Insurance Types and Insurable Entities

Oracle Health Insurance supports multiple types of insurance besides health, such as life, property, travel. Each Oracle Health Insurance instance can hold multiple user-configurable insurance types that support one or more insurable entities.

Insurance Types

The insurance type specifies the type of insurance like health, travel, or vehicle.

The type drives the label text on the user interface pages to be specific to a particular insurance type.

Example

The user interface page for health type uses the label First Name as an identifier of a person. That same page can display the label as Brand and Type as an identifier of a vehicle.

An insurance type also determines entities used in an insurance.

The insurance type is essential for referencing policies and enrollment products (in Oracle Health Insurance Enterprise Policy Administration), claim forms (in Oracle Health Insurance Claims Adjudication and Pricing), and authorization forms (in Oracle Health Insurance Authorizations).

An insurance type has the following fields:

Field	Description
Code	Code for the insurance type
Description	Description of the insurance type
Supported Insurable Entity Types	The list of supported insurable entity types

Insurable Entities

An insurable entity is the object that is covered under the insurance, such as a person, building, a vehicle, a pet. An insurable entity defines a name for the covered entity used throughout the application.

An insurable entity has the following fields:

Field	Description
Code	Code of the insurable entity
Description	Description of the insurable entity
Entity Date	The starting point used in configuring logic For example, for configuring an adjudication limit of an insurable entity, the entity date is the start date for setting up counter periods.

Insurable Entity Types

Oracle Health Insurance supports up to eleven types of insurable entities. One of these is a person type, which is fixed. The rest are configurable objects like vehicle, pet, building, etc.

An insurable entity type has the following fields:

Field	Description
Type	Type of insurable entity
Code	Code of the insurable entity type
Plural Display Name	Display name in plural
Singular Display Name	Display name in singular
Usage Name	Name used by the application for the entity
Resource Name	Resource name of the insurable entity type

The usage name must comprise letters, numbers, or underscores. Each name must begin with a letter. Spaces and special characters are not allowed. The usage name is used in JET floorplans to refer to an insurable entity. The Oracle Health Insurance floorplans use a person as an insurable entity. Using a different usage name requires a change in the floorplan configuration.

Insurable Persons

Insurable Persons use the Oracle Health Insurance Relation model that supports the use of addresses, titles, email addresses, etc. An insurable person is uniquely identified through a relations code. Refer to Relations for more details on Person.

Insurable Objects

Oracle Health Insurance supports the use of up to ten different insurable object types. Each insurable object has a unique code specific to its insurable object type. This means that building or a vehicle can have the same codes in their separate categories.

Each of the ten insurable object types allows extending the model of its insurable objects through Oracle Health Insurance extensibility (dynamic fields, dynamic records, etc.). This means that the fields for a vehicle type differ from those of the building type.