EDI 112 Property Damage Report
Functional Group PQ
X12N Insurance Subcommittee
This Draft Standard for Trial Use contains the format and establishes the data contents of the Property Damage Report Transaction Set (112) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set will be used to provide property damage information between property and casualty insurance companies, independent agents, service and information providers. This information includes, but is not limited to providing cost estimates involving functions such as demolishing, new constructions, damage repair and replacement.
Heading
- 0100Transaction Set HeaderMandatoryMax 1
To indicate the start of a transaction set and to assign a control number
- 0200Beginning SegmentMandatoryMax 1
To indicate the beginning of a transaction set
- 0300Date or Time or PeriodOptionalMax 1
To specify any or all of a date, a time, or a time period
- 0400CurrencyOptionalMax 1
To specify the currency being used in the transaction set
- 1000 Loop OptionalRepeat >1
- 0500Supplementary InformationMandatoryMax 1
To provide processible supplementary information
- 0600Message TextOptionalMax >1
To provide a free-form format that allows the transmission of text information
- 1100 Loop MandatoryRepeat >1
- 0700Individual or Organizational NameMandatoryMax 1
To supply the full name of an individual or organizational entity
Loop 1100 is used to identify the specific entity related to the Supplementary Information. - 0800Additional Name InformationOptionalMax 1
To specify additional names
- 0900Address InformationOptionalMax 1
To specify the location of the named party
- 1000Geographic LocationOptionalMax 1
To specify the geographic place of the named party
- 1100Administrative Communications ContactOptionalMax >1
To identify a person or office to whom administrative communications should be directed
- 0700Individual or Organizational NameMandatoryMax 1
- 0500Supplementary InformationMandatoryMax 1
Detail
- 2000 Loop MandatoryRepeat >1
- 0100Hierarchical LevelMandatoryMax 1
To identify dependencies among and the content of hierarchically related groups of data segments
HL01 (Hierarchical ID Number) will be assigned sequentially within the hierarchy starting with one and incremented by one for each HL segment.HL03 (Hierarchical Level Code) may only contain the codes: AD (Administrative Information), FI (Financial Information), GC (Group Coverage Options), V (Name and Address Information), BD (Building), UT (Unit or Lot), RM (Room), SR (Subroom), EX (Exception), PS (Property Segment Group), PB (Personal Property), and 9 (Line Item).The AD (Administrative Information Level) is mandatory. All other levels are optional.The levels BD (Building), UT (Unit or Lot), RM (Room), SR (Subroom), EX (Exception), PS (Property Segment Group), PB (Personal Property), and 9 (Line Item), must always appear (in the transaction set), in the above order, e.g., the Building level cannot be subordinate to the Room level, however the Building level may be omitted.V (Name and Address Information) level may be used as a subordinate level to level 9 (Line Item) in order to identify a specific vendor related to the line item. - 0200Reference IdentificationOptionalMax 1
To transmit identifying information as specified by the Reference Identification Qualifier
- 0300Administrative MessageOptionalMax 1
To transmit information in a free-form format for comment or special instruction
- 0400QuantityOptionalMax 1
To specify quantity information
- 0500Date or Time or PeriodOptionalMax 1
To specify any or all of a date, a time, or a time period
- 0600Tax InformationOptionalMax 1
To specify tax information
- 2100 Loop OptionalRepeat >1
- 0700Code Source InformationMandatoryMax 1
To transmit standard code list identification information
The LM is used in the Line Item Hierarchical Level. The Agency Qualifier Code will identify the Agency whose code list will be used to identify the Product/Service in the SLN. - 0800Subline Item DetailMandatoryMax 1
To specify product subline detail item data
- 0900Monetary AmountOptionalMax >1
To indicate the total monetary amount
- 0950Date or Time or PeriodOptionalMax >1
To specify any or all of a date, a time, or a time period
- 0700Code Source InformationMandatoryMax 1
- 2200 Loop OptionalRepeat >1
- 1000InformationMandatoryMax 1
To report information
- 1100Monetary AmountOptionalMax >1
To indicate the total monetary amount
- 1200Percent AmountsOptionalMax 1
To qualify percent amounts and supply percent amounts
- 1000InformationMandatoryMax 1
- 2300 Loop OptionalRepeat >1
- 1300Individual or Organizational NameMandatoryMax 1
To supply the full name of an individual or organizational entity
- 1400Additional Name InformationOptionalMax 1
To specify additional names
- 1500Address InformationOptionalMax 1
To specify the location of the named party
- 1600Geographic LocationOptionalMax 1
To specify the geographic place of the named party
- 1700Equipment, Shipment, or Real Property LocationOptionalMax 1
To specify the location of a piece of equipment, a shipment, or real property in terms of city and state or longitude and latitude
- 1800Administrative Communications ContactOptionalMax >1
To identify a person or office to whom administrative communications should be directed
- 1300Individual or Organizational NameMandatoryMax 1
- 2400 Loop OptionalRepeat >1
- 1900Characteristic/Class IDMandatoryMax 1
To specify the general class or specific characteristic upon which test results are being reported or are to be taken
- 2000MeasurementsOptionalMax >1
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
- 1900Characteristic/Class IDMandatoryMax 1
- 0100Hierarchical LevelMandatoryMax 1
- 2100Transaction Set TrailerMandatoryMax 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)