187 Premium Audit Request and Return
187 Premium Audit Request and Return
Function Group AE
This X12 Transaction Set contains the format and establishes the data contents of the Premium Audit Request and Return Transaction Set (187) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate premium audit information between property and casualty insurers, and independent premium audit service providers. This information includes, but is not limited to: premium audit request information (i.e., type of audit being requested, policyholder name, business locations, class codes, estimated exposures, date of coverage, producing agency, endorsements); and completed audit information (i.e., actual classification codes and exposures, description of operations, sources of financial information, subcontractor exposures) for the auditable general liability, commercial automobile and worker's compensation lines of insurance.
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
Message TextOptional
Max >1
To provide a free-form format that allows the transmission of text information
0400
Reference InformationOptional
Max >1
To specify identifying information
0500
Administrative Communications ContactOptional
Max 3
To identify a person or office to whom administrative communications should be directed
0600
Date or Time or PeriodOptional
Max 10
To specify any or all of a date, a time, or a time period
1000Loop
Optional
Repeat >1
0700
Party IdentificationMandatory
Max 1
To identify a party by type of organization, name, and code
0800
Additional Name InformationOptional
Max 2
To specify additional names
0900
Party LocationOptional
Max 2
To specify the location of the named party
1000
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
1100
Reference InformationOptional
Max 12
To specify identifying information
1200
Administrative Communications ContactOptional
Max 3
To identify a person or office to whom administrative communications should be directed
Position
Segment
Name
Max Use
2000Loop
Mandatory
Repeat >1
0100
Hierarchical LevelMandatory
Max 1
To identify dependencies among and the content of hierarchically related groups of data segments
2100Loop
Optional
Repeat 1
0200
Transaction Set Line NumberMandatory
Max 1
To reference a line number in a transaction set
0300
Vehicle InformationOptional
Max 1
To provide descriptions that identify a specific vehicle
0400
Vehicle AttributeOptional
Max 20
Identifies attributes associated with a vehicle
0500
Dynamic Vehicle InformationOptional
Max 1
To provide dynamic information pertaining to a vehicle
0600
Service Characteristic IdentificationOptional
Max 8
To specify service characteristic data
0700
Product/Item DescriptionOptional
Max 10
To describe a product or process in coded or free-form format
0800
MeasurementsOptional
Max 10
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See X12 EDI Standard Figures, https://figures.x12.org, for example of use of C001)
0900
Reference InformationOptional
Max >1
To specify identifying information
1000
Monetary Amount InformationOptional
Max 5
To indicate the total monetary amount
1100
Adjustment AmountOptional
Max 20
To specify the characteristics of an adjustment
1200
Date or Time or PeriodOptional
Max 20
To specify any or all of a date, a time, or a time period
1300
Tax InformationOptional
Max >1
To specify tax information
2110Loop
Optional
Repeat >1
1400
Quantity InformationMandatory
Max 1
To specify quantity information
1500
Service Characteristic IdentificationOptional
Max 1
To specify service characteristic data
2120Loop
Optional
Repeat 5
1600
Electronic Format IdentificationMandatory
Max 1
To provide basic information about the electronic format of the interchange data
1700
Binary Data SegmentOptional
Max >1
To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment
2200Loop
Optional
Repeat 1
1800
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
1900
Additional Name InformationOptional
Max 2
To specify additional names
2000
Party LocationOptional
Max 2
To specify the location of the named party
2100
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
2200
Demographic InformationOptional
Max 1
To supply demographic information
2300
Additional Demographic InformationOptional
Max 1
To supply additional demographic identification
2400
MeasurementsOptional
Max 10
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See X12 EDI Standard Figures, https://figures.x12.org, for example of use of C001)
2500
Location ID ComponentOptional
Max 1
To define types and values of a geographic location
2600
Reference InformationOptional
Max 10
To specify identifying information
2700
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed
2300Loop
Optional
Repeat >1
2800
InformationMandatory
Max 1
To report information
2900
Service Characteristic IdentificationOptional
Max 2
To specify service characteristic data
3000
Product/Item DescriptionOptional
Max 10
To describe a product or process in coded or free-form format
3100
MeasurementsOptional
Max 10
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See X12 EDI Standard Figures, https://figures.x12.org, for example of use of C001)
3200
Reference InformationOptional
Max >1
To specify identifying information
3300
Date or Time or PeriodOptional
Max 10
To specify any or all of a date, a time, or a time period
3400
Message TextOptional
Max >1
To provide a free-form format that allows the transmission of text information
3500
Monetary Amount InformationOptional
Max 10
To indicate the total monetary amount
3600
Adjustment AmountOptional
Max 20
To specify the characteristics of an adjustment
3700
Conditions IndicatorOptional
Max 50
To supply information on conditions
3800
Percent AmountsOptional
Max 10
To qualify percent amounts and supply percent amounts
3900
Property Description - PersonalOptional
Max >1
To provide a description of personal property
4000
Property Description - RealOptional
Max >1
To provide a description of real property
4100
Property Description/Legal DescriptionOptional
Max >1
To provide specifics on property or legal description; this segment provides for a simple legal description such as lot, block and subdivision
2310Loop
Mandatory
Repeat >1
4200
Supplementary InformationMandatory
Max 1
To provide processible supplementary information
4300
MeasurementsOptional
Max 1
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See X12 EDI Standard Figures, https://figures.x12.org, for example of use of C001)
4400
Reference InformationOptional
Max >1
To specify identifying information
4500
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
4600
Monetary Amount InformationOptional
Max >1
To indicate the total monetary amount
4700
Adjustment AmountOptional
Max >1
To specify the characteristics of an adjustment
2320Loop
Optional
Repeat >1
4800
Quantity InformationMandatory
Max 1
To specify quantity information
4900
Service Characteristic IdentificationOptional
Max 1
To specify service characteristic data
2330Loop
Optional
Repeat >1
5000
Industry Code IdentificationMandatory
Max 1
To identify standard industry codes
5100
Monetary Amount InformationOptional
Max 10
To indicate the total monetary amount
5200
Adjustment AmountOptional
Max 10
To specify the characteristics of an adjustment
5300
Percent AmountsOptional
Max 10
To qualify percent amounts and supply percent amounts
2340Loop
Optional
Repeat >1
5400
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
5500
Additional Name InformationOptional
Max 2
To specify additional names
5600
Party LocationOptional
Max 2
To specify the location of the named party
5700
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
5800
Demographic InformationOptional
Max 1
To supply demographic information
5900
Additional Demographic InformationOptional
Max 1
To supply additional demographic identification
6000
Location ID ComponentOptional
Max 1
To define types and values of a geographic location
6100
Reference InformationOptional
Max >1
To specify identifying information
6200
Administrative Communications ContactOptional
Max >1
To identify a person or office to whom administrative communications should be directed
2350Loop
Optional
Repeat >1
6300
Allowance, Charge or ServiceMandatory
Max 1
To specify allowances, charges, or services
6400
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
6500
Reference InformationOptional
Max 5
To specify identifying information
6600
CurrencyOptional
Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
Position
Segment
Name
Max Use
0100
Total Monetary Value SummaryMandatory
Max 1
To specify the total invoice discounts and amounts
3000Loop
Optional
Repeat >1
0200
Allowance, Charge or ServiceMandatory
Max 1
To specify allowances, charges, or services
0300
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
0400
Reference InformationOptional
Max >1
To specify identifying information
0500
CurrencyOptional
Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
3100Loop
Optional
Repeat >1
0600
Balance DetailMandatory
Max 1
To identify the specific monetary balances associated with a particular account
0700
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
3200Loop
Optional
Repeat >1
0800
Party IdentificationMandatory
Max 1
To identify a party by type of organization, name, and code
3210Loop
Optional
Repeat >1
0900
Balance DetailMandatory
Max 1
To identify the specific monetary balances associated with a particular account
1000
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
3220Loop
Optional
Repeat >1
1100
Allowance, Charge or ServiceMandatory
Max 1
To specify allowances, charges, or services
1200
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
1300
Reference InformationOptional
Max >1
To specify identifying information
1400
CurrencyOptional
Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
1500
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)