Example 3 - Policy Change/ Endorsement

Examples for Consolidated Service Invoice/Statement (811)

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
  • 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 Contractor
  • 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*120594856756453; 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*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
  • 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*42.15; An entry endorsement resulted in an amount due. This policy should be paid using the 820 remittance advice.
  • EA Policy premium dollars
  • 814 Remittance Due Date
  • 009 Process date
  • 152 Policy effective date of change
  • 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
III*CV*OS; Insurance policy coverages.
  • OS Other Structures
  • 2Y Other Structures risk amount