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Examples for Consolidated Service Invoice/Statement (811)

Example 3 - Policy Change/ Endorsement

Table 2 - Policy Detail

When a change to an insurance policy affects the premium, State Farm sends an Entry Endorsement. If the change does not affect the premium, a Non Entry Endorsement is created. Either of these changes will result in State Farm sending a Policy Change/ Endorsement for those lenders whose delivery method is electronic (or electronic & paper).

811 Data Format

Description

HL*5*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*PCH;

The transaction type for this request.

  • PCH Policy Change/Endorsement

PID*S*02*AD*IN;

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*120594856756453;

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

  • LD Loan Number

REF*IG*13GJ12139;

  • 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-5440*FUNGUS(INCLUDING MOLD) EXCL:

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*649;

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*20040601;

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*42.15;

An entry endorsement resulted in an amount due. This policy should be paid using the 820 remittance advice.

  • EA Policy premium dollars

DTM*814*20040726;

  • 814 Remittance Due Date

DTM*009*20040507;

  • 009 Process date

DTM*152*20040601;

  • 152 Policy effective date of change

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

III*CV*OS;

Insurance policy coverages.

  • OS Other Structures

AMT*2Y*21490;

  • 2Y Other Structures risk amount

 

 
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