Claims

The Claims business feature provides institutions with a consolidated, enterprise-wide view of all the claims for a party and the policy or contract to which the claim applies. This helps identify potential problems such as fraudulent claims.

Claims to items or holdings are required to track the moneys issued against a particular personal belonging. As part of the Claims design, holdings or items that can be called assets and liabilities are persisted and linked to a claim through the Agreement (Contract) component.

A claim is a request for insurance agreement benefits from one or more interested parties. A claim can have one or more other claim items associated with it; for example, a single-loss event such as a flood catastrophe triggers different claims on different insurance agreements, for example, household, car, life policy and so on, and every claim is eventually composed of one or more claim coverage parts, such as the water damage in the household policy. Depending on the particular line of business, claim files can have a very short to a very long life cycle. The life cycle of a claim can exceed the end date of the insurance agreement.

The Claims feature is dependent on the Financial and Party project packages. That is, claims can be related to one or more policies and can involve one or more parties. Interfaces, classes, and other elements of claims are packaged into a project called claims residing within the Financial project. The Holdings feature is dependent on the Party project packages: a holding can exist without a link to a party in this design, but it is assumed that roles are associated to the holding.