FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 - Version 0.0.1-snapshot-2. See the Directory of published versions

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: Cross-version VS for R5.RoleClassClaimant for use in FHIR R4 - XML Representation

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="R5-v3-RoleClassClaimant-for-R4"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet R5-v3-RoleClassClaimant-for-R4</b></p><a name="R5-v3-RoleClassClaimant-for-R4"> </a><a name="hcR5-v3-RoleClassClaimant-for-R4"> </a><p>This value set expansion contains 1 concepts.</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>System</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap"><a name="R5-v3-RoleClassClaimant-for-R4-http://terminology.hl7.org/CodeSystem/v3-RoleClass-CLAIM"> </a>  <a href="http://terminology.hl7.org/6.5.0/CodeSystem-v3-RoleClass.html#v3-RoleClass-CLAIM">CLAIM</a></td><td>http://terminology.hl7.org/CodeSystem/v3-RoleClass</td><td>claimant</td><td><div><p><strong>Description:</strong> 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.</p>
<p><strong>Discussion:</strong> 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.</p>
<p><strong>Note:</strong> 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.</p>
<p>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 &quot;claim&quot; 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.</p>
<p><strong>Example:</strong> A claimant under automobile policy that is not the named insured.</p>
</div></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fhir"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/package-source">
    <extension url="packageId">
      <valueId value="hl7.fhir.uv.xver-r5.r4"/>
    </extension>
    <extension url="version">
      <valueString value="0.0.1-snapshot-2"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="0">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
      </extension>
    </valueInteger>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="informative">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/5.0/ValueSet/R5-v3-RoleClassClaimant-for-R4"/>
  <version value="0.0.1-snapshot-2"/>
  <name value="R5_v3_RoleClassClaimant_for_R4"/>
  <title
         value="Cross-version VS for R5.RoleClassClaimant for use in FHIR R4"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2025-09-01T22:37:05.363857+10:00"/>
  <publisher value="FHIR Infrastructure"/>
  <contact>
    <name value="FHIR Infrastructure"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fiwg"/>
    </telecom>
  </contact>
  <description
               value="This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-RoleClassClaimant|2.0.0 for use in FHIR R4. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4."/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
      <display value="World"/>
    </coding>
  </jurisdiction>
  <compose>
    <include>
      <system value="http://terminology.hl7.org/CodeSystem/v3-RoleClass"/>
      <version value="3.1.0"/>
      <concept>
        <code value="CLAIM"/>
        <display value="claimant"/>
      </concept>
    </include>
  </compose>
  <expansion>
    <timestamp value="2025-09-01T22:37:05.363856+10:00"/>
    <contains>
      <system value="http://terminology.hl7.org/CodeSystem/v3-RoleClass"/>
      <version value="3.1.0"/>
      <code value="CLAIM"/>
      <display value="claimant"/>
    </contains>
  </expansion>
</ValueSet>