dates relating to the document, such as date requested, date received.

    8. To specify monetary amounts relating to the document.

    9. To specify the response to coded questions relating to the document.

    10. To specify quantities relating to the document, such as number of pages, number of copies.

    11. To provide text information about the document, such as document description.

  12. Segment group 12
    Repeat 99

    1. To identify one party related to a claim described within this message.

    2. To specify identification numbers for the party which are used to link the party to other entities within the message.

    3. To specify coded attributes related to the party, such as value added tax status code, marital status code.

    4. To specify dates related to the party, such as date of birth, date of death.

    5. To provide measurements relating to the party, such as level of blood alcohol.

    6. To specify references related to the party, such as value added tax registration number.

    7. To provide the response to coded questions about the party.

    8. To specify percentages related to the party, such as party proportion of risk.

    9. To provide text information relating to the party.

    10. Segment group 13
      Repeat 99

      1. Provides a coded identification of one type of input or output component related to the party.

      2. To provide identification numbers for the party component that may be used to link the component to other entities.

      3. To specify address details for a party.

      4. To provide a set of financial account details for a party.

      5. To specify coded attributes relating to the party component, such as offence code, type of blood alcohol test code.

      6. To provide communication details relating to a party component, such as telephone and fax numbers at address.

      7. To specify dates relating to the party component, such as start date at address, length of sentence.

      8. To provide one set of employment details for a party.

      9. To specify monetary amounts relating to the party component, such as fine amount.

      10. To provide the response to coded questions relating to the party component.

      11. To specify quantities relating to the party component, such as total licence penalty points.

      12. To specify references relating to the party component, such as conviction reference, financial account number.

      13. To provide text information relating to the party component, such as offence description, employment description.

  13. Segment group 14
    Repeat 99

    1. To identify one risk object that is the subject of the claim.

    2. To provide identification numbers for the risk object that may be used to link the object to other entities within the message, such as cover.

    3. To specify reference numbers for the risk object, such as vehicle identification number, chassis number.

    4. To specify monetary amounts relating to the risk object, such as sum insured, replacement value.

    5. To specify percentages relating to the risk object.

    6. To specify tax/fee details relating to the risk object.

    7. To specify dates relating to the risk object, such as date first registered, date inspected.

    8. To specify a place/location related to the risk object.

    9. To specify coded attributes relating to the risk object, such as body type code, nature of occupancy.

    10. To specify measurements relating to the risk object, such as length, width, floor area.

    11. To specify quantities relating to the risk object, such as number of occupants, number of seats.

    12. To provide the response to coded questions about the risk object.

    13. To specify rate details relating to the risk object.

    14. To provide text descriptions relating to the risk object, such as object description, business usage of building description.

    15. Segment group 15
      Repeat 99

      1. To identify one charge or cost related to the risk object. To identify one charge or cost related to the risk object.

      2. To reference a party to whom the charge relates.

      3. To specify coded attributes relating to the cost or charge, such as method of calculation.

      4. To specify monetary amounts relating to the cost or charge, such as tax amount, discount amount.

      5. To specify percentages relating to the cost or charge.

      6. To provide text descriptions relating to the cost or charge.

      7. Segment group 16
        Repeat 99

        1. To identify one contribution or recovery related to the cost or charge.

        2. To reference a party to whom this contribution or recovery relates.

        3. To specify coded attributes relating to the contribution or recovery, such as contribution or recovery status code.

        4. To specify monetary amounts relating to the contribution or recovery, such as contribution or recovery amount.

        5. To specify percentages relating to the contribution or recovery, such as percentage of insurer's responsibility.

        6. To specify references relating to the contribution or recovery.

        7. To provide text descriptions relating to the contribution or recovery.

    16. Segment group 17
      Repeat 999

      1. Provides a coded identification of one type of component related to the risk object.

      2. To provide identification numbers for the risk object component which may be used to link the component to other entities.

      3. To specify addresses relating to the risk object.

      4. To specify coded attributes relating to the risk object component, such as severity of damage code, security device code.

      5. To specify communication numbers for the address, such as telephone, fax numbers.

      6. To specify the damage to the risk object.

      7. To specify dates relating to the risk object component, such as start date at address.

      8. To specify measurements relating to the risk object component.

      9. To specify monetary amounts relating to the risk object component, such as pre-incident value, resultant value.

      10. To specify percentages relating to the risk object component, such as percentage of under insurance, percentage of cost allocation.

      11. To specify the response to coded questions relating to the risk object component.

      12. To specify quantities relating to the risk object component.

      13. To specify references relating to the risk object component.

      14. To provide text information for the risk object component, such as specialist valuation description, explanation of a video image.

      15. Segment group 18
        Repeat 99

        1. To identify one charge relating to the loss or damage.

        2. To reference a party to whom this cost or charge relates.

        3. To specify coded attributes relating to the cost or charge, such as method of calculation.

        4. To specify monetary amounts relating to the cost or charge component, such as tax amount, discount amount.

        5. To specify percentages relating to the cost or charge component, such as cost or charge discount percentage.

        6. To provide text information about the cost or charge component.

        7. Segment group 19
          Repeat 99

          1. To identify one contribution or recovery component relating to the risk object component cost or charge.

          2. To reference a party to whom this contribution or recovery relates.

          3. To specify coded attributes relating to the contribution or recovery component, such as contribution or recovery status code.

          4. To specify monetary amounts relating to the contribution or recovery component, such as contribution or recovery amount.

          5. To specify percentages relating to the contribution or recovery component, such as percentage of insurer's liability.

          6. To provide references relating to the contribution or recovery component.

          7. To provide text information about the contribution or recovery component.

      16. Segment group 20
        Repeat 99

        1. To identify one part or task that relates to the risk object loss/damage component.

        2. To reference a party that relates to this part or task such as service provider.

        3. To specify coded attributes relating to the part or task item, such as paint system code, category of labour code.

        4. To specify dates relating to the part or task item, such as task/service start date.

        5. To specify measurements relating to the part or task item, such as tyre pressure, tyre tread depth.

        6. To specify percentages relating to the part or task.

        7. To specify the response to coded questions about the part or task item.

        8. To specify quantities relating to the part or task.

        9. To specify references relating to the part or task.

        10. To provide text information relating to the part or task, such as evidence of personal injury.

        11. Segment group 21
          Repeat 9

          1. To identify one charge related to the part or task item.

          2. To reference a party to whom this cost or charge relates.

          3. To specify coded attributes relating to the cost or charge, such as method of calculation.

          4. To specify monetary amounts relating to the cost or charge component, such as tax amount, discount amount.

          5. To specify percentages relating to the cost or charge component, such as cost or charge discount percentage.

          6. To provide text information about the cost or charge component.

          7. Segment group 22
            Repeat 99

            1. To identify one contribution or recovery component relating to the risk object cost or charge.

            2. To reference a party to whom this contribution or recovery relates.

            3. To specify coded attributes relating to the contribution or recovery component, such as contribution or recovery status code.

            4. To provide monetary amounts relating to the contribution or recovery component, such as contribution or recovery amount.

            5. To specify percentages relating to the contribution or recovery component, such as percentage of insurer's responsibility.

            6. To specify references relating to the contribution or recovery component.

            7. To provide text information relating to the contribution or recovery component.

  14. Segment group 23
    Repeat 99

    1. To identify one action related to the claim.

    2. To reference parties related to the claim.

    3. To specify coded attributes relating to the action, such as assessment report type, manner of settlement.

    4. To specify dates related to the action, such as date of report, date inspection to be performed.

    5. To specify monetary amounts related to the action, such as settlement amount.

    6. To provide the response to coded questions about the action.

    7. To specify references related to the action, such as instructor's assessment reference, assessor's assessment reference.

    8. To provide text information about the action, such as progress description, verdict description.

  15. Segment group 24
    Repeat 99

    1. Identifies the sequence of this period of previous insurance.

    2. To reference parties related to this period of insurance history.

    3. To specify coded attributes relating to the previous insurance history, such as policy class.

    4. To specify dates relating to the period of insurance history, such as inception date, expiry date.

    5. To specify references relating to the period of previous insurance history, such as policy number.

    6. Segment group 25
      Repeat 99

      1. To identify one prior loss that relates to the period of previous insurance.

      2. To reference party numbers for the prior loss as specified by the intermediary, insurer and client.

      3. To specify coded attributes relating to the prior loss, such as loss type, incident type.

      4. To specify dates relating to the prior loss, such as loss date, settlement date.

      5. To specify monetary amounts relating to the prior loss, such as loss amount.

      6. To specify the response to coded questions relating to the prior loss.

      7. To specify references for the prior loss, such as insurer's historical claim reference.

      8. To provide free text about the prior loss, such as prior loss description.

  16. 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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