Insurable Entites

This guide describes the model that OHI Claims has to support multiline insurance capabilities. This means that the system supports multiple lines of insurance, within the same instance. For example, a customer can submit claims related to his/her car insurance and claims related to health insurance within the same OHI Claims instance.

Insurable Entity Types

OHI supports up to eleven types of insurable entities. One of these types is fixed as a person, the other ten are configurable objects. A configurable object can be a car, a boat, a house, etc. The insurable entity types offer the possibility to define the naming that is to be used throughout the system for that entity type.

The insurable entity type has the following fields :

Field	Description
Type	Type specifies if the insurable entity is a person or an object. The OHI systems support configuration of up to 10 object types.
Code	The unique code for the insurable entity type
Plural Display Name	The display name in plural
Singular Display Name	The display name in singular
Usage Name	The insurable entity will be identified by the specified name as 'resource' in the system, for example, in the dynamic logic, insurable Object IP
Resource Name	The resource name of the insurable entity type

The usage name must be composed of letters, numbers, and the underscore _, and must begin with a letter. So for example spaces and special characters like * are not allowed in the usage name.

OHI recommends that the code, usage name and resource name of an insurable entity type is kept similar across OHI components.

Insurable Entities

Insurable Entities are either insurable persons or insurable objects like a car, a boat or a house.

An insurable entity has the following fields:

Field	Description
Code	The code of the insurable entity
Description	The description of the insurable entity
Entity Date	The entity date used by the system and/or in dynamic logics to indicate a starting point. Example - If an adjudication limit is configured having reference as Insurable Entity'; then for an insured object the system takes this date as the start date for setting up counter periods.

Insurable Persons

Insurable Persons use the OHI Person model which supports the use of addresses, titles, formatted names, etc. An insurable person is uniquely identified by its relation code. Refer Relations for more details on Person.

Insurable Objects

OHI supports the use of ten different insurable object types. Each insurable object is identified by its code within the context of its insurable object type. This means that a boat and a car could use the same code but still be identified separately.

Each of the ten insurable object types allow extending the model of its insurable objects through OHI extensibility (dynamic fields, dynamic records). This means that the insured objects of type boat can have different fields than insured objects of type car.

Line of Business

The line of business specifies the configurable insurance line. Examples: Health Insurance, Travel Insurance, Motor Vehicle Insurance. For the user interface pages where the context of the line of business is specified it is possible to configure boilerplate text specific to it. This is especially useful for the fields that are used in more than one line of business. The terminology that is visible to the end-user, therefore matches the line of business specified in the context. The line of business also drives which insurable entities can be serviced though the claim.

The line of business has the following fields:

Field	Description
Code	The unique code for the line of business
Description	The description of the line of business
Line Of Business Insurable Entity Types	The list of insurable entity types supported by the line of business

Example

Consider an insurable entity type configured as :

Type	Code	Plural Display Name	Singular Display	Usage Name
Object	CAR	Cars	Car	car

Such a configuration will make OHI system aware that Car is intended to be used as an insured object. A menu item named 'Cars' is now available to add information about the cars for which the claims are required to be processed. Using the extensibility feature, dynamic fields and records can be defined for object ; to capture details specific to a car like named drivers, registration information etc.

Now in order to process claims having serviced object as CAR the insurable entity type CAR must be linked to the line of business CARINSURANCE.

Line of Business

Code	Description	* Insurable Entity Types*
CARINSURANCE	Car Insurance	CAR

The above configuration helps the system to know that line of Business 'CARINSURANCE' deals with an insurable object - CAR. The line of business is then referenced by the claim form which in turn is referenced by the claim.