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EDIFACT message guide · Insurance

LRECLM Life reinsurance claims

The UN/EDIFACT message companies use to exchange information about claims on life policies that have been reinsured.

Sent by
Ceding life insurer or reinsurer
Received by
Reinsurer or ceding insurer
Standard
UN/EDIFACT · Batch message
X12 equivalent
No direct equivalent

What is the EDIFACT LRECLM message?

LRECLM is the UN/EDIFACT life reinsurance claims message. The directory defines it as a message companies use to exchange information about a claim or claims on policies that have been reinsured, for both ceded and assumed reinsurance.

When a reinsured life dies or becomes disabled, the ceding insurer notifies the reinsurer and recovers the reinsured share of the benefit. The claims message identifies the policy and claim, the benefit amounts and the reinsurer's share. Supporting documents, such as death certificates, are usually exchanged separately under data protection rules.

How the EDIFACT LRECLM message worksDiagram of the UN/EDIFACT LRECLM Life reinsurance claims message. Ceding life insurer or reinsurer sends it to reinsurer or ceding insurer. It usually follows LREACT. Inside the UNB and UNH envelopes, the directory D.21A requires, in the start of message: BGM (Beginning of message) and DTM (Date/time/period) and body and segment groups: the required SG1 loop with IMD (Item description), ATT (Attribute), the required SG3 loop with PNA (Party identification) and DTM (Date/time/period) and the required SG5 loop with GEI (Processing information) and RFF (Reference). 4 conditional segment groups are listed by their trigger segment.How the EDIFACT LRECLM message worksLife reinsurance claims: who sends it, where it fits and what the directory marks mandatory1 WHERE IT FITSUSUALLY FOLLOWSLREACTLife reinsuranceactivityLRECLMSENDERCeding life insurer orreinsurerRECEIVERReinsurer or cedinginsurerCONTRL syntax report back, if agreedUSUALLY FOLLOWED BYNo business reply expected2 WHAT DIRECTORY D.21A REQUIRESInterchange: sender and recipient IDsUNB … UNZMessage LRECLMUNH … UNTSTART OF MESSAGEBGMBeginning of messageDTMDate/time/periodBODY AND SEGMENT GROUPSMandatory group SG1 · repeats many timesIMDItem descriptionATTAttributeMandatory group SG3 · repeats up to 1PNAParty identificationDTMDate/time/periodMandatory group SG5 · repeats up to 99GEIProcessing informationRFFReference+ 4 conditional groups, starting with:MOAIDEBlue box: mandatory segment group. Conditional groups are listed by the trigger segment that starts them; a group is sent only when its data applies.Conditional segments outside groups are not drawn.Structure: mandatory segments and groups in the UN/EDIFACT directory D.21A listing for LRECLM. Your trading partner's implementation guide adds itsown requirements.
How the EDIFACT LRECLM message worksDiagram of the UN/EDIFACT LRECLM Life reinsurance claims message. Ceding life insurer or reinsurer sends it to reinsurer or ceding insurer. It usually follows LREACT. Inside the UNB and UNH envelopes, the directory D.21A requires, in the start of message: BGM (Beginning of message) and DTM (Date/time/period) and body and segment groups: the required SG1 loop with IMD (Item description), ATT (Attribute), the required SG3 loop with PNA (Party identification) and DTM (Date/time/period) and the required SG5 loop with GEI (Processing information) and RFF (Reference). 4 conditional segment groups are listed by their trigger segment.How the EDIFACT LRECLMmessage worksLife reinsurance claims: who sends it, where itfits and what the directory marks mandatory1 WHERE IT FITSUSUALLY FOLLOWSLREACTLife reinsurance activityLRECLMSENDERCeding lifeinsurer orreinsurerRECEIVERReinsurer orceding insurerCONTRL syntax report back, if agreedUSUALLY FOLLOWED BYNo business reply expected2 WHAT DIRECTORY D.21A REQUIRESInterchange: sender and recipient IDs(UNB … UNZ)Message LRECLM (UNH … UNT)START OF MESSAGEBGMBeginning of messageDTMDate/time/periodBODY AND SEGMENT GROUPSMandatory group SG1 · repeatsmany timesIMDItem descriptionATTAttributeMandatory group SG3 · repeatsup to 1PNAParty identificationDTMDate/time/periodMandatory group SG5 · repeatsup to 99GEIProcessing informationRFFReference+ 4 conditional groups, starting with:MOAIDEBlue box: mandatory segment group. Conditionalgroups are listed by the trigger segment thatstarts them; a group is sent only when its dataapplies. Conditional segments outside groups arenot drawn.Structure: mandatory segments and groups in theUN/EDIFACT directory D.21A listing for LRECLM.Your trading partner's implementation guide adds itsown requirements.

How to read this diagram: the top row shows who sends LRECLM, to whom, and which messages usually come before and after it. The lower part shows what the directory D.21A itself requires: the envelopes around LRECLM and the segments and segment groups it marks mandatory. Conditional groups are listed by their trigger segment rather than drawn in full. This is the directory's minimum, not a trading partner's requirement: a message implementation guide, such as an industry subset or a partner’s own guide, usually makes some conditional groups mandatory, restricts the codes and may use an older directory.

Expand diagram Download SVG

When it is used

  • Notifying reinsurers of claims on reinsured policies
  • Requesting recovery of reinsured benefits
  • Updating claim status and amounts

Where it fits in the message flow

Usually follows LREACT Life reinsurance activity
This message LRECLM Life reinsurance claims

Structure

Mandatory segments in LRECLM (directory D.21A)

In UN/EDIFACT directory D.21A, the LRECLM message has 40 segment positions arranged in 9 segment groups. These are the segments and segment groups marked mandatory at message level, in order; a mandatory group is shown with the segment that starts it. Segments inside conditional groups are needed only when the group is used. This is the directory’s requirement, not your trading partner’s: each partner’s message implementation guide names the directory it uses, often an older one such as D.96A or D.01B where the structure can differ, makes some conditional segments mandatory and restricts the codes.

  • UNH
  • BGM
  • DTM
  • SG1 (IMD)
  • UNT

Practical example

LRECLM in practice

A life insurer pays a death claim on a policy partly reinsured. It sends the reinsurer an LRECLM with the policy, the claim date, the benefit paid and the reinsured share. The reinsurer validates the claim against its records of the policy and pays the recovery.

Implementation

Implementation considerations for LRECLM

  • Protect personal and health data under applicable law.
  • Reference policies as reported in activity messages.
  • Report claim status changes as well as payments.
  • Reconcile recoveries with payments received.

How ECOM helps

Automate LRECLM with ECOM

Industry

Financial Services

Secure file transfer and B2B integration for banks and financial institutions.

Industry

Healthcare

Secure B2B integration and file transfer for providers, suppliers, distributors and healthcare partners.

Solution

Financial Document Automation

Automate invoices, remittances, payment files and bank statements from capture to posting.

Compare X12 and EDIFACT, or see answers to general questions in the EDI FAQ.

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