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

1. 0100 · ST · Transaction Set Header · Max 1 · Mandatory

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

2. 0200 · BGN · Beginning Segment · Max 1 · Mandatory

   To indicate the beginning of a transaction set

3. 0300 · DTP · Date or Time or Period · Max 1 · Optional

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

4. 0400 · C3 · Currency · Max 1 · Optional

   To specify the currency being used in the transaction set

5. 1000 Loop Optional Repeat >1

   1. 0500 · SUP · Supplementary Information · Max 1 · Mandatory

      To provide processible supplementary information

   2. 0600 · MSG · Message Text · Max >1 · Optional

      To provide a free-form format that allows the transmission of text information

   3. 1100 Loop Mandatory Repeat >1

      1. 0700 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

         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.

      2. 0800 · N2 · Additional Name Information · Max 1 · Optional

         To specify additional names

      3. 0900 · N3 · Address Information · Max 1 · Optional

         To specify the location of the named party

      4. 1000 · N4 · Geographic Location · Max 1 · Optional

         To specify the geographic place of the named party

      5. 1100 · PER · Administrative Communications Contact · Max >1 · Optional

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

Detail

1. 2000 Loop Mandatory Repeat >1

   1. 0100 · HL · Hierarchical Level · Max 1 · Mandatory

      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.

   2. 0200 · N9 · Reference Identification · Max >1 · Optional

      To transmit identifying information as specified by the Reference Identification Qualifier

   3. 0300 · K2 · Administrative Message · Max 1 · Optional

      To transmit information in a free-form format for comment or special instruction

   4. 0400 · QTY · Quantity · Max 1 · Optional

      To specify quantity information

   5. 0500 · DTP · Date or Time or Period · Max >1 · Optional

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

   6. 0600 · TXI · Tax Information · Max 1 · Optional

      To specify tax information

   7. 2100 Loop Optional Repeat >1

      1. 0700 · LM · Code Source Information · Max 1 · Mandatory

         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.

      2. 0800 · SLN · Subline Item Detail · Max 1 · Mandatory

         To specify product subline detail item data

      3. 0900 · AMT · Monetary Amount · Max >1 · Optional

         To indicate the total monetary amount

      4. 0950 · DTP · Date or Time or Period · Max >1 · Optional

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

   8. 2200 Loop Optional Repeat >1

      1. 1000 · III · Information · Max 1 · Mandatory

         To report information

      2. 1100 · AMT · Monetary Amount · Max >1 · Optional

         To indicate the total monetary amount

      3. 1200 · PCT · Percent Amounts · Max 1 · Optional

         To qualify percent amounts and supply percent amounts

   9. 2300 Loop Optional Repeat >1

      1. 1300 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

         To supply the full name of an individual or organizational entity

      2. 1400 · N2 · Additional Name Information · Max 1 · Optional

         To specify additional names

      3. 1500 · N3 · Address Information · Max 1 · Optional

         To specify the location of the named party

      4. 1600 · N4 · Geographic Location · Max 1 · Optional

         To specify the geographic place of the named party

      5. 1700 · MS1 · Equipment, Shipment, or Real Property Location · Max 1 · Optional

         To specify the location of a piece of equipment, a shipment, or real property in terms of city and state or longitude and latitude or postal code

      6. 1800 · PER · Administrative Communications Contact · Max >1 · Optional

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

   10. 2400 Loop Optional Repeat >1

       1. 1900 · CID · Characteristic/Class ID · Max 1 · Mandatory

          To specify the general class or specific characteristic upon which test results are being reported or are to be taken

       2. 2000 · MEA · Measurements · Max >1 · Optional

          To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)

2. 2100 · 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)