112 Property Damage Report

Functional Group PQ

X12N Insurance Subcommittee

This X12 Transaction Set 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.

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Heading

Position
Segment
Name
Max use
0100
Transaction Set HeaderMandatory
Max 1
To indicate the start of a transaction set and to assign a control number
0200
Beginning SegmentMandatory
Max 1
To indicate the beginning of a transaction set
0300
Date or Time or PeriodOptional
Max 1
To specify any or all of a date, a time, or a time period
0400
Currency IdentifierOptional
Max 1
To specify the currency being used in the transaction set
1000 Loop
Repeat >1
0500
Supplementary InformationMandatory
Max 1
To provide processible supplementary information
0600
Message TextOptional
Max >1
To provide a free-form format that allows the transmission of text information
1100 Loop
Repeat >1
0700
Individual or Organizational NameMandatory
Max 1
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.
0800
Additional Name InformationOptional
Max 1
To specify additional names
0900
Party LocationOptional
Max 1
To specify the location of the named party
1000
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
1100
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed

Detail

Position
Segment
Name
Max use
2000 Loop
Repeat >1
0100
Hierarchical LevelMandatory
Max 1
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.
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.
0200
Extended Reference InformationOptional
Max >1
To transmit identifying information as specified by the Reference Identification Qualifier
0300
Administrative MessageOptional
Max 1
To transmit information in a free-form format for comment or special instruction
0400
Quantity InformationOptional
Max 1
To specify quantity information
0500
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
0600
Tax InformationOptional
Max 1
To specify tax information
2100 Loop
Repeat >1
0700
Code Source InformationMandatory
Max 1
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.
0800
Subline Item DetailMandatory
Max 1
To specify product subline detail item data
0900
Monetary Amount InformationOptional
Max >1
To indicate the total monetary amount
0950
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
2200 Loop
Repeat >1
1000
InformationMandatory
Max 1
To report information
1100
Monetary Amount InformationOptional
Max >1
To indicate the total monetary amount
1200
Percent AmountsOptional
Max 1
To qualify percent amounts and supply percent amounts
2300 Loop
Repeat >1
1300
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
1400
Additional Name InformationOptional
Max 1
To specify additional names
1500
Party LocationOptional
Max 1
To specify the location of the named party
1600
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
1700
Equipment, Shipment, or Real Property LocationOptional
Max 1
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
1800
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed
2400 Loop
Repeat >1
1900
Characteristic/Class IDMandatory
Max 1
To specify the general class or specific characteristic upon which test results are being reported or are to be taken
2000
MeasurementsOptional
Max >1
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
2100
Transaction Set TrailerMandatory
Max 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)
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