Create New Claim Programs

If you want to use the advantages the Claim Program offers for your individual treaty claims administration, and cannot find an existing Program that matches your claim, you can create a new Claim Program from:

• Find Claim Program window, or
• The Business Claim List Claim Program tab, or
• As part of any of the claim or move claim wizards.

Each of these processes will be described in detail in this chapter. Which one to select, depends on where in the system you are. Regardless of from where in the system you initiate the process, the system takes you through the Create New Claim Program wizard.

When creating a new claim program, the system will check that all mandatory class of business classifications on the linked business section has at least one active value per classification type. If not, claim program cannot be created.

Create Claim Program from Find Claim Program Window #

1. Open the Claim Program folder from the SICS desktop to access the Find Claim Program window. Search for the existing Claim Programs by clicking Find Now. New Claim Programs can only be created after a search has been performed.
2. Select New from the pop-up menu.
3. Select the treaty to which you want to link the Claim Program by typing the Business identifier. Alternatively, you can use the ‘typeahead’ facility. Type in the business title or part of the title in the field, and you will receive possible matches for the text.
4. You can also click the Find button to access the Find Business window (some default extract criteria are already entered).
5. Select the Insured Period and Section of the Treaty.
6. Define the Claim Program Properties, Classifications, Exclusions/GNPI. If Claim Bdx is in use, note that this indicator appears on the Claim Program as an output field only, and cannot be modified.
7. If the selected treaty is linked to a Reinsurance Program, other treaties linked to the same Reinsurance Program with matching classifications, cession basis, and cover basis are already pre-selected.
8. Add additional single treaties by pressing the menu button in the lower right corner, and selecting “Add Single Treaties”. The system opens the find business window with search criteria defaulted based upon the source treaty. Press Find Now, and transfer the selected treaty back to the Create Claim Program wizard. Repeat this process for all treaties you want to include in the Claim Program.
9. Add additional treaties linked to other Reinsurance Programs by pressing the menu button in the lower right corner, and selecting “Add Reinsurance Program. The system opens the find business window with search criteria defaulted based upon the source treaty. Press Find Now, and transfer the selected Reinsurance Program back to the Create Claim Program wizard. Repeat this process for all Reinsurance Programs you want to include in the Claim Program.
10. Move treaties you want to include in the Claim Program from available to selected, and press Next
11. The system validates that the selected treaties have the same Cedent, the same classifications (i.e. Main Class of Business, Class of Business, Sub Class of Business, Additional Classification, Geographical Scope, Cession Basis), and also cover the Claim Program Period. In addition the system validates that the selected non-proportional treaties have the same type (Cost cover, Clash Cover, Regular), and that their limits do not overlap. If Claim Bdx is in use the system validates that all treaties have the same Bdx indicator. If any of these tests fail, the system will return a validation error, and the offending treaty cannot be added. A warning message is also returned if the selected treaties have different brokers, and if the selected non-proportional treaty limits have any gaps. Note that both gaps and overlaps are validated per Reinsurer.
12. Select the Transfer to Ledger indicator for each of the included treaties. (The suggested Transfer to Ledger indicator is as defined by your System Administrator.)
13. Click Finish

Create Claim Program from Business Claim List #

1. Open the business, and click the Claims icon to access the Business Claim List.
2. Navigate to the correct section.
3. Select New from the pop-up menu.
4. Define the Claim Program Properties, Classifications, Exclusions/GNPI.
5. If the selected treaty is linked to a Reinsurance Program, other treaties linked to the same Reinsurance Program with matching classifications, cession basis, and cover basis are already pre-selected.
6. Add additional single treaties by pressing the menu button in the lower right corner, and selecting “Add Single Treaties”. The system opens the find business window with search criteria defaulted based upon the source treaty. Press Find Now, and transfer the selected treaty back to the Create Claim Program wizard. Repeat this process for all treaties you want to include in the Claim Program.
7. Add additional treaties linked to other Reinsurance Programs by pressing the menu button in the lower right corner, and selecting “Add Reinsurance Program. The system opens the find business window with search criteria defaulted based upon the source treaty. Press Find Now, and transfer the selected Reinsurance Program back to the Create Claim Program wizard. Repeat this process for all Reinsurance Programs you want to include in the Claim Program.
8. Move treaties you want to include in the Claim Program from available to selected, and press Next
9. The system validates that the selected treaties have the same Cedent, the same classifications (i.e. Main Class of Business, Class of Business, Sub Class of Business, Additional Classification, Geographical Scope, Cession Basis), and also cover the Claim Program Period. In addition the system validates that the selected non-proportional treaties have the same type (Cost cover, Clash Cover, Regular), and that their limits do not overlap. Note that overlaps are validated per Reinsurer. If Claim Bdx is in use, the system also validates that all treaties have the same value. If any of these tests fail, the system will return a validation error, and the offending treaty cannot be added. A warning message is also returned if the selected treaties have different brokers, and if the selected non-proportional treaty limits have any gaps.
10. Select the Transfer to Ledger indicator for each of the included treaties. Note that gaps are validated per Reinsurer. (The suggested Transfer to Ledger indicator is as defined by your System Administrator.)
11. Click Finish

Create Claim Program as part of Wizards #

When you are in the process of creating claims, copying existing claims, or assigning claims on Assumed Treaty Business, you have the option to create a new Claim Program as part of the wizard. This option is available on the Claim Program link page. Refer to Create Claim in this chapter for further details

This option is also available if you select to Link a Claim to a Claim Program or Move a Claim from one Claim program to another. Refer to Link Claim to Claim Program and Move Claim later in this chapter for further details.

1. Go through the wizard until you get to the page where you can select a Claim Program.
2. Click the Menu button and select Create Claim Program.
3. Define the Claim Program Properties, Classifications, Exclusions/GNPI.
4. If the selected treaty is linked to a Reinsurance Program, other treaties linked to the same Reinsurance Program with matching classifications, cession basis, and cover basis are already pre-selected.
5. Add additional single treaties by pressing the menu button in the lower right corner, and selecting “Add Single Treaties”. The system opens the find business window with search criteria defaulted based upon the source treaty. Press Find Now, and transfer the selected treaty back to the Create Claim Program wizard. Repeat this process for all treaties you want to include in the Claim Program.
6. Add additional treaties linked to other Reinsurance Programs by pressing the menu button in the lower right corner, and selecting “Add Reinsurance Program. The system opens the find business window with search criteria defaulted based upon the source treaty. Press Find Now, and transfer the selected Reinsurance Program back to the Create Claim Program wizard. Repeat this process for all Reinsurance Programs you want to include in the Claim Program.
7. Move treaties you want to include in the Claim Program from available to selected, and press Next
8. The system validates that the selected treaties have the same Cedent and Reinsurer, the same classifications (i.e. Main Class of Business, Class of Business, Sub Class of Business, Additional Classification, Geographical Scope, Cession Basis), and also cover the Claim Program Period. In addition the system validates that the selected non-proportional treaties have the same type (Cost cover, Clash Cover, Regular), and that their limits do not overlap. If Claimm Bdx is in use, the system also validates that all included treaties have the same value. If any of these tests fail, the system will return a validation error, and the offending treaty cannot be added. A warning message is also returned if the selected treaties have different brokers, and if the selected non-proportional treaty limits have any gaps.
9. Select the Transfer to Ledger indicator for each of the included treaties. (The suggested Transfer to Ledger indicator is as defined by your System Administrator.)
10. Click Finish

Refer to Handle Claim Program Properties, Record GNPI/Exclusion Information, and Handle Treaty Links.

| Period From | The inception date of the Claim Program.

Value: Any date within the selected Insured Period - DD/MM/YYYY

Default: The Insured Period Start Date if the selected Business is not linked to a Reinsurance Program. The Reinsurance Program Period Start date to which the selected Business and Insured Period is linked.

Mandatory: Yes

Validations: Yes | | Claim Program Period To | The end date of the Claim Program.

Value: Any date within the selected Insured Period - DD/MM/YYYY

Default: The Insured Period End Date if the selected Business is not linked to a Reinsurance Program. The Reinsurance Program Period End date to which the selected Business and Insured Period is linked.

Mandatory: Yes

Validations: Yes | | Claim Program Year | The year the Claim Program is valid.

Value: Output field only.

Derived: Derived from Claim Program From Date

Mandatory: Yes | | FGU | Indicator that claims linked to the Claim Program should be accounted for using FGU.

Value: Selected / cleared

Default: As defined by your System Administrator | | Notes | Notes and remarks.

Value: Free-text entry.

Mandatory: No | | Main Class of Business | The Main Class of Business covered by the Claim Program

Value: Any of the Main Classes of Business defined on the selected Business Scope of Cover.

Default: The Main Class of Business on the chosen Business Scope of Cover if only one defined.

Mandatory: Yes

Functional impact: Yes. All claims linked to this Claim Program must have this Main class of Business. | | Class of Business | The Class of Business covered by the Claim Program

Value: Any of the Classes of Business defined on the selected Business Scope of Cover and that are valid for the selected Main Class of Business.

Default: The Class of Business on the chosen Business Scope of Cover if only one defined.

Mandatory: Yes

Functional impact: Yes. All claims linked to this Claim Program must have this Class of Business. | | Sub Class of Business | The Sub Class of Business covered by the Claim Program

Value: Any of the Sub Classes of Business defined on the selected Business Scope of Cover and that are valid for the selected Main and Class of Business.

Default: The Sub Class of Business on the chosen Business Scope of Cover if only one defined.

Mandatory: No

Functional impact: None

| | Additional Classification | A further description of the Claim Program’s coverage available if activated by your System Administrator.

Value: Any of the Additional Classification items defined on the selected Business Scope of Cover and that are valid for the selected Main and Class of Business, Sub Class of Business, or does not have any parent dependencies defined.

Default: The Sub Class of Business on the chosen Business Scope of Cover if only one defined.

Mandatory: No

Functional impact: None | | Country/Country Group | The geographical area for which the Claim Program is valid.

Value: A country group (or a member of this country group) or a country defined on the selected Business Scope of Cover.

Default: The country or country group defined on the selected Business Scope of Cover if only one is defined.

Mandatory: Yes

Functional impact: All claims linked to this Claim Program must have this location (or a member of this location). | | Cession Basis | The method used when the business is accounted for.

Value: The Cession Basis defined on the selected Business Scope of Cover’s Administration Condition.

Mandatory: No

Functional impact: All treaties linked to this Claim Program must have the same Cession Basis defined. | | Treaty | Description of the treaties/part of the treaties that are excluded from the Claim Program or Claim Program Premium overview.

Value: Customised.

Mandatory: No

Functional impact: None | | Insured Period | Description of the Insured Period or parts of the Insured Period that are excluded from the Claim Program or Claim Program Premium overview.

Value: Customised

Mandatory: No

Functional impact: None | | From | The start date of the period for which premiums are included in the Claim Program Premium overview.

Value: Any date DD/MM/YYYY.

Default: Claim Program Period start date.

Mandatory: Yes

Functional impact: No | | To | The end date of the period included in the Claim Program Period overview.

Value: Any date DD/MM/YYYY.

Default: Claim Program Period end date.

Mandatory: Yes

Functional impact: No | | GNPI Code | A description of the premium amounts, for example Gross Premium or Deposit Premium.

Value: System defined values.

Mandatory: No

Functional impact: None | | Amount | The premium amount. Field is only enabled when a GNPI Code has been defined.

Value: Decimal field - maximum 18 + 2 decimals.

Mandatory: No

Functional impact: None | | Currency | The premium currency. The field is enabled when GNPI Code has been defined.

Value: Any currency defined in the system.

Mandatory: Mandatory when Amount field has been specified.

Functional impact: None | | GNPI Code 1 | A further description of the Premium, for example Booked or Earned.

Value: Any of the values that is valid for the chosen GNPI Code.

Mandatory: No

Functional impact: None | | Number | A further description of how the Premium is calculated, enabled when GNPI Code “Other” is chosen.

Value: Integer - maximum 10.

Mandatory: No

Functional impact: None | | Description | A description of the Number field, enabled when GNPI Code “Other” is chosen.

Value: Customised.

Mandatory: No

Functional impact: None | | Note | Remarks relevant to the GNPI or Exclusion information.

Value: Free-text entry.

Mandatory: None | | Available | The scopes of covers that are part of the same Reinsurance Program as the chosen Business which for one reason or another does not fit the Claim Program | | Selected | The scopes of cover that are part of the same reinsurance Program as the Business originally chosen that fit the Claim Program classifications.

Functional impact: All claims created on this Claim Program will be linked to all the Scopes of Cover. | | Transfer to Ledger | Businesses, which claim worksheet bookings, will be transferred to Business Ledgers.

Default: As defined by System Administrator.

Functional impact: Claim Booking information will display this check box, and claim worksheet bookings will be transferred to ledgers. | | Not Transfer to Ledger | Businesses, which claim worksheet bookings, will not be transferred to Business Ledgers.

Default: As defined by System Administrator.

Functional impact: Claim Booking information will display this check box, and claim worksheet bookings will be displayed on Claim Ledger only. |