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EDIFACT message guide · Insurance

RECLAM Reinsurance claims

The UN/EDIFACT message insurers, intermediaries and reinsurers use to send loss information and request settlement of reinsurance claims.

Sent by
Insurer (cedent) or reinsurance intermediary
Received by
Reinsurer or intermediary
Standard
UN/EDIFACT · Batch message
X12 equivalent
No direct equivalent

What is the EDIFACT RECLAM message?

RECLAM is the UN/EDIFACT reinsurance claims message. The directory defines it as a message exchanged between insurers, professional intermediaries and reinsurers to send information about a loss, to request settlement (payment or refund) of the loss, or both.

When an insured loss falls under a reinsurance contract, the insurer recovers part of it from its reinsurers. The claims message identifies the contract, the loss, the amounts paid and reserved and the reinsurer's share, so recoveries can be processed quickly. Large losses are often notified before they are fully settled.

How the EDIFACT RECLAM message worksDiagram of the UN/EDIFACT RECLAM Reinsurance claims message. Insurer (cedent) or reinsurance intermediary sends it to reinsurer or intermediary. It usually starts the exchange. It is usually followed by RESETT. Inside the UNB and UNH envelopes, the directory D.21A requires, in the body and segment groups: the required SG1 loop with GEI (Processing information), the required SG2 loop with NAD (Name and address), UNS (Section control), DTM (Date/time/period) and UNS (Section control). 3 conditional segment groups are listed by their trigger segment.How the EDIFACT RECLAM message worksReinsurance claims: who sends it, where it fits and what the directory marks mandatory1 WHERE IT FITSUSUALLY FOLLOWSStarts the exchangeRECLAMSENDERInsurer (cedent) orreinsuranceintermediaryRECEIVERReinsurer orintermediaryCONTRL syntax report back, if agreedUSUALLY FOLLOWED BYRESETTReinsurancesettlement2 WHAT DIRECTORY D.21A REQUIRESInterchange: sender and recipient IDsUNB … UNZMessage RECLAMUNH … UNTBODY AND SEGMENT GROUPSMandatory group SG1 · repeats up to 99GEIProcessing informationMandatory group SG2 · repeats up to 999NADName and addressUNSSection controlDTMDate/time/periodUNSSection control+ 3 conditional groups, starting with:RFFGEICUXBlue 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 RECLAM. Your trading partner's implementation guide adds itsown requirements.
How the EDIFACT RECLAM message worksDiagram of the UN/EDIFACT RECLAM Reinsurance claims message. Insurer (cedent) or reinsurance intermediary sends it to reinsurer or intermediary. It usually starts the exchange. It is usually followed by RESETT. Inside the UNB and UNH envelopes, the directory D.21A requires, in the body and segment groups: the required SG1 loop with GEI (Processing information), the required SG2 loop with NAD (Name and address), UNS (Section control), DTM (Date/time/period) and UNS (Section control). 3 conditional segment groups are listed by their trigger segment.How the EDIFACT RECLAMmessage worksReinsurance claims: who sends it, where it fitsand what the directory marks mandatory1 WHERE IT FITSUSUALLY FOLLOWSStarts the exchangeRECLAMSENDERInsurer(cedent) orreinsuranceintermediaryRECEIVERReinsurer orintermediaryCONTRL syntax report back, if agreedUSUALLY FOLLOWED BYRESETTReinsurance settlement2 WHAT DIRECTORY D.21A REQUIRESInterchange: sender and recipient IDs(UNB … UNZ)Message RECLAM (UNH … UNT)BODY AND SEGMENT GROUPSMandatory group SG1 · repeats upto 99GEIProcessing informationMandatory group SG2 · repeats upto 999NADName and addressUNSSection controlDTMDate/time/periodUNSSection control+ 3 conditional groups, starting with:RFFGEICUXBlue 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 RECLAM.Your trading partner's implementation guide adds itsown requirements.

How to read this diagram: the top row shows who sends RECLAM, 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 RECLAM 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 a large loss
  • Requesting payment of a reinsurance recovery
  • Updating loss reserves and payments

Where it fits in the message flow

This message RECLAM Reinsurance claims
Usually followed by RESETT Reinsurance settlement

Structure

Mandatory segments in RECLAM (directory D.21A)

In UN/EDIFACT directory D.21A, the RECLAM message has 49 segment positions arranged in 10 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
  • SG1 (GEI)
  • SG2 (NAD)
  • UNS
  • DTM
  • UNS
  • UNT

Practical example

RECLAM in practice

A property insurer pays a large fire claim covered by its excess-of-loss reinsurance. Its reinsurance system sends a RECLAM through the broker to each reinsurer with the contract, the loss date, the amount paid and the share due. The reinsurers approve and settle through the next settlement cycle.

Implementation

Implementation considerations for RECLAM

  • Reference the reinsurance contract and loss consistently.
  • Report paid and outstanding amounts separately.
  • Follow market standards, such as those maintained by insurance standards bodies.
  • Track each recovery until it is settled.

How ECOM helps

Automate RECLAM with ECOM

Industry

Financial Services

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

Solution

Financial Document Automation

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

Solution

B2B Integration

Connect every customer, supplier, carrier and bank across EDI, API, file and portal channels.

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

Related messages

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