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

1. 010 · ST · Transaction Set Header · Max 1 · Mandatory

   To indicate the start of a transaction set and to assign a control number

2. 020 · BGN · Beginning Segment · Max 1 · Mandatory

   To indicate the beginning of a transaction set.

3. 030 · DTP · Date or Time or Period · Max 10 · Optional

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

4. 1000 Loop Optional Repeat >1

   1. 040 · N9 · Reference Number · Max 1 · Mandatory

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

   2. 050 · MSG · Message Text · Max >1 · Optional

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

5. 1100 Loop Optional Repeat 15

   1. 060 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

      To supply the full name of an individual or organizational entity

   2. 070 · N2 · Additional Name Information · Max 2 · Optional

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

   3. 080 · N3 · Address Information · Max 2 · Optional

      To specify the location of the named party

   4. 090 · N4 · Geographic Location · Max 1 · Optional

      To specify the geographic place of the named party

   5. 100 · N9 · Reference Number · Max 15 · Optional

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

   6. 110 · PER · Administrative Communications Contact · Max 5 · Optional

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

Detail

1. 2000 Loop Mandatory Repeat >1

   1. 010 · LID · Loss Information Description · Max 1 · Mandatory

      To provide details on a specific insurance claim

   2. 020 · DTP · Date or Time or Period · Max 10 · Optional

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

   3. 030 · BCI · Basic Claim Information · Max 1 · Optional

      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. 040 · SI · Service Characteristic Identification · Max 2 · Optional

      To specify service characteristic data

   5. 2100 Loop Optional Repeat 1

      1. 050 · LIE · Individual or Event Location · Max 1 · Mandatory

         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. 060 · N3 · Address Information · Max 1 · Optional

         To specify the location of the named party

      3. 070 · N4 · Geographic Location · Max 1 · Optional

         To specify the geographic place of the named party

   6. 2200 Loop Optional Repeat >1

      1. 080 · N9 · Reference Number · Max 1 · Mandatory

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

      2. 090 · MSG · Message Text · Max >1 · Optional

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

   7. 2300 Loop Optional Repeat >1

      1. 100 · PWK · Paperwork · Max 1 · Mandatory

         To identify the type and transmission of paperwork or supporting information

      2. 110 · DTP · Date or Time or Period · Max 1 · Optional

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

      3. 120 · N9 · Reference Number · Max 5 · Optional

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

      4. 130 · N4 · Geographic Location · Max 1 · Optional

         To specify the geographic place of the named party

      5. 140 · NM1 · Individual or Organizational Name · Max 1 · Optional

         To supply the full name of an individual or organizational entity

      6. 150 · PER · Administrative Communications Contact · Max 1 · Optional

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

   8. 160 · LS · Loop Header · Max 1 · Optional

      To indicate that the next segment begins a loop

   9. 2400 Loop Optional Repeat 10

      1. 170 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

         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. 180 · N2 · Additional Name Information · Max 2 · Optional

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

      3. 190 · N3 · Address Information · Max 2 · Optional

         To specify the location of the named party

      4. 200 · N4 · Geographic Location · Max 1 · Optional

         To specify the geographic place of the named party

      5. 210 · N9 · Reference Number · Max 15 · Optional

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

      6. 220 · PER · Administrative Communications Contact · Max 5 · Optional

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

      7. 2410 Loop Optional Repeat 1

         1. 230 · LIE · Individual or Event Location · Max 1 · Mandatory

            To provide an accurate description of where an individual was located or an event took place

         2. 240 · N3 · Address Information · Max 1 · Optional

            To specify the location of the named party

         3. 250 · N4 · Geographic Location · Max 1 · Optional

            To specify the geographic place of the named party

   10. 260 · LE · Loop Trailer · Max 1 · Optional

       To indicate that the loop immediately preceding this segment is complete

   11. 2500 Loop Optional Repeat >1

       1. 270 · LX · Assigned Number · Max 1 · Mandatory

          To reference a line number in a transaction set.

          This Assigned Number (LX) loop is used to specify information about a loss exposure.

       2. 280 · VEH · Vehicle Information · Max 1 · Optional

          To provide descriptions that identify a specific vehicle

       3. 290 · VAT · Vehicle Attribute · Max 100 · Optional

          Identifies attributes associated with a vehicle

       4. 300 · N9 · Reference Number · Max >1 · Optional

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

       5. 310 · DVI · Dynamic Vehicle Information · Max 1 · Optional

          To provide dynamic information pertaining to a vehicle

       6. 320 · VRC · Vehicle Recovery · Max 1 · Optional

          To provide information about the recovery of a vehicle

       7. 330 · DAM · Damage Information · Max >1 · Optional

          To identify the part of the vehicle that was damaged

       8. 2510 Loop Optional Repeat 1

          1. 340 · LIE · Individual or Event Location · Max 1 · Mandatory

             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. 350 · N3 · Address Information · Max 1 · Optional

             To specify the location of the named party

          3. 360 · N4 · Geographic Location · Max 1 · Optional

             To specify the geographic place of the named party

       9. 2520 Loop Optional Repeat >1

          1. 370 · NX1 · Property or Entity Identification · Max 1 · Mandatory

             To define the attributes of a property or an entity

             This NX1 loop is used to specify information pertinent to an involved party.

          2. 380 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

             To supply the full name of an individual or organizational entity

          3. 390 · N2 · Additional Name Information · Max 2 · Optional

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

          4. 400 · N3 · Address Information · Max 2 · Optional

             To specify the location of the named party

          5. 410 · N4 · Geographic Location · Max 1 · Optional

             To specify the geographic place of the named party

          6. 420 · N9 · Reference Number · Max 10 · Optional

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

          7. 430 · PER · Administrative Communications Contact · Max 10 · Optional

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

          8. 440 · ICH · Individual Characteristics · Max 1 · Optional

             To provide personal information on an individual

          9. 450 · CRC · Conditions Indicator · Max >1 · Optional

             To supply information on conditions

          10. 460 · BCI · Basic Claim Information · Max 1 · Optional

              To identify information basic to the processing of any claims transaction

          11. 2525 Loop Optional Repeat >1

              1. 470 · LQ · Industry Code · Max 1 · Mandatory

                 Code to transmit standard industry codes

              2. 480 · DTP · Date or Time or Period · Max 5 · Optional

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

              3. 490 · AMT · Monetary Amount · Max 5 · Optional

                 To indicate the total monetary amount.

              4. 500 · PCT · Percent Amounts · Max 5 · Optional

                 To qualify percent amounts, and supply percent amounts

              5. 510 · LS · Loop Header · Max 1 · Optional

                 To indicate that the next segment begins a loop

              6. 2528 Loop Optional Repeat >1

                 1. 520 · LQ · Industry Code · Max 1 · Mandatory

                    Code to transmit standard industry codes

                 2. 530 · AMT · Monetary Amount · Max 5 · Optional

                    To indicate the total monetary amount.

                 3. 540 · PCT · Percent Amounts · Max 5 · Optional

                    To qualify percent amounts, and supply percent amounts

              7. 550 · LE · Loop Trailer · Max 1 · Optional

                 To indicate that the loop immediately preceding this segment is complete

              8. 2600 Loop Optional Repeat >1

                 1. 560 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

                    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. 570 · N2 · Additional Name Information · Max 2 · Optional

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

                 3. 580 · N3 · Address Information · Max 2 · Optional

                    To specify the location of the named party

                 4. 590 · N4 · Geographic Location · Max 1 · Optional

                    To specify the geographic place of the named party

                 5. 600 · N9 · Reference Number · Max 10 · Optional

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

                 6. 610 · PER · Administrative Communications Contact · Max 10 · Optional

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

                 7. 620 · ICH · Individual Characteristics · Max 1 · Optional

                    To provide personal information on an individual

                 8. 630 · CRC · Conditions Indicator · Max >1 · Optional

                    To supply information on conditions

                 9. 640 · BCI · Basic Claim Information · Max 1 · Optional

                    To identify information basic to the processing of any claims transaction

                 10. 2610 Loop Optional Repeat >1

                     1. 650 · III · Information · Max 1 · Mandatory

                        To report optionally codified information

                     2. 660 · DTP · Date or Time or Period · Max 5 · Optional

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

                     3. 670 · AMT · Monetary Amount · Max 5 · Optional

                        To indicate the total monetary amount.

                     4. 680 · PCT · Percent Amounts · Max 5 · Optional

                        To qualify percent amounts, and supply percent amounts

                     5. 690 · LS · Loop Header · Max 1 · Optional

                        To indicate that the next segment begins a loop

                     6. 2615 Loop Optional Repeat >1

                        1. 700 · LQ · Industry Code · Max 1 · Mandatory

                           Code to transmit standard industry codes

                        2. 710 · AMT · Monetary Amount · Max 5 · Optional

                           To indicate the total monetary amount.

                        3. 720 · PCT · Percent Amounts · Max 5 · Optional

                           To qualify percent amounts, and supply percent amounts

                 11. 730 · LE · Loop Trailer · Max 1 · Optional

                     To indicate that the loop immediately preceding this segment is complete

       10. 2700 Loop Optional Repeat 5

           1. 740 · PIN · Previous Incident · Max 1 · Mandatory

              To identify details of previous insurance losses

           2. 750 · BCI · Basic Claim Information · Max 1 · Mandatory

              To identify information basic to the processing of any claims transaction

           3. 760 · N3 · Address Information · Max 2 · Optional

              To specify the location of the named party

           4. 770 · N4 · Geographic Location · Max 1 · Optional

              To specify the geographic place of the named party

           5. 2710 Loop Optional Repeat >1

              1. 780 · PWK · Paperwork · Max 1 · Mandatory

                 To identify the type and transmission of paperwork or supporting information

              2. 790 · DTP · Date or Time or Period · Max 1 · Optional

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

              3. 800 · N9 · Reference Number · Max 5 · Optional

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

              4. 810 · N4 · Geographic Location · Max 1 · Optional

                 To specify the geographic place of the named party

              5. 820 · NM1 · Individual or Organizational Name · Max 1 · Optional

                 To supply the full name of an individual or organizational entity

              6. 830 · PER · Administrative Communications Contact · Max 1 · Optional

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

2. 840 · SE · Transaction Set Trailer · Max 1 · Mandatory

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