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Packagehl7.fhir.uv.xver-r5.r4
Resource TypeValueSet
IdValueSet-R5-v3-RoleClassClaimant-for-R4.json
FHIR VersionR4
Sourcehttp://hl7.org/fhir/uv/xver-r5.r4/0.1.0/ValueSet-R5-v3-RoleClassClaimant-for-R4.html
URLhttp://hl7.org/fhir/uv/xver/ValueSet/R5-v3-RoleClassClaimant-for-R4
Version0.1.0
Statusactive
Date2026-03-17T21:02:03.8104715+00:00
NameR5V3RoleClassClaimantForR4
TitleCross-version ValueSet R5.RoleClassClaimant for use in FHIR R4
Realmuv
Authorityhl7
DescriptionThis cross-version ValueSet represents content from `http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0` for use in FHIR R4.
PurposeThis value set is part of the cross-version definitions generated to enable use of the value set `http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0` as defined in FHIR R5 in FHIR R4. The source value set is bound to the following FHIR R5 elements: * Note that all concepts are included in this cross-version definition because no concepts have compatible representations Following are the generation technical comments: FHIR ValueSet `http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0`, defined in FHIR R5 does not have any mapping to FHIR R4

Resources that use this resource

No resources found


Resources that this resource uses

CodeSystem
hl7.terminology#currentv3-RoleClassRoleClass

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ValueSet R5-v3-RoleClassClaimant-for-R4

This value set expansion contains 1 concepts.

SystemVersionCodeDisplayDefinition
http://terminology.hl7.org/CodeSystem/v3-RoleClass3.1.0  CLAIMclaimant

Description: A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible.

Discussion: With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary.

Note: A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.

In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a claim for a loss. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.

Example: A claimant under automobile policy that is not the named insured.


Source1

{
  "resourceType": "ValueSet",
  "id": "R5-v3-RoleClassClaimant-for-R4",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
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      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
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    {
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        {
          "url": "version",
          "valueString": "0.1.0"
        },
        {
          "url": "uri",
          "valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"
          }
        ]
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    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
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          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-RoleClassClaimant-for-R4",
  "version": "0.1.0",
  "name": "R5V3RoleClassClaimantForR4",
  "title": "Cross-version ValueSet R5.RoleClassClaimant for use in FHIR R4",
  "status": "active",
  "experimental": false,
  "date": "2026-03-17T21:02:03.8104715+00:00",
  "publisher": "FHIR Infrastructure",
  "contact": [
    {
      "name": "FHIR Infrastructure",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "description": "This cross-version ValueSet represents content from `http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0` for use in FHIR R4.",
  "jurisdiction": [
    {
      "coding": [
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          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "purpose": "This value set is part of the cross-version definitions generated to enable use of the\r\nvalue set `http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0` as defined in FHIR R5\r\nin FHIR R4.\r\n\r\nThe source value set is bound to the following FHIR R5 elements:\r\n* \r\n\r\nNote that all concepts are included in this cross-version definition because no concepts have compatible representations\r\n\r\nFollowing are the generation technical comments:\r\n\nFHIR ValueSet `http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0`, defined in FHIR R5 does not have any mapping to FHIR R4",
  "compose": {
    "include": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RoleClass",
        "version": "3.1.0",
        "concept": [
          {
            "code": "CLAIM",
            "display": "claimant"
          }
        ]
      }
    ]
  },
  "expansion": {
    "timestamp": "2026-03-17T21:02:03.8104715+00:00",
    "contains": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RoleClass",
        "version": "3.1.0",
        "code": "CLAIM",
        "display": "claimant"
      }
    ]
  }
}