Database Documentation -19.01.2011

MI database Documentation The MI database documentation contains the database explanation and user manual

2010

Oyun Tenger Insurance

12/13/2010

Table of contents

1. Tables 2. Forms 3. Reports

1. TABLES ENROLLMENT

Enrollment part of the database consists of seven tables, which cover all information about Insured. These tables are based on the actual enrollment form. The division was done corresponding to information category and specification of relationship between the tables.

a.

This table contains information only about policyholder: INSURED

• Policyholder’s Family name • First name • Gender • Birth date • Register number • ID card number • Home address • Home address • Telephone number 1 • Telephone number 2 • Occupation • Employer

b.

The Family table lists all family members of policyholder with following family member information:

FAMILY

• Relationship to policyholder • Family name • First name • Gender • Register number • ID card number • Insured’s register number

The table will be connected to the Insured table by register number of a main Insured and two tables have one-to-many relationship, i.e. one Insured has many family members.

c. Several policies can be assigned one insured. It is because every time a loan holder gets loan that person has to get new policy. This is common situation. In this case again we create one-to-many relationship between Insured and Policy tables (relationship through Insured’s register number);

POLICY

as well each policy record contains information about corresponding loan. Information to be entered in the Policy table is:

• Policy number • Insured’s register number • Original issue date • Next renewal date • Premium credit from old policy • Premium refund • Cancellation date • Loan number • Loan amount • Loan term • Loan officer name • Branch ID

It’s necessary to underline the fact that if policy renews, it doesn’t change its number, but its policy year changes in Policy version table.

d. In case Insured renews his/her policy new record in Policy version table shows this fact. The indication of renewal will be Policy year entry. If insured changes his/her policy coverage type or product level this will be captured in this table.

POLICY VERSION

• Policy version ID (will be given automatically) • Policy number • Policy year • Coverage type • Product level • Insurance start date • Insurance end date • Premium amount

One-to-many relationship of this table and the Policy table happens through policy number.

e. This table has a purpose to show all money flows, concerning the given policy version. These can premium, refund or claim payment. It’s necessary to catch each payment made.

TRANSACTION RECORD

One-to-many relationship is created between Policy version table and this table by policy version ID.

The table takes following data: • Transaction ID (will be given automatically) • Policy version ID • Transaction direction (incoming, outgoing) • Transaction type (premium, refund, claim) • Amount • Payment date • Payment received by

f.

According to MI product design each insured is eligible to have a few beneficiaries with benefit percentages equal to 100% total. It means the table structure and its relationship to the Insured table is similar to the Family table, but the table is connected to the Policy table because insured can change his/her beneficiary for every new policy.

BENEFICIARY

Following information has to be captured for each Beneficiary: • Policy number • Relationship to policyholder • Family name • First name • Gender • Register number • ID card number • Claim percentage

One-to–many relationship is realized by policy number.

g. Trustee has to be assigned for each beneficiary under age 18. It means one-to-one relationship is needed between Beneficiary and his/her trustee. The relationship is based on beneficiary’s’ register number. Trustee information is:

TRUSTEE

• Relationship to policyholder • First name • Date of birth • Gender • Registration number • ID card number • Home address • Telephone number

Figure 1- Table relationships

CLAIMS Claims part consists of three tables: Accidental Death Claims table, Accidental Hospitalization table and Hospitalization table. Each table captures corresponding information about claim events and also information about internal claim process, which are supposed to be stated in the claim forms.

a. This table captures information about the accident and Insured’s death details with internal claim process information. Following fields are to be filled:

ACCIDENTAL DEATH CLAIM

• Policy version ID • Place of death • Date of death • Exact reason of death • Place of accident • Date of accident • Hospital served • Full name of doctor registered death • Telephone number • Name of organization registered death • Date of death registration • Police department registered accident

• Date first informed about insurance event • Insurance event informed by • Date of all documents completed • Decision date • Decision (to choose from “To pay”/”Reject”) • Decision explanation (if rejected) • Claim amount to be paid • Person in guilt (to choose from Yes/No) • Amount subrogated • Date subrogated

b.

For hospitalization caused by accident we capture correspinding information about the accident. Fields to be filled are:

ACCIDENTAL HOSPITALIZATION CLAIM

• Policy version ID • Place of Accident • Date of accident • Injured parts of body • Treatment details • Hospitalization days • Surgery details • Full name of a doctor treated after accident • Doctor’s telephone • Hospital served • Hospital telephone number • Date first informed about insurance event • Insurance event informed by • Date of all documents completed • Decision date • Decision • Decision explanation (if rejected) • Claim amount to be paid • Person in guilt (to choose from Yes/No) • Amount subrogated • Date subrogated

c.

This table is suppeosed to store information about claims concerning hospitalizations caused by illness.

HOSPITALIZATION CLAIM

• Policy version ID • Doctor’s diagnosis

• Symptoms • Duration of symptoms • Treatment details • Hospitalization days • Surgery details • Was the hospitalization related to pregnancy, miscarriage, abortion? • Was the hospitalization due to self-destruction, alcohol or drugs? • Was the hospitalization due to cosmetic surgery, dental treatment or

an elective surgery? • Hospital/clinic name • Hospital/clinic telephone number • Full name of doctor • Doctor qualification • Date first informed about insurance event • Insurance event informed by • Date of all documents completed • Decision date • Decision • Decision explanation (if rejected) • Claim amount to be paid • Person in guilt (to choose from Yes/No) • Amount subrogated • Date subrogated

In figure below you can see the relationships between the insurance and claim tables. Every claim event is attached to insurance version and relationship type is one to many as soon as the can be several claim events per policy version.

Figure 2 - Claim's table relationships

2. FORMS Forms give a convenient way to enter data into the database. As there many tables connected with one-to-many relationships the process of filling enrollment information needs to fill three forms:

a. INSURED FORM

Insured form consists of two tables: Insured and Family. To enter an Insured user has to press New Record button and fill Insured’s information and in case insured gets family coverage fill family members’ information in table beneath. After this user has to save the record and choose Open Insurance Form button to enter insurance information. The appearing window requires register number.

b. This form consists of three tables: Insurance, Beneficiary and Trustee. The same procedure as described above has to be completed and the Open Insurance version Form button to be pressed.

INSURANCE FORM

c.

The last form consists of two tables: Policy version and Transaction record. The process of filling the form is similar to those described above.

INSURANCE VERSION FORM

d. TRANSACTION RECORD FORM

After filling policy version information the user can transfer to the Transaction Record form to fill the premium income information. Only in this situation it will arise as a separate form. For Claims information the transaction records for claim payment will be included in the claim’s forms.

e. As mentioned above the Form consisits of two tables Accidental Death Claim and Transaction Record. Those tables are connected with one to many relationship taking into the account the fact that there could be several payments made per claim.

ACCIDENTAL DEATH CLAIM FORM

f.

The form construction is the same as above. ACCIDENTAL HOSPITALIZATION CLAIM FORM

g.

The form construction is the same as above. HOSPITALIZATION CLAIM FORM

3. Reporting In order to get reports during a specified period of time the user needs to open the “Report Request” form and fill the report beginning and report ending date or policy number. After that the user needs to select the report name. In that case the according query will select all records which satisfy requirements.

ENROLLMENT

a. The report shows all policyholders, whose policy is active during the specified time period in Report request form. General information consists of

INSURED GENERAL INFO REPORT

• First name • Family name • Gender • Birth date • Register number • Occupation • Employer

All policyholders are grouped by gender.

b. This report shows all policyholders grouped by number of family members in family without counting the policyholder himself. Report shows following information for each record:

INSURED’S’ FAMILY MEMBERS NUMBER REPORT

• First name • Family name • Policy year (last one) • Insurance starts date • Policy number • Coverage type • Product level

Because of specific way of building the query (counting the family numbers) it was complicated to select those policies which lie between the dates set in the Report requesting form. In other words the dates entered in the Report requesting form don’t play a role.

c. Active policies’ report selects all policies, which end date is after the current report date. The report shows policies grouped by coverage type and details such:

ACTIVE POLICIES’ REPORT

• Insurance start date • Insurance end date • Policy number • Policy year • Policyholder’s First name • Family name • Product level

d.

Report selects policies, which start date lies between dates specified in the Report request form. All records shown in the report are grouped by loan type, loan amount and loan term. Besides this information the report shows:

POLICIES BY LOAN CHARACTERISTICS

• Policyholder’s First name • Family name • Coverage type • Product level • Premium amount

This report is intended for analyzing relationship between loan characteristics and policy type.

e. The report shows all transactions happened between dates entered in Report request form. It has to provide with information about premium incomes. In this case the corresponding query selects all transaction records with payment date between report beginning and report ending dates and transaction type is “Premium”. All records in the report are ordered by policy number. Other policy information as

PREMIUM INCOME REPORT

• Policyholder’s First name • Family name • Policy year • Coverage type • Product level • Payment amount • Transaction type

are indicated in the report.

f. The report shows the list of policies which end date lies between the two dates specified in the Report request form. Following information is available in the report:

POLICIES BY END DATE

• Policy number • Policyholder’s First name • Registration number • Telephone number • Insurance start date • Insurance end date • Coverage type • Product level

Claims Claim’s reports show lists of insured that has paid claim by corresponding risk. There three reports: ACCIDENTAL DEATH CLAIMS, ACCIDENTAL HOSPITALIZATION CLAIMS and HOSPITALIZATION CLAIMS

• Policy number . All of them show following information:

• First name • Family name • Register number • Policy year • Coverage type • Product level

• Insurance start date • Insurance end date • Decision date • Decision date

The report selects all claim events, which decision date lies between dates entered in Report request form in Report start date and Report end date fields. For claims reports there is no need to fill the policy number field.