255 - Underwriting Information Services

FUNCTIONAL GROUP=UI

This X12 Transaction Set contains the format and establishes the data contents of the Underwriting Information Services Transaction Set (255) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to request specific services from information providers in support of the underwriting process. In addition, the standard can be used between trading partners to request/receive status information on outstanding requests.

SCHEMA

ST

Segment	Name	Position
ST	Transaction Set Header	0100
BGN	Beginning Segment	0200
CUR	Currency	0300

NM1

Segment	Name	Position
NM1	Individual or Organizational Name	0400
N3	Party Location	0500
N4	Geographic Location	0600
REF	Reference Information	0700
PER	Administrative Communications Contact	0800

ACT

Segment	Name	Position
ACT	Account Identification	0100
AM1	Informational Values	0200
PWK	Paperwork	0300
REF	Reference Information	0400
PER	Administrative Communications Contact	0500
DTM	Date/Time Reference	0600
MSG	Message Text	0700
YNQ	Yes/No Question	0750
NTE	Note/Special Instruction	0760

NM1

Segment	Name	Position
NM1	Individual or Organizational Name	0800
N2	Additional Name Information	0900

LX

Segment	Name	Position
LX	Transaction Set Line Number	0950
N3	Party Location	1000
N4	Geographic Location	1100
ASI	Action or Status Indicator	1200
PER	Administrative Communications Contact	1300
DMG	Demographic Information	1400
IND	Additional Individual Demographic Information	1500
CD2	Multi-Valued Characteristics	1600
MSG	Message Text	1700

EFI

Segment	Name	Position
EFI	Electronic Format Identification	1800
BIN	Binary Data Segment	2000

PO1

Segment	Name	Position
PO1	Baseline Item Data	2100
ASI	Action or Status Indicator	2200
DMA	Additional Demographic Information	2300
REF	Reference Information	2400
DTP	Date or Time or Period	2500
MSG	Message Text	2600
LS	Loop Header	2650

LX

Segment	Name	Position
LX	Transaction Set Line Number	2700
NM1	Individual or Organizational Name	2800
N2	Additional Name Information	2900
NX2	Location ID Component	3000
N4	Geographic Location	3100
REC	Real Estate Condition	3150
IND	Additional Individual Demographic Information	3200
EMS	Employment Position	3300
PER	Administrative Communications Contact	3400
CN1	Contract Information	3500
DTP	Date or Time or Period	3600
CD2	Multi-Valued Characteristics	3700
REF	Reference Information	3800
PWK	Paperwork	3900
MSG	Message Text	4000
AM1	Informational Values	4020
LE	Loop Trailer	4050
SE	Transaction Set Trailer	4100

COMMENTS

Notes
1/0400	The NM1 loop allows for one or more insurance companies to request the same information.
2/0100	The ACT loop is the primary loop for the requested services. It is based on the procurement of services for a unique policy/application/account or other unique identifier for one or more proposed insureds. The ACT segment contains the case identification.
2/0760	The NTE segment is used to communicate specific underwriting instructions to the service provider.
2/0800	The NM1 loop contains proposed insured's name, address & other information necessary to identify him/her. It is possible that there may be multiple proposed insureds within a policy number in one ACT loop.
2/1800	The EFI is included to provide a vehicle for capturing the proposed insured's signature to authorize specific services.
2/2100	The PO1 loop contains services requested to be performed by the information provider.
2/2700	The LX loop contains detailed information sources used by the information provider in completing their assignments. These could be doctors, clinics, employers, and other references. The LX segment is used as a unique reference number within the PO1 loop.

rev 29/11/2024