Example 1 – Insurance Verification

Examples for Consolidated Service Invoice/Statement (811)

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
  • PPTHO Renters
  • PPUHO Condo Unit Owners
  • DFIRE Fire
  • EQKP Earthquake
  • FARM Farm
  • BOAT Boat owners
  • RCUP Rental condo unit owner
  • PPMBH Mobil Home
  • PPCHO Condominium
  • PPART Apartment
  • FLOOD Flood
  • RDP Rental dwelling
  • COTHR Business Other
  • BOP Business owner
  • CNT Contractors
  • PPCHR Church
  • PAP Personal Articles
  • PLU Personal Liability Umbrella
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
  • 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


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 
  • U3 Insurance agent name
N3*42 NORTH MAIN STREET; Insurance agent address
N4*LAPTON*AZ*85289; Insurance agent city, state and zip
  • 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
  • 009 Process date
  • 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
  • 2Y Dwelling risk amount
  • LU Option coverage amount
  • AU Building Ordinance or Law amount
  • PH Deductible amount
  • 35 Hurricane Coverage Addition
  • 2Y Hurricane risk amount
  • PH Hurricane deductible
III*CV*OS; Insurance policy coverages.
  • OS Other Structures
  • 2Y Other Structures risk amount