Insurance Claims

This ERD (see the following figure) shows the important entities in the Insurance Claim recording and handling process. It illustrates the relationship between claims and claim elements and the various parties to the claim. It covers the association of invoices, invoice line items, payments and recoveries to claims. Also illustrated is the relationship between claim and insurance policy, activity, service request, document, appraisal, and so forth. The diagram also shows the metadata that supports claims and claim elements.

Insurance Claims: This image is described in the surrounding text.

The following table lists the entities in this ERD and their corresponding tables.

Entity Table

Activity

S_EVT_ACT, S_EVT_ACT_FNX

Assignment Group (Territory)

S_ASGN_GRP, S_INSCLM_TERR

Claim Account

S_INSCLM_ORG

Claim Appraisal

S_INSCLM_APRSL

Claim Appraisal Attachment

S_INSCLM_AP_ATT

Claim Contact

S_INSCLM_CON, S_INSCLMCON_ORG

Claim Document

S_INSCLM_DOC

Claim Element

S_INSCLM_ELMNT

Claim File Attachment

S_INSCLM_CL_ATT

Claim Payment

S_SRCPAY_INSCLM

Claim Property

S_INSCLM_PRPTY

Claim Recovery

S_INSCLM_RECVRY

Contact

S_CONTACT, S_PARTY, S_CONTACT_FNX

Default Coverage

S_DEFAULT_ADMIN

Injury

S_INSCLM_INJURY

Insurance Claim

S_INS_CLAIM S_INSCLM_FRAUD S_INSCLM_SBRGTN S_INSCLM_UW

Insurance Policy

S_ASSET

Insurance Policy Item

S_INS_ITEM

Invoice

S_INVOICE, S_INVC_PAYMENT

Invoice Line Item

S_INVOICE_ITEM

Loss Code

S_INS_LOSS_CODE, S_LOSSCD_PLNITM

Loss Code Coverage

S_INS_LOSCD_COV

Loss Event

S_INSCLM_EVT

Organization

S_ORG_EXT S_PARTY S_ORG_EXT_FNX

Party

S_PARTY

Payment

S_SRC_PAYMENT S_SRCPAYMT_CON S_SRCPAYMT_ORG S_INVC_PAYMENT

Position

S_POSTN, S_PARTY

Reserve Code

S_INS_RSRV_CODE

Service Request

S_SRV_REQ, S_SRV_REQ2_FNX