Database Reference
In-Depth Information
Claims Processing Steps
Data Generated / Used
ClaimNo
, PolicyHolderName, PhoneNo, PolicyNo,
AccidentDate
,
AccidentDesc
Receive and enter claim into system
PolicyNo, PolicyPeriod, PolicyStatus
Verify if policy is current
ClaimNo
,
DamageDesc
,
DamageAmount
Assess damage from reports
PolicyNo, DeductibleAmount, PolicyTerms
Check deductible and other terms
ClaimNo
,
DamageAmount
, PolicyTerms,
DeductibleAmount,
SettlementAmount
Calculate settlement amount
PolicyNo, PolicyHolderName, Address,
SettlementAmount
Create payment check
PolicyNo,
PremiumAdjustment
, AgentID,
AgentName, AgentAddress, AgentPhone
Adjust policy premium, if required
NOTE:
Data generated by this process shown in
italics
.
Figure 4-10
Claims processing: data requirements.
process needs to make use of some data elements generated by some other busi-
ness unit. Figure 4-10 illustrates data generated and used by this process. Note each
step of the process and observe the data generated and the data used at each step.
Also, see how the data requirements are tied to business objects that are relevant
to the company.
When you finish confirming the requirements through the observation of busi-
ness processes, your requirements definition solidifies. Any vagueness in the require-
ments determined through interviews is removed. We have two more steps that
accomplish similar confirmation of requirements: review of applications and study
of documents. Let us go over these two steps before finishing the requirements
definition phase.
Review of Applications
During the interviews, you would have completed a list of all the current computer
applications that support the various business processes. In fact, you would have
noted all the applications reports and screens that are especially important to the
user groups. Now in this step you will use the compiled list of applications, reports,
and screens to review the data requirements. This step is another step to augment
the requirements gathering through interviews.
While reviewing the current applications, you are not interested in how the users
navigate through the menus and screens. That goes with the design of applications.
In DDLC, you are finding out what data are required to support the applications.
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