Implement Basic Claims Functionality Prototype

This prototype shows the create claim, update claim status and copy to claim fields transaction for the rules added to implement the limited claims database tables in OIPA via configuration.

Prerequisites

An Active Policy with required roles and segments should exist to create claim transaction along with the business rules.

New Items

Add following new business rules for claims transactions.

Changes to Existing Items

N/A

Configuration Details

The following configuration is added as the prototype at Client Level under,

Main Explorer --> Companies-->Prototype-->Subsidiary Companies-->Plans-->Client Plan-->Transactions-->Client Transactions–>CreateClaim -->Attached rule-->CreateClaim

CreateClaimPrototype

<Transaction>
<EffectiveDate STATUS="Enabled" TYPE="SYSTEM"></EffectiveDate>
<Fields>
<Field>
<Name>ClaimAmount</Name>
<Display>Claim Amount</Display>
<DataType>Money</DataType>
<DefaultValue>0</DefaultValue>
<Currency>KRW,THB,INR,USD</Currency>
<DefaultCurrency>USD</DefaultCurrency>
</Field>
<Field>
<Name>ClaimReferenceNumber</Name>
<Display>ClaimReferenceNumber</Display>
<DataType>Text</DataType>
</Field>
<Field>
<Name>ClaimTypeCode</Name>
<Display>ClaimTypeCode</Display>
<DataType>Combo</DataType>
<Query TYPE="SQL">Select AsCode.CodeValue , AsCode.ShortDescription from AsCode where AsCode.Codename= 'AsCodeClaimType'</Query>
</Field>
<Field>
<Name>StatusCode</Name>
<Display>StatusCode</Display>
<DataType>Combo</DataType>
<Query TYPE="SQL">Select AsCode.CodeValue , AsCode.ShortDescription from AsCode where AsCode.Codename= 'AsCodeClaimStatus'</Query>
</Field>
<Field>
<Name>ClaimEntityType</Name>
<Display>ClaimEntityType</Display>
<DataType>Combo</DataType>
<Query TYPE="FIXED">
<Options>
<Option>
<OptionValue></OptionValue>
<OptionText></OptionText>
</Option>
<Option>
<OptionValue>POLICY</OptionValue>
<OptionText>POLICY</OptionText>
</Option>
<Option>
<OptionValue>SEGMENT</OptionValue>
<OptionText>SEGMENT</OptionText>
</Option>
<Option>
<OptionValue>CLIENT</OptionValue>
<OptionText>CLIENT</OptionText>
</Option>
</Options>
</Query>
<DefaultValue>POLICY</DefaultValue>
</Field>
</Fields>
<Math>
<MathVariables>
<!--<MathVariable VARIABLENAME="CreateClaimMV" TYPE="FIELD" DATATYPE="BOOLEAN">True</MathVariable>-->
<MathVariable VARIABLENAME="ClaimAmountMV" TYPE="FIELD" DATATYPE="CURRENCY">Activity:ClaimAmount</MathVariable>
<MathVariable VARIABLENAME="ClaimEffectiveDateMV" TYPE="FIELD" DATATYPE="DATE">Activity:EffectiveDate</MathVariable>
<MathVariable VARIABLENAME="ClaimReferenceNumberMV" TYPE="FIELD" DATATYPE="TEXT">Activity:ClaimReferenceNumber</MathVariable>
<!--<MathVariable VARIABLENAME="CurrencyCodeMV" TYPE="VALUE" DATATYPE="TEXT">USD</MathVariable>-->
<MathVariable VARIABLENAME="ClaimTypeCodeMV" TYPE="FIELD" DATATYPE="TEXT">Activity:ClaimTypeCode</MathVariable>
<MathVariable VARIABLENAME="EntityGUIDMV" TYPE="FIELD" DATATYPE="TEXT">Client:ClientGUID</MathVariable>
<MathVariable VARIABLENAME="EntityTypeMV" TYPE="FIELD" DATATYPE="TEXT">Activity:ClaimEntityType</MathVariable>
<MathVariable VARIABLENAME="ClientGUIDMV" TYPE="FIELD" DATATYPE="TEXT">Client:ClientGUID</MathVariable>
<MathVariable VARIABLENAME="StatusCodeMV" TYPE="FIELD" DATATYPE="TEXT"
>Activity:StatusCode</MathVariable>
</MathVariables>
</Math>
</Transaction>

UpdateClaimStatusPrototype

Main Explorer --> Companies-->Prototype-->Subsidiary Companies-->Plans-->Client Plan-->Transactions-->Client Transactions–>UpdateClaimStatus -->Attached rule-->UpdateClaimStatus

<Transaction>
<EffectiveDate STATUS="Enabled" TYPE="SYSTEM"></EffectiveDate>
<Fields>
<Field>
<Name>Status</Name>
<Display>Status</Display>
<DataType>Combo</DataType>
<Query TYPE="SQL">SELECT AsCode.CodeValue, AsCode.ShortDescription From AsCode where AsCode.CodeName = 'AsCodeClaimStatus'</Query>
</Field>
<Field>
<Name>ClaimGUID</Name>
<Display>Claim Record</Display>
<DataType>Combo</DataType>
<Query TYPE="SQL">SELECT AsClaim.ClaimGUID, AsClaim.ClaimReferenceNumber from AsClaim</Query>
</Field>
</Fields>
<Math>
<MathVariables>
<MathVariable VARIABLENAME="ClaimGuidMV" TYPE="FIELD" DATATYPE="TEXT">Activity:ClaimGUID</MathVariable>
</MathVariables>
</Math>
</Transaction>

            

CopyToClaimFieldsPrototype

Main Explorer --> Companies-->Prototype-->Subsidiary Companies-->Plans-->Client Plan-->Transactions-->Client Transactions–>CopyToClaimFields -->Attached rule-->CopyToClaimFields

<Transaction>
<EffectiveDate STATUS="Enabled" TYPE="SYSTEM"></EffectiveDate>
<Fields>
<Field>
<Name>Amount</Name>
<Display>Claim Amount</Display>
<DataType>Money</DataType>
<DefaultValue>0</DefaultValue>
<Currency>KRW,THB,INR,USD</Currency>
<DefaultCurrency>USD</DefaultCurrency>
</Field>
<Field>
<Name>Claim</Name>
<Display>Claim Reference Number</Display>
<DataType>Combo</DataType>
<Query TYPE="SQL">SELECT AsClaim.ClaimGUID, AsClaim.ClaimReferenceNumber FROM AsClaim</Query>
</Field>
<Field>
<Name>EffectiveDate1</Name>
<Display>Claim Effective Date</Display>
<DataType>Date</DataType>
</Field>
</Fields>
<Math>
<MathVariables>
<MathVariable VARIABLENAME="AmountMV" TYPE="EXPRESSION" DATATYPE="CURRENCY">Activity:Amount</MathVariable>
<MathVariable VARIABLENAME="ClaimGuidMV" TYPE="FIELD" DATATYPE="TEXT">Activity:Claim</MathVariable>
<MathVariable VARIABLENAME="DateMV" TYPE="FIELD" DATATYPE="DATE">Activity:EffectiveDate1</MathVariable>
</MathVariables>
</Math>
</Transaction>
     
Copyright © 2017, Oracle and/or its affiliates. All rights reserved. About Oracle Insurance | Contact Us