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Examples for Consolidated Service Invoice/Statement (811)

Example 1 – Insurance Verification

Table 2 - Policy Detail

State Farm will respond to an electronic, telephone or written request for insurance information with an Insurance Verification if the delivery method for the lender is electronic (or electronic & paper).

811 Data Format 

Description

HL*3*2*4*1;

HL segments represent a looping structure within the standard transaction set. This loop is for policy detail

LX*1;

Section separator. This field will increment with each new notification.

SI*AD*01*EPI;

The transaction type for this request.

  • EPI Insurance verification

PID*S*02*AD*MG;

The PID identifies the party responsible for paying the insurance premium.

  • IN Insured pays
  • MG Mortgagee pays

REF*TV*HOME;

Line of business identifies the type of policy.

  • HOME Homeowner’s policy
Other Lines of business are:
  • FLOOD Flood
  • RDP Rental dwelling
  • DFIRE Fire
  • EQKP Earthquake
  • FARM Farm
  • BOAT Boat owners
  • RCUP Rental condo unit owner
  • PPMBH Mobil Home
  • PPCHO Condominium
  • PPART Apartment
  • COTHR Business Other
  • BOP Business owner

REF*NF*25143;

The NAIC code identifies the State Farm affiliate underwriting the insurance policy.

  • 25143 State Farm Fire
  • 43419 State Farm Lloyds
  • 25151 State Farm General
  • 10739 State Farm Florida

REF*LD*A123459687;

Loan number of the mortgaged property as identified on the insurance policy.

  • LD Loan Number

REF*IG*75RV34457;

  • IG Insurance policy number

REF*ABC*01;

The Operation Center number is expected back with the 820 remittance advice (REF*32).

  • ABC State Farm Operation Center Number

REF*0K*FP-7955.IL*HOMEOWNER POLICY;

REF*0K*LSP A1*REPLACEMENT COST;

REF*0K*FE-5703.1*HURRICANE DEDUCTIBLE:

These segments represent the forms and endorsements associated with this insurance policy.

  • 0K Policy form number and description

REF*UA*1;

State Farm does not keep track of Loan Type. This is the order at which this lender appears on the insurance policy.

  • 1 First mortgagee
  • 2 Second mortgagee
  • 3 Third mortgagee

AMT*PE*1012;

This is the cost of the insurance policy for the entire term. This is NOT the amount due.

  • PE Full term premium amount of the policy

DTM*007*20040131;

This is the beginning date of the insurance policy’s term.

  • 007 Policy effective date

DTM*036*20050131;

State Farm insurance policies are continuous until cancelled. This is when the insurance policy term expires unless renewed.

  • 036 Policy expiration date 

NM1*U3*1*LITTLE, JOHN C;

  • U3 Insurance agent name

N3*42 NORTH MAIN STREET;

Insurance agent address

N4*LAPTON*AZ*85289;

Insurance agent city, state and zip

PER*AG**TE*5124984051;

  • AG Insurance agent telephone number

IT1**1*EA*0;

Insurance Verification does not include a balance due and therefore, this amount should always be zero.

  • EA Policy premium dollars

DTM*009*2004115;

  • 009 Process date

NM1*IL*1*DOE, JOHN;

  • IL Insured name

N3*27 COURT STREET;

Insured mailing street address.

N4*SAN FRANCISCO*CA*94111;

Insured mailing city, state and zip

NX2*15*12 MARKET STREET;

Insured property street address.

  • 15 Unstructured street address

NX2*07*BLOOMINGTON;

Insured property city name.

  • 07 City name

NX2*08*IL;

Insured property state name.

  • 08 State abbreviation

NX2*19*617050001;

9 digit Insured property zip code if present.

  • 19 Insured property zip (9 digit)

III*CV*DWELL;

Insurance policy coverages.

  • DWELL Dwelling

AMT*2Y*214900;

  • 2Y Dwelling risk amount

AMT*LU*42980;

  • LU Option coverage amount

AMT*AU*21490;

  • AU Building Ordinance or Law amount

AMT*PH*500;

  • PH Deductible amount

LQ*ZZ*35;

  • 35 Hurricane Coverage Addition

AMT*2Y*214900;

  • 2Y Hurricane risk amount

PCT*PH*.05;

  • PH Hurricane deductible

III*CV*OS;

Insurance policy coverages.

  • OS Other Structures

AMT*2Y*21490;

  • 2Y Other Structures risk amount

 

 
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