D05A | EDIFACTORY

Message D05A/ICSOLI

Insurance claim solicitor's instruction message

The Insurance claim solicitor's instruction message is exchanged between insurers and solicitors acting on behalf of the insurer during claim dispute resolution. It allows the insurer to provide claim details and instructions and the solicitor to report progress and resolution details.

Message description

UNH

M(1) : Message header

A service segment starting and uniquely identifying a message. The message type code for the Insurance claim solicitor's instruction message is ICSOLI. Note: Insurance claim solicitor's instruction messages conforming to this document must contain the following data in segment UNH, composite S009: Data element 0065 ICSOLI 0052 D 0054 05A 0051 UN

BGM

M(1) : Beginning of message

To identify the purpose and status of the Insurance claim solicitor's instruction message, such as instruction, progress report, resolution details.

RFF

C(9) : Reference

To identify the version of the message implementation guide being used in the application.

SEQ

C(1) : Sequence details

To identify the sequence number of the message in a series of messages relating to the same claim, incident or action.

DTM

C(9) : Date/time/period

Contains the creation date of the message.

EFI

C(9) : External file link identification

To enable cross reference to electronic files containing photographic or video files associated with this message.

SG1 M(1) : ICD-MOA-ATT-RFF-DTM-QRS-FTX

Contains details of one policy under which the claim was reported. Required when the message type is instruction.

ICD

M(1) : Insurance cover description

To identify the class of policy.

MOA

C(9) : Monetary amount

Contains monetary amounts relating to the policy excesses and indemnity limits.

ATT

C(9) : Attribute

Identifies the type of indemnity provided, and the area of jurisdiction specified by the policy.

RFF

C(9) : Reference

To specify reference numbers which are specific to the policy, e.g. policy number.

DTM

C(9) : Date/time/period

To specify the start and end dates for the cover under the policy.

QRS

C(9) : Query and response

Used to convey whether indemnity is unlimited and whether there was a previous policy in force.

FTX

C(9) : Free text

Contains a text description of the reason why policy cover is at issue and the legal venue specified in the policy.

SG2 M(9) : PNA-RFF-EMP-DTM-PCD-QRS-FTX-COM-ATT-SG3-SG4-SG5

A group of segments used to identify all the parties involved in the transaction. The group will be used in all identified transaction types.

PNA

M(1) : Party identification

Contains the name of the party in text or a coded identification of the name and address of the party together with the role of the party in the message.

RFF

C(99) : Reference

To specify those references which are specific to the party, e.g. national insurance number.

EMP

C(9) : Employment details

Contains a coded description of the occupation or business of the party.

DTM

C(9) : Date/time/period

Indicates dates which are relevant to the party, e.g. date of birth, date exposure commenced.

PCD

C(9) : Percentage details

To specify percentages applicable to the party, e.g. co- insurers proportion.

QRS

C(9) : Query and response

Used to convey whether the party is registered for value added tax or under a legal disability.

FTX

C(1) : Free text

Provides a textual description of the function of a party in a message.

COM

C(9) : Communication contact

Provides the communication number and channel for a contact party. Note: where the communication details are linked to an address they should be included in the address group.

ATT

C(9) : Attribute

Contains a coded identification or text description of an attribute of the party, e.g. title, gender, trading status.

SG3 C(9) : ADR-COM

Contains address details for the party and communication information related to that address. Note: if the address is included in the coded identification of the party it does not need to be repeated here.

ADR

M(1) : Address

Contains the address type and details for the party.

COM

C(9) : Communication contact

Contains a communication number and type of communication for the party at the address, e.g. telephone number.

SG4 C(9) : ROD-MOA-FTX

Contains details and amounts relating to quantum applicable to the party in respect of damage, loss or injury caused to the party by the insured risk.

ROD

M(1) : Risk object type

Contains the type of quantum in respect of the damage, injury or loss caused to the party by the insured risk.

MOA

M(1) : Monetary amount

Contains the monetary amount and status of the quantum.

FTX

C(1) : Free text

Contains the text description of the type of quantum, required if non-standard and no code available.

SG5 C(99) : COD-ATT-IDE-RFF-DTM-MOA-EQN-QRS

Contains details of convictions sustained by the party.

COD

M(1) : Component details

Identifies the group as containing conviction information.

ATT

C(9) : Attribute

Identifies the type of sentence.

IDE

C(1) : Identity

Makes reference to other parties related to the offence.

RFF

C(9) : Reference

Contains a reference which uniquely identifies the conviction.

DTM

C(9) : Date/time/period

Contains the date of the conviction and periods relating to the conviction, e.g. length of disqualification.

MOA

C(9) : Monetary amount

Contains the monetary amount of a fine resulting from the conviction.

EQN

C(9) : Number of units

Contains the number of penalty points relating to the conviction.

QRS

C(9) : Query and response

Advises whether the conviction is related to the claim which is the subject of the message.

UNS

M(1) : Section control

A service segment placed at the start of the detail section to avoid segment collision.

SG6 C(9) : EVE-ADR-RFF-DTM-QRS-FTX-SG7

A group of segments containing details of the claim event.

EVE

M(1) : Event

Contains a qualifier identifying the segment as claim/loss.

ADR

C(9) : Address

Contains the location or addresses relevant to the claim event.

RFF

C(9) : Reference

Identifies the claim number.

DTM

C(9) : Date/time/period

Contains dates relating to the claim event, e.g. incident start and end date.

QRS

C(9) : Query and response

Used to convey information relevant to the claim such as whether the solicitor has delegated authority, whether aggregate indemnity/excess or indemnity is at issue, whether the claim is a recovery etc.

FTX

C(9) : Free text

Contains a text description of the claim. e.g. claim circumstances.

SG7 C(9) : ATT-MOA

Contains the type, status and amount of a recovery or the type and amount of reserve applicable to the claim.

ATT

M(1) : Attribute

Contains the type and status of a recovery or the type of reserve.

MOA

C(1) : Monetary amount

Contains the monetary amount of the reserve or recovery.

SG8 C(99) : PYT-MOA-PNA-FII-ATT-RFF

A group of segments containing information relating to payments in connection with the claim or dispute resolution.

PYT

M(1) : Payment terms

Contains a coded identification or textual description of the nature of the monetary value, also whether it is a payment or receipt.

MOA

M(9) : Monetary amount

Contains the payment/receipt amount.

PNA

C(1) : Party identification

Contains the full name of the payee.

FII

C(1) : Financial institution information

Contains the financial institution account number and sort code of the payee.

ATT

C(9) : Attribute

Contains a coded identification of the payment status, e.g. payment made, make payment etc.

RFF

C(9) : Reference

Contains the roll number, accounting reference of the payee and a coded identification of the party to whom the payment should be sent.

SG9 C(99) : COD-ATT-RFF-ADR-DTM-QRS-FTX-SG10

A group of segments containing information relating to a dispute resolution in connection with the claim.

COD

M(1) : Component details

Contains a coded identification of the method of dispute resolution, e.g. Crown Court, Civil County Court, mediation etc.

ATT

C(9) : Attribute

To specify coded attributes relating to the dispute resolution.

RFF

C(9) : Reference

Contains the reference of the dispute resolution.

ADR

C(9) : Address

Contains the address details or location where the dispute resolution is to be held. Note: this is used where the address or location is not related to a party, e.g. an inquest may be held at any suitable location such as a cinema or local hall.

DTM

C(9) : Date/time/period

Contains dates relevant to the dispute resolution e.g. proceedings issue date, dispute resolution date etc.

QRS

C(9) : Query and response

Used to request whether there are other proceedings in force.

FTX

C(9) : Free text

Contains a textual description of the dispute resolution or other proceedings.

SG10 C(99) : IMD-ATT-RFF-DTM-MOA-FTX

A group of segments containing information relating to progress in connection with a dispute resolution.

Message structure

UNH, Message header                           M        1
BGM, Beginning of message                     M        1
RFF, Reference                                C        9
SEQ, Sequence details                         C        1
DTM, Date/time/period                         C        9
EFI, External file link identification        C        9

--- Segment Group 1 ------------------------- M        1 -------+
ICD, Insurance cover description              M        1        |
MOA, Monetary amount                          C        9        |
ATT, Attribute                                C        9        |
RFF, Reference                                C        9        |
DTM, Date/time/period                         C        9        |
QRS, Query and response                       C        9        |
FTX, Free text                                C        9        |
---- -----------------------------------------------------------+

--- Segment Group 2 ------------------------- M        9 -------+
PNA, Party identification                     M        1        |
RFF, Reference                                C       99        |
EMP, Employment details                       C        9        |
DTM, Date/time/period                         C        9        |
PCD, Percentage details                       C        9        |
QRS, Query and response                       C        9        |
FTX, Free text                                C        1        |
COM, Communication contact                    C        9        |
ATT, Attribute                                C        9        |
                                                                |
--- Segment Group 3 ------------------------- C        9 ------+|
ADR, Address                                  M        1       ||
COM, Communication contact                    C        9       ||
---- ----------------------------------------------------------+|
                                                                |
--- Segment Group 4 ------------------------- C        9 ------+|
ROD, Risk object type                         M        1       ||
MOA, Monetary amount                          M        1       ||
FTX, Free text                                C        1       ||
---- ----------------------------------------------------------+|
                                                                |
--- Segment Group 5 ------------------------- C       99 ------+|
COD, Component details                        M        1       ||
ATT, Attribute                                C        9       ||
IDE, Identity                                 C        1       ||
RFF, Reference                                C        9       ||
DTM, Date/time/period                         C        9       ||
MOA, Monetary amount                          C        9       ||
EQN, Number of units                          C        9       ||
QRS, Query and response                       C        9       ||
---- ----------------------------------------------------------++
UNS, Section control                          M        1

--- Segment Group 6 ------------------------- C        9 -------+
EVE, Event                                    M        1        |
ADR, Address                                  C        9        |
RFF, Reference                                C        9        |
DTM, Date/time/period                         C        9        |
QRS, Query and response                       C        9        |
FTX, Free text                                C        9        |
                                                                |
--- Segment Group 7 ------------------------- C        9 ------+|
ATT, Attribute                                M        1       ||
MOA, Monetary amount                          C        1       ||
---- ----------------------------------------------------------++

--- Segment Group 8 ------------------------- C       99 -------+
PYT, Payment terms                            M        1        |
MOA, Monetary amount                          M        9        |
PNA, Party identification                     C        1        |
FII, Financial institution information        C        1        |
ATT, Attribute                                C        9        |
RFF, Reference                                C        9        |
---- -----------------------------------------------------------+

--- Segment Group 9 ------------------------- C       99 -------+
COD, Component details                        M        1        |
ATT, Attribute                                C        9        |
RFF, Reference                                C        9        |
ADR, Address                                  C        9        |
DTM, Date/time/period                         C        9        |
QRS, Query and response                       C        9        |
FTX, Free text                                C        9        |
                                                                |
--- Segment Group 10 ------------------------ C       99 ------+|
IMD, Item description                         M        1       ||
ATT, Attribute                                C        9       ||
RFF, Reference                                C        9       ||
DTM, Date/time/period                         C        9       ||
MOA, Monetary amount                          C        9       ||
FTX, Free text                                C        9       ||
---- ----------------------------------------------------------++
UNT, Message trailer                          M        1