UNH M 1 MESSAGE HEADER

  • Mandatory
  • Max repeat: 1
A service segment starting and uniquely identifying a message. The message type code for the Insurance premium payment message is PRPAID.
0062
MESSAGE REFERENCE NUMBER
  • Mandatory
  • Type: an
  • Length: 0..14
Unique message reference assigned by the sender.
S009
MESSAGE IDENTIFIER
  • Mandatory
Identification of the type, version, etc. of the message being interchanged.
0065
Message type
  • Mandatory
  • Type: an
  • Length: 0..6
Code identifying a type of message and assigned by its controlling agency.
0052
Message version number
  • Mandatory
  • Type: an
  • Length: 0..3
Version number of a message type.
0054
Message release number
  • Mandatory
  • Type: an
  • Length: 0..3
Release number within the current message version number.
0051
Controlling agency, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.
0057
Association assigned code
  • Conditional
  • Type: an
  • Length: 0..6
Code, assigned by the association responsible for the design and maintenance of the message type concerned, which further identifies the message.
0110
Code list directory version number
  • Conditional
  • Type: an
  • Length: 0..6
Version number of the code list directory.
0113
Message type sub-function identification
  • Conditional
  • Type: an
  • Length: 0..6
Code identifying a sub-function of a message type.
0068
COMMON ACCESS REFERENCE
  • Conditional
  • Type: an
  • Length: 0..35
Reference serving as a key to relate all subsequent transfers of data to the same business case or file.
S010
STATUS OF THE TRANSFER
  • Conditional
Statement that the message is one in a sequence of transfers relating to the same topic.
0070
Sequence of transfers
  • Mandatory
  • Type: n
  • Length: 0..2
Number assigned by the sender indicating the transfer sequence of a message related to the same topic. The message could be an addition or a change to an earlier transfer related to the same topic.
0073
First and last transfer
  • Conditional
  • Type: a
  • Length: 1
Indication used for the first and last message in a sequence of messages related to the same topic.
S016
MESSAGE SUBSET IDENTIFICATION
  • Conditional
Identification of a message subset by its identifier, version, release and source.
0115
Message subset identification
  • Mandatory
  • Type: an
  • Length: 0..14
Coded identification of a message subset, assigned by its controlling agency.
0116
Message subset version number
  • Conditional
  • Type: an
  • Length: 0..3
Version number of the message subset.
0118
Message subset release number
  • Conditional
  • Type: an
  • Length: 0..3
Release number within the message subset version number.
0051
Controlling agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.
S017
MESSAGE IMPLEMENTATION GUIDELINE IDENTIFICATION
  • Conditional
Identification of a message implementation guideline by its identifier, version, release and source.
0121
Message implementation guideline identification
  • Mandatory
  • Type: an
  • Length: 0..14
Coded identification of the message implementation guideline, assigned by its controlling agency.
0122
Message implementation guideline version number
  • Conditional
  • Type: an
  • Length: 0..3
Version number of the message implementation guideline.
0124
Message implementation guideline release number
  • Conditional
  • Type: an
  • Length: 0..3
Release number within the message implementation guideline version number.
0051
Controlling agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.
S018
SCENARIO IDENTIFICATION
  • Conditional
Identification of a scenario.
0127
Scenario identification
  • Mandatory
  • Type: an
  • Length: 0..14
Code identifying scenario.
0128
Scenario version number
  • Conditional
  • Type: an
  • Length: 0..3
Version number of a scenario.
0130
Scenario release number
  • Conditional
  • Type: an
  • Length: 0..3
Release number within the scenario version number.
0051
Controlling agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.

BGM C 1 BEGINNING OF MESSAGE

  • Conditional
  • Max repeat: 1
A segment for specifying message name and function.
C002
DOCUMENT/MESSAGE NAME
  • Conditional
Identification of a type of document/message by code or name. Code preferred.
1001
Document/message name, coded
  • Conditional
  • Type: an
  • Length: 0..3
Document/message identifier expressed in code.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
1000
Document/message name
  • Conditional
  • Type: an
  • Length: 0..35
Plain language identifier specifying the function of a document/message.
C106
DOCUMENT/MESSAGE IDENTIFICATION
  • Conditional
Identification of a document/message by its number and eventually its version or revision.
1004
Document/message number
  • Conditional
  • Type: an
  • Length: 0..35
Reference number assigned to the document/message by the issuer.
1056
Version
  • Conditional
  • Type: an
  • Length: 0..9
To specify the version number or name of an object.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.
1225
MESSAGE FUNCTION, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating the function of the message.
4343
RESPONSE TYPE, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of acknowledgment required or transmitted.

GIS M 1 GENERAL INDICATOR

  • Mandatory
  • Max repeat: 1
A segment containing the indication of the type of the Insurance Premium Payment message.
C529
PROCESSING INDICATOR
  • Mandatory
Type of process indication.
7365
Processing indicator, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Identifies the value to be attributed to indicators required by the processing system.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
7187
Process type identification
  • Conditional
  • Type: an
  • Length: 0..17
Specification of a process or subprocess.

RFF M 9 REFERENCE

  • Mandatory
  • Max repeat: 9
A segment containing identifying numbers of the Insurance Premium Payment message or of the statement or the bordereau.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a reference segment or a reference number.
1154
Reference number
  • Conditional
  • Type: an
  • Length: 0..35
Identification number the nature and function of which can be qualified by an entry in data element 1153 Reference qualifier.
1156
Line number
  • Conditional
  • Type: an
  • Length: 0..6
Number of the line in the document/message referenced in 1154 Reference number.
4000
Reference version number
  • Conditional
  • Type: an
  • Length: 0..35
To uniquely identify a reference by its version number.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.

DTM M 9 DATE/TIME/PERIOD

  • Mandatory
  • Max repeat: 9
A segment specifying dates related to the Insurance Premium Payment message or to the statement or the bordereau.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date/time/period qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a date, time or period.
2380
Date/time/period
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date/time/period format qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Specification of the representation of a date, a date and time or of a period.

ICD C 1 INSURANCE COVER DESCRIPTION

  • Conditional
  • Max repeat: 1
The main class of business for premiums or claims within the message.
C330
INSURANCE COVER TYPE
  • Mandatory
To provide the insurance cover type.
4497
Insurance cover type, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the meaning of the insurance cover.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C331
INSURANCE COVER DETAILS
  • Mandatory
To provide the insurance cover details.
4495
Insurance cover identification
  • Conditional
  • Type: an
  • Length: 0..17
Coded identification of the insurance cover.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
4494
Insurance cover
  • Conditional
  • Type: an
  • Length: 0..35
Identification of the insurance cover.
4494
Insurance cover
  • Conditional
  • Type: an
  • Length: 0..35
Identification of the insurance cover.

GRP1 M 9 NAD CTA COM RFF

  • Mandatory
  • Max repeat: 9
A group of segments providing identification, names and addresses, contacts and references of the parties involved in the exchange of the message.

NAD M 1 NAME AND ADDRESS

  • Mandatory
  • Max repeat: 1
A segment for identifying either by names and addresses, or by codes, the parties and their function in the exchange of the Insurance Premium Payment message.
3035
PARTY QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identification
  • Mandatory
  • Type: an
  • Length: 0..35
Code identifying a party involved in a transaction.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C058
NAME AND ADDRESS
  • Conditional
Unstructured name and address: one to five lines.
3124
Name and address line
  • Mandatory
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
C080
PARTY NAME
  • Conditional
Identification of a transaction party by name, one to five lines. Party name may be formatted.
3036
Party name
  • Mandatory
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3045
Party name format, coded
  • Conditional
  • Type: an
  • Length: 0..3
Specification of the representation of a party name.
C059
STREET
  • Conditional
Street address and/or PO Box number in a structured address: one to four lines.
3042
Street and number/p.o. box
  • Mandatory
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3042
Street and number/p.o. box
  • Conditional
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3042
Street and number/p.o. box
  • Conditional
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3042
Street and number/p.o. box
  • Conditional
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3164
CITY NAME
  • Conditional
  • Type: an
  • Length: 0..35
Name of a city (a town, a village) for addressing purposes.
3229
COUNTRY SUB-ENTITY IDENTIFICATION
  • Conditional
  • Type: an
  • Length: 0..9
Identification of the name of sub-entities (state, province) defined by appropriate governmental agencies.
3251
POSTCODE IDENTIFICATION
  • Conditional
  • Type: an
  • Length: 0..9
Code defining postal zones or addresses.
3207
COUNTRY, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of a country or other geographical entity as specified in ISO 3166.

CTA C 1 CONTACT INFORMATION

  • Conditional
  • Max repeat: 1
A segment giving additional contact information of the party specified in the NAD segment.
3139
CONTACT FUNCTION, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of a contact (e.g. department or person).
C056
DEPARTMENT OR EMPLOYEE DETAILS
  • Conditional
Code and/or name of a department or employee. Code preferred.
3413
Department or employee identification
  • Conditional
  • Type: an
  • Length: 0..17
Internal identification code.
3412
Department or employee
  • Conditional
  • Type: an
  • Length: 0..35
The department or person within an organizational entity.

COM C 3 COMMUNICATION CONTACT

  • Conditional
  • Max repeat: 3
A segment specifying the communication channel and number for the contact specified in the CTA.
C076
COMMUNICATION CONTACT
  • Mandatory
Communication number of a department or employee in a specified channel.
3148
Communication number
  • Mandatory
  • Type: an
  • Length: 0..512
The communication number.
3155
Communication channel qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code identifying the type of communication channel being used.

RFF C 9 REFERENCE

  • Conditional
  • Max repeat: 9
A segment for additional identifying references of the party specified in the NAD.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a reference segment or a reference number.
1154
Reference number
  • Conditional
  • Type: an
  • Length: 0..35
Identification number the nature and function of which can be qualified by an entry in data element 1153 Reference qualifier.
1156
Line number
  • Conditional
  • Type: an
  • Length: 0..6
Number of the line in the document/message referenced in 1154 Reference number.
4000
Reference version number
  • Conditional
  • Type: an
  • Length: 0..35
To uniquely identify a reference by its version number.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.

GRP2 C 9999 DOC GRP3 DTM NAD GRP4 RFF GRP5 GRP6 CUX

  • Conditional
  • Max repeat: 9999
A group of segments providing detailed information concerning individual insurance premiums.

DOC M 1 DOCUMENT/MESSAGE DETAILS

  • Mandatory
  • Max repeat: 1
A segment providing a unique identification of an Insurance Premium message or a statement line.
C002
DOCUMENT/MESSAGE NAME
  • Mandatory
Identification of a type of document/message by code or name. Code preferred.
1001
Document/message name, coded
  • Conditional
  • Type: an
  • Length: 0..3
Document/message identifier expressed in code.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
1000
Document/message name
  • Conditional
  • Type: an
  • Length: 0..35
Plain language identifier specifying the function of a document/message.
C503
DOCUMENT/MESSAGE DETAILS
  • Conditional
Identification of document/message by number, status, source and/or language.
1004
Document/message number
  • Conditional
  • Type: an
  • Length: 0..35
Reference number assigned to the document/message by the issuer.
1373
Document/message status, coded
  • Conditional
  • Type: an
  • Length: 0..3
To identify the status of a document/message.
1366
Document/message source
  • Conditional
  • Type: an
  • Length: 0..70
Indication of the source from which the printed information is to be or has been obtained.
3453
Language, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code of language (ISO 639-1988).
1056
Version
  • Conditional
  • Type: an
  • Length: 0..9
To specify the version number or name of an object.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.
3153
COMMUNICATION CHANNEL IDENTIFIER, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the type of communication channel being used.
1220
NUMBER OF COPIES OF DOCUMENT REQUIRED
  • Conditional
  • Type: n
  • Length: 0..2
Number of originals or copies of a document stipulated or referred to as being required.
1218
NUMBER OF ORIGINALS OF DOCUMENT REQUIRED
  • Conditional
  • Type: n
  • Length: 0..2
Specification of the number of originals of a stipulated document that are required.

GRP3 C 1 GIS FTX

  • Conditional
  • Max repeat: 1
A group of segments providing the paid/partly paid/not paid indicator and the reason for partly or non payment.

GIS M 1 GENERAL INDICATOR

  • Mandatory
  • Max repeat: 1
A segment providing the paid/partly paid/not paid indicator.
C529
PROCESSING INDICATOR
  • Mandatory
Type of process indication.
7365
Processing indicator, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Identifies the value to be attributed to indicators required by the processing system.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
7187
Process type identification
  • Conditional
  • Type: an
  • Length: 0..17
Specification of a process or subprocess.

FTX C 1 FREE TEXT

  • Conditional
  • Max repeat: 1
A segment providing the reason for partly or non payment.
4451
TEXT SUBJECT QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying subject of a free text.
4453
TEXT FUNCTION, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the purpose of the text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text identification
  • Mandatory
  • Type: an
  • Length: 0..17
Free text in coded form.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..70
Free text field available to the message sender for information.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..70
Free text field available to the message sender for information.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..70
Free text field available to the message sender for information.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..70
Free text field available to the message sender for information.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..70
Free text field available to the message sender for information.
3453
LANGUAGE, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code of language (ISO 639-1988).
4447
TEXT FORMATTING, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the formatting parameters for the text.

DTM C 9 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 9
A segment specifying dates related to the insurance premium.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date/time/period qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a date, time or period.
2380
Date/time/period
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date/time/period format qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Specification of the representation of a date, a date and time or of a period.

NAD C 9 NAME AND ADDRESS

  • Conditional
  • Max repeat: 9
A segment specifying the policy holder or the insured.
3035
PARTY QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identification
  • Mandatory
  • Type: an
  • Length: 0..35
Code identifying a party involved in a transaction.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C058
NAME AND ADDRESS
  • Conditional
Unstructured name and address: one to five lines.
3124
Name and address line
  • Mandatory
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
3124
Name and address line
  • Conditional
  • Type: an
  • Length: 0..35
Free form name and address description.
C080
PARTY NAME
  • Conditional
Identification of a transaction party by name, one to five lines. Party name may be formatted.
3036
Party name
  • Mandatory
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3036
Party name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a party involved in a transaction.
3045
Party name format, coded
  • Conditional
  • Type: an
  • Length: 0..3
Specification of the representation of a party name.
C059
STREET
  • Conditional
Street address and/or PO Box number in a structured address: one to four lines.
3042
Street and number/p.o. box
  • Mandatory
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3042
Street and number/p.o. box
  • Conditional
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3042
Street and number/p.o. box
  • Conditional
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3042
Street and number/p.o. box
  • Conditional
  • Type: an
  • Length: 0..35
Street and number in plain language, or Post Office Box No.
3164
CITY NAME
  • Conditional
  • Type: an
  • Length: 0..35
Name of a city (a town, a village) for addressing purposes.
3229
COUNTRY SUB-ENTITY IDENTIFICATION
  • Conditional
  • Type: an
  • Length: 0..9
Identification of the name of sub-entities (state, province) defined by appropriate governmental agencies.
3251
POSTCODE IDENTIFICATION
  • Conditional
  • Type: an
  • Length: 0..9
Code defining postal zones or addresses.
3207
COUNTRY, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of a country or other geographical entity as specified in ISO 3166.

GRP4 C 99 MOA DTM PCD

  • Conditional
  • Max repeat: 99
A group of segments providing total amounts of an Insurance Premium message or of a statement line. These amounts are detailed amounts for the borderau or for the statement.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying premiums, taxes, fees, commissions and other amounts coming from the Insurance Premium message or from the statement line.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Indication of type of amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
Number of monetary units.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
4405
Status, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating the relative standing, condition or position.

DTM C 1 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 1
A segment specifying dates related to the insurance premium.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date/time/period qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a date, time or period.
2380
Date/time/period
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date/time/period format qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Specification of the representation of a date, a date and time or of a period.

PCD C 1 PERCENTAGE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying the commission rate for commission amounts.
C501
PERCENTAGE DETAILS
  • Mandatory
Percentage relating to a specified basis.
5245
Percentage qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Identification of the usage of a percentage.
5482
Percentage
  • Conditional
  • Type: n
  • Length: 0..10
Value expressed as a percentage of a specified amount.
5249
Percentage basis, coded
  • Conditional
  • Type: an
  • Length: 0..3
Indication of the application of a percentage.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.

RFF M 9 REFERENCE

  • Mandatory
  • Max repeat: 9
A segment specifying references to documents to which the insurance premium relates.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a reference segment or a reference number.
1154
Reference number
  • Conditional
  • Type: an
  • Length: 0..35
Identification number the nature and function of which can be qualified by an entry in data element 1153 Reference qualifier.
1156
Line number
  • Conditional
  • Type: an
  • Length: 0..6
Number of the line in the document/message referenced in 1154 Reference number.
4000
Reference version number
  • Conditional
  • Type: an
  • Length: 0..35
To uniquely identify a reference by its version number.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.

GRP5 C 99 ICD MOA RFF PCD

  • Conditional
  • Max repeat: 99
To specify the covers that apply to the bordereau line.

ICD M 1 INSURANCE COVER DESCRIPTION

  • Mandatory
  • Max repeat: 1
A segment specifying the main class of business of the insurance premium.
C330
INSURANCE COVER TYPE
  • Mandatory
To provide the insurance cover type.
4497
Insurance cover type, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the meaning of the insurance cover.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C331
INSURANCE COVER DETAILS
  • Mandatory
To provide the insurance cover details.
4495
Insurance cover identification
  • Conditional
  • Type: an
  • Length: 0..17
Coded identification of the insurance cover.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
4494
Insurance cover
  • Conditional
  • Type: an
  • Length: 0..35
Identification of the insurance cover.
4494
Insurance cover
  • Conditional
  • Type: an
  • Length: 0..35
Identification of the insurance cover.

MOA C 99 MONETARY AMOUNT

  • Conditional
  • Max repeat: 99
To specify the monetary amount associated with the cover such as claim amounts.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Indication of type of amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
Number of monetary units.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
4405
Status, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating the relative standing, condition or position.

RFF C 9 REFERENCE

  • Conditional
  • Max repeat: 9
A segment to specify references for the cover.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a reference segment or a reference number.
1154
Reference number
  • Conditional
  • Type: an
  • Length: 0..35
Identification number the nature and function of which can be qualified by an entry in data element 1153 Reference qualifier.
1156
Line number
  • Conditional
  • Type: an
  • Length: 0..6
Number of the line in the document/message referenced in 1154 Reference number.
4000
Reference version number
  • Conditional
  • Type: an
  • Length: 0..35
To uniquely identify a reference by its version number.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.

PCD C 1 PERCENTAGE DETAILS

  • Conditional
  • Max repeat: 1
To specify the percentage of co-insurance for the cover.
C501
PERCENTAGE DETAILS
  • Mandatory
Percentage relating to a specified basis.
5245
Percentage qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Identification of the usage of a percentage.
5482
Percentage
  • Conditional
  • Type: n
  • Length: 0..10
Value expressed as a percentage of a specified amount.
5249
Percentage basis, coded
  • Conditional
  • Type: an
  • Length: 0..3
Indication of the application of a percentage.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.

GRP6 C 9 ATT PCD

  • Conditional
  • Max repeat: 9
A group of segments providing details about the collection of the insurance premium.

ATT M 1 ATTRIBUTE

  • Mandatory
  • Max repeat: 1
A segment providing the type of insurance premium, the collection details and the co-insurance information.
9017
ATTRIBUTE FUNCTION QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the meaning of an attribute function.
C955
ATTRIBUTE TYPE
  • Conditional
Identification of the type of attribute.
9021
Attribute type identification
  • Mandatory
  • Type: an
  • Length: 0..17
Coded specification of the type attribute.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C956
ATTRIBUTE DETAILS
  • Conditional
Identification of the attribute related to an entity.
9019
Attribute identification
  • Conditional
  • Type: an
  • Length: 0..17
Identification of an attribute.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
9018
Attribute
  • Conditional
  • Type: an
  • Length: 0..35
Description of an attribute of an entity.

PCD C 1 PERCENTAGE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying the percentage of the total premium of a co-insurance contract, covered by this insurance premium.
C501
PERCENTAGE DETAILS
  • Mandatory
Percentage relating to a specified basis.
5245
Percentage qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Identification of the usage of a percentage.
5482
Percentage
  • Conditional
  • Type: n
  • Length: 0..10
Value expressed as a percentage of a specified amount.
5249
Percentage basis, coded
  • Conditional
  • Type: an
  • Length: 0..3
Indication of the application of a percentage.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.

CUX C 1 CURRENCIES

  • Conditional
  • Max repeat: 1
A segment specifying currencies and relevant details for the rate of exchange.
C504
CURRENCY DETAILS
  • Conditional
The usage to which a currency relates.
6347
Currency details qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the usage to which the currency relates.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
6348
Currency rate base
  • Conditional
  • Type: n
  • Length: 0..4
Multiplying factor used in expressing the number of currency units.
C504
CURRENCY DETAILS
  • Conditional
The usage to which a currency relates.
6347
Currency details qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the usage to which the currency relates.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
6348
Currency rate base
  • Conditional
  • Type: n
  • Length: 0..4
Multiplying factor used in expressing the number of currency units.
5402
RATE OF EXCHANGE
  • Conditional
  • Type: n
  • Length: 0..12
The rate at which one specified currency is expressed in another specified currency.
6341
CURRENCY MARKET EXCHANGE, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the market upon which the currency exchange rate is based.

UNS M 1 SECTION CONTROL

  • Mandatory
  • Max repeat: 1
A mandatory service segment to be placed before the first user segment in the summary section to avoid segment collision.
0081
SECTION IDENTIFICATION
  • Mandatory
  • Type: a
  • Length: 1
Identification of the separation of sections of a message.

GRP7 C 99 MOA GIS DTM RFF ATT ICD CUX

  • Conditional
  • Max repeat: 99
A group of segments providing total amounts of the bordereau or of the statement.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying total amounts.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Indication of type of amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
Number of monetary units.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
4405
Status, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating the relative standing, condition or position.

GIS C 1 GENERAL INDICATOR

  • Conditional
  • Max repeat: 1
A segment specifying the totalization criterion paid/partly paid/not paid.
C529
PROCESSING INDICATOR
  • Mandatory
Type of process indication.
7365
Processing indicator, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Identifies the value to be attributed to indicators required by the processing system.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
7187
Process type identification
  • Conditional
  • Type: an
  • Length: 0..17
Specification of a process or subprocess.

DTM C 1 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 1
A segment specifying the totalization criterion expressed by a date.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date/time/period qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a date, time or period.
2380
Date/time/period
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date/time/period format qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Specification of the representation of a date, a date and time or of a period.

RFF C 1 REFERENCE

  • Conditional
  • Max repeat: 1
A segment specifying a policy number as totalisation criterion.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a reference segment or a reference number.
1154
Reference number
  • Conditional
  • Type: an
  • Length: 0..35
Identification number the nature and function of which can be qualified by an entry in data element 1153 Reference qualifier.
1156
Line number
  • Conditional
  • Type: an
  • Length: 0..6
Number of the line in the document/message referenced in 1154 Reference number.
4000
Reference version number
  • Conditional
  • Type: an
  • Length: 0..35
To uniquely identify a reference by its version number.
1060
Revision number
  • Conditional
  • Type: an
  • Length: 0..6
To specify a revision number.

ATT C 1 ATTRIBUTE

  • Conditional
  • Max repeat: 1
A segment specifying the type of premium and/or collection specifications as totalization criterion.
9017
ATTRIBUTE FUNCTION QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the meaning of an attribute function.
C955
ATTRIBUTE TYPE
  • Conditional
Identification of the type of attribute.
9021
Attribute type identification
  • Mandatory
  • Type: an
  • Length: 0..17
Coded specification of the type attribute.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C956
ATTRIBUTE DETAILS
  • Conditional
Identification of the attribute related to an entity.
9019
Attribute identification
  • Conditional
  • Type: an
  • Length: 0..17
Identification of an attribute.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
9018
Attribute
  • Conditional
  • Type: an
  • Length: 0..35
Description of an attribute of an entity.

ICD C 1 INSURANCE COVER DESCRIPTION

  • Conditional
  • Max repeat: 1
A segment specifying the type of insurance as totalization criterion.
C330
INSURANCE COVER TYPE
  • Mandatory
To provide the insurance cover type.
4497
Insurance cover type, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the meaning of the insurance cover.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
C331
INSURANCE COVER DETAILS
  • Mandatory
To provide the insurance cover details.
4495
Insurance cover identification
  • Conditional
  • Type: an
  • Length: 0..17
Coded identification of the insurance cover.
1131
Code list qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Identification of a code list.
3055
Code list responsible agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the agency responsible for a code list.
4494
Insurance cover
  • Conditional
  • Type: an
  • Length: 0..35
Identification of the insurance cover.
4494
Insurance cover
  • Conditional
  • Type: an
  • Length: 0..35
Identification of the insurance cover.

CUX C 1 CURRENCIES

  • Conditional
  • Max repeat: 1
A segment specifying the currency as a totalization criterion.
C504
CURRENCY DETAILS
  • Conditional
The usage to which a currency relates.
6347
Currency details qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the usage to which the currency relates.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
6348
Currency rate base
  • Conditional
  • Type: n
  • Length: 0..4
Multiplying factor used in expressing the number of currency units.
C504
CURRENCY DETAILS
  • Conditional
The usage to which a currency relates.
6347
Currency details qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Specification of the usage to which the currency relates.
6345
Currency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name or symbol of the monetary unit involved in the transaction.
6343
Currency qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code giving specific meaning to data element 6345 Currency.
6348
Currency rate base
  • Conditional
  • Type: n
  • Length: 0..4
Multiplying factor used in expressing the number of currency units.
5402
RATE OF EXCHANGE
  • Conditional
  • Type: n
  • Length: 0..12
The rate at which one specified currency is expressed in another specified currency.
6341
CURRENCY MARKET EXCHANGE, CODED
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying the market upon which the currency exchange rate is based.

UNT M 1 MESSAGE TRAILER

  • Mandatory
  • Max repeat: 1
A service segment ending a message, giving the total number of segments in the message and the control reference number of the message.
0074
NUMBER OF SEGMENTS IN A MESSAGE
  • Mandatory
  • Type: n
  • Length: 0..10
The number of segments in a message body, plus the message header segment and message trailer segment.
0062
MESSAGE REFERENCE NUMBER
  • Mandatory
  • Type: an
  • Length: 0..14
Unique message reference assigned by the sender.