Aviva Business Rules
Aviva Business Rules
Date Tab Updated 7/6/2012 All Tabs 7/17/2012 Business Rules 7/24/2012 Business Rules 8/1/2012 Error Messages 8/31/2012 8/31/2012 8/31/2012 9/14/2012 Business Rules, Error messages Buiness Rules Business Rules Business Rules
Kunal Saigal Kunal Saigal Anuj Khorwal Kunal Saigal Mohiyuddin Imran Shaik Kunal Saigal
10/22/2012 Business Rules 10/25/2012 Business Rules, Error messages 10/25/2012 Error Message 10/25/2012 Business Rules 10/26/2012 Business Rules 10/30/2012 Business Rules
Kunal Saigal Jeff Suarez Mohiyuddin Imran Shaik Kunal Saigal Amy Cacho-Negrete Amy Cacho-Negrete
11/13/2012 Business Rules 11/20/2012 Business Rules 11/23/2012 Business Rules 11/27/2012 Error Message 12/3/2012 Business Rules, Error messages 12/4/2012 Business Rules, Error messages
Kunal Saigal
28/01/2013
Anuj Khorwal Mohiyuddin Imran Shaik Amy Cacho-Negrete Jeff Suarez Amy Cacho-Negrete Amy Cacho-Negrete S.BHANDAL Amy Cacho-Negrete Kunal Saigal Mohiyuddin Imran Shaik Kunal Saigal Jeff Suarez Amy Cacho-Negrete Jeff Suarez Amy Cacho-Negrete Jeff Suarez Kunal Saigal Jeff Suarez Amy Cacho-Negrete Mohiyuddin Imran Shaik Anuj Khorwal Amy Cacho-Negrete Mohiyuddin Imran Shaik Jeff Suarez Mohiyuddin Imran Shaik Anuj Khorwal Amy Cacho-Negrete Mohiyuddin Imran Shaik Mohiyuddin Imran Shaik Mohiyuddin Imran Shaik Anuj Khorwal Jeff Suarez Gerry Moore
1/28/2013 Business Rules 1/30/2013 Error Messages 2/4/2013 2/4/2013 2/4/2013 2/5/2013 2/5/2013 2/6/2013 2/6/2013 2/6/2013 Error Messages Business Rules Error Messages Business Rules, Error messages Business Rules Error Messages Business Rules Business Rules
2/6/2013 Business Rules 2/8/2013 Business Rules 2/8/2013 Error Messages 2/13/2013 2/15/2013 3/5/2013 3/15/2013 Business Rules Error Messages Business Rules Business Rules
3/19/2013 Business Rules 4/2/2013 Business Rules, Error messages 4/15/2013 Business Rules 4/16/2013 Business Rules 4/16/2013 Business Rules 4/17/2013 Business Rules 4/18/2013 Business Rules 4/24/2013 Business Rules 4/24/2013 Business Rules 4/25/2013 Business Rules 4/25/2013 Business Rules, Error messages 4/26/2013 Business Rules 4/26/2013 Business Rules 4/30/2013 Business Rules 5/1/2013 Business Rules 5/10/2013 Business Rules
Amy Cacho-Negrete Gerry Moore Mohiyuddin Imran Shaik Amy Cacho-Negrete Gerry Moore Amy Cacho-Negrete Anuj Khorwal S.BHANDAL Gerry Moore Anuj Khorwal Amy Cacho-Negrete Amy Cacho-Negrete Jeff Suarez Mohiyuddin Imran Shaik Gerry Moore
5/20/2013 Error messages 5/21/2013 Business Rules 5/22/2013 Business Rules 5/31/2013 Error messages 5/21/2013 Business Rules Error Messages 6/4/2013 Error messages 6/7/2013 Error messages 6/12/2013 6/12/2013 Business Rules Error Messages 6/12/2013 Business Rules 6/13/2013 Business Rules, Error messages 6/13/2013 Business Rules, Error messages 6/14/2013 Business Rules, Error messages 6/14/2013 Business Rules, Error messages 6/18/2013 Business Rules
Business Rules Business Rules Business Rules Business Rules Error Messages
Business Rules Business Rules Business Rules Business Rules Business Rules Error Messages
Amy Cacho-Negrete
Change Reason Initial draft BR005 added Config Changes re-introduced, ref numbers renumbered Added a column to show Iteration for each error message new new new rules BR010 - 013 New Rules BR014 - 016 Added BR030 for EM010 from Iteration 2 for better documentation. Added EMs and BRs for Contact Manager. Added BR032 for Documents Added BR033 for Documents, Added Error Messages for Enterprise Location Service Added EM019 for Claim Number look up Added BR034 and BR035 for relating contacts acrodd contact types Added BR036 for validation bank data permissions before editing bank data Updated BR022, BR023, BR024, BR025, BR026 per Chris B comments. Updated BR028 to mention 'City' instead of 'Geo'. Added BR037,BR038, EM034 and EM035 per Donna's inputs Added BR039 and EM036 for CPL contact BR040 was added Updated BR009 - changed BACS to EFT Added EM037 per config query on the postcode format. Added BR041 and EM038 as per requirement 12062 Removed previously added BR041 and EM038 as requirement 12062 no longer applies and cannot be tested. Added new EM per Aviva BA's request Updated EM010 text per testing defect 23297 Added further comments to BR035 to provide more clarity to the requirement Added EM039 to document Aviva requirement and EM040 to reflect OOTB behaviour
Added BR041 and EM041 for 'Email' checkbox on 'Create from a template' screen. Added BR042 Added EM042, EM043 and EM044 Added EM046-EM058 Added BR043-BR049 Added EM046-EM059 Added BR050, EM060, EM061 Added BR051 Added EM062, EM063 Added BR052 for outbound documents Added BR053 and BR054 for different policy search error scenarios Added BR055 - BR060 and EM065 for Services. Updated based on Core Team Feedback Updated EM049, EM050,and EM051 and warning messages Added EM066 Added EM067 Updated BR058 Update verbiage for EM041 to cater to both 'To' and 'CC' recipients. Removed BR046 as per Core Team's Request Added BR061 Added BR062, BR063 & EM068 Added BR064 Updated BR061 Added BR065, BR066, BR067, BR68 & EM069, EM070, EM071, EM072 EM72 added due to Defect 26159 Added BR078 and EM077 Added BR079 Updated EM045-EM063 details Added BR080, BR081, EM078, EM079, EM080, EM081 Modified BR063 as per the final agreed duplicate check criteria Removed BR081 and EM081 as separate BR and EM not required Corrected BR0064 BR045 - BR Catalogie & UC brought in line following discussions with Bryan McNaught
Added BR082 for subrogation; Modified BR078 and EM077 to match business requirements Added EM081 to BR081 BR045 - Clarified the wording following discussions with Bryan McNaught Modified BR078 and EM077 to based on config query Added BR094-BR097 Added BR098 Added EM082 Removed EM049, EM50, EM051, EM063; Added EM083-085, BR101 and 102 Strikethrough EM065 as per defect 28236 Added BR117 Added EM088 Added BR118 Added BR119 and EM089 Removed BR094 per RDW session; added BR120; updated EMs45-48 and 52-67 Added Business Rules and Error Messages Added BR126,127,135,136 and EM091 Added comments to BR002 & BR063 (duplicate claims check) to the effect that the duplicate claims check must include archived claims Updated BR093 to include assignment for NI Updated BR101 and 102 wording Update BR059 Updated BR098 & EM082 - document size limit now 10mb (x-ref email from Steve Hood) incorporated review comments for BR118 Changed BR135 to be based on Net Incurred Cost instead of Gross Incurred Cost; elaborated BR147 Updated BR087 Updated BR088 BR096 Updatd BRs 101 and 102 EM088 was a duplicate number. The EM088 related to UC19 has been renumbered to EM094 Added EM095 as required by BR087
Ref
1 BR004 1 BR005
Documents N/A
Payment Wizard Loss Intake Loss Intake Loss Intake Also ongoing Claim Handling Loss Intake Loss Intake Loss Intake Loss Intake Payment Wizard Foundational
Step 2 of 3 Step 1 - Search or Create Policy Step 1 - Search or Create Policy Step 1 - Search or Create Policy Thereafter in 'Policy' option in ongoing Claims handling. Step 1 - Search or Create Policy FNOL Loss Details GPA Injury Incident FNOL Loss Details GPA Step 3 of 3 Desktop - Claims, Pending Assignment
3 BR019
Foundational
3 BR020
Foundational
FNOL Save Contact Manager - Merge Contacts Contact Manager - Merge Contacts
3 BR024
Contact Manager
3 BR025
Contact Manager
3 BR026
Contact Manager
Contact Manager Contact Manager Contact Manager QAS Address Look Up Contact Manager Foundational
Contact Manager - Search View Create Edit Contact Contact Manager - Search Contact Manager - Search All Address fields Screens Contact Manager - Search View Create Edit Contact Documents - Templates Search
3 BR033 3 BR034
3 BR035
Contact Manager
3 BR036 3 BR037 3 BR038 3 BR039 3 BR040 4 BR041 4 4 4 4 BR042 BR043 BR044 BR045
Contact Manager Contact Manager Contact Manager Contact Manager Payment Wizard Foundational Foundational All Areas All Areas All Areas
Contact Manager - Search View Create Edit Contact Contact Manager - Search Contact Manager - Search Contact Manager - Search Payments - Create Edit Documents - Create from a template Close Exposure **** **** ****
4 BR051
All Areas
Set Reserves
4 BR052
All Areas
Step 1 - Search or Create Policy Step 1 - Search or Create Policy Services - Transactions
4 BR056
All Areas
Services - Transactions
4 BR057
All Areas
Services - Transactions
4 BR058
All Areas
Services - Transactions
4 BR059
All Areas
Services - Transactions
4 BR060
All Areas
Services - Transactions
Desktop - Activities FNOL Basic Information Property FNOL Basic Information Property
5 BR064
Admin
Users
5 BR065 5 BR066
Subrogation Subrogation
5 BR067
Loss Investigation
Subrogation
5 BR071
Payment Wizard
Step 3 of 3
5 BR072
Payment Wizard
Step 3 of 3
5 BR073
Payment Wizard
Step 3 of 3
5 BR074 5 BR075
5 BR076 5 BR077
Step 3 of 3 Step 3 of 3
5 BR078
Loss Intake
5 5 5 5 6
6 BR084
Assignment
Assign
6 BR085
Assignment
Assign
6 BR086
Assignment
Assign
6 BR087
Assignment
Assign
6 BR088
Assignment
Assign
6 BR089
Assignment
Assign
6 BR090
Assignment
Assign
6 BR091
Assignment
Assign
6 BR092
Assignment
Assign
6 BR093
Assignment
Assign
6 BR102
6 BR103
Exposure
6 BR104
Exposure
6 BR105
Exposure
6 BR106
Exposure
6 BR107
Exposure
6 BR108 6 BR109 6 BR110 6 BR111 6 BR112 6 BR113 6 BR114 6 BR115 6 BR116 6 BR117 6 BR118 Assignment
Payments - Create Edit Payments - Create Edit Payments - Create Edit Payments - Create Edit Payments - Create Edit Payments - Create Edit Payments - Create Edit Payments - Recode Payment - Void Transfer Reissue Clone Delete Send Documents Assign
6 BR119
Property Incident
6 BR120
Claim Summary
6 BR121
Policy
Policy Details
6 BR124
Policy
Policy Details
6 BR125
Policy
Policy Details
Bulk Recovery Bulk Recovery Payment Create Edit Reserves View Create Edit Payment Create Edit Payment Create Edit Exposure
6 BR133
Exposures
Exposure
6 BR134 6 BR135
6 BR136 6 BR137
Loss Investigation
6 BR138
Exposures
Exposure
6 BR139
Reserve, Payments
6 BR140
Aggregate limits
Aggregate Limits
6 BR141 6 BR142
6 BR143
Aggregate limits
Aggregate Limits
6 BR144
Recovery Reserve
6 BR145
6 BR146
Aggregate Limits
6 BR147
Payment Create Edit Supplier Assignment Aggregate Limits Invoice and PO activities
Description Session Expiry time should be 2 hours Duplicate Claim Check for GPA should trigger by Loss date (+/- 31 days) and Name NB The Duplicate Claims Check must include Archived Claims (x-ref UC121) When the document is uploaded to GW Claim Center using 'Attach an existing document' functionality OR when a notification is received on the ClaimCenter from Content Manager, an activity would be generated based on the 'type' of the document uploaded. Once selected document types generate activities and these activities are completed, a rule fires that delivers a message to the doc summary that the document has been actioned An activity to be created when Large Loss Threshold is breached for a particular policy type and assigned to the file owner. Activity to flag Large Loss Claim Upon upload of a document to ClaimCenter/Content Manager a rule fires that generates the New Note screen If you add a document to ClaimCenter by 'Create from a template' a rule fires that marks the document as Outbound If the detailed Injury field is seleceted as 'Not Yet Known' from the detailed Injury typelist, then the exposure related to the Injury Incident should not be closable. Error message should be displayed on the close claim screen /close exposure screen / all related alternate flows. The total of all payments should be validated as follows: When the method of payment is equal to 'BACS,' payment cannot be greater than 500,000 Where a user creates an unverified policy then upon 'Save Claim' the Coverage in Question indicator should be set to 'Yes' and the associated Activity for Coverage in Question created (as per OOTB). If user has not completed at least one of the available Policy Search fields then search should not proceed and error maessage displayed. Current Permission set allows for users to Edit Policies, with no separate Create Policy permission. Aviva require that users should be able to create new Unverified Policies, but not be able to Edit Policies where that Policy information has initially been received from a Policy System, be that PolicyCenter or any other Policy should legacy system. Users not be able to create Exposures on a claim against an Unverified Policy. This option needs to be disabled where the Policy is unverified. The cause of loss codes would vary based on the Line of Business selected If the policy has A&H coverages attached, the A&H relevant fields will be displayed in the Injury incident If Coverage in Question indicator is set to Yes, Without Prejudice needs to be printed on all correspondence Payments cannot be future dated beyond 30 days. It must be less than or equal to 30 days Complexity Rating for a claim would be the highest complexity rating of the individual exposures associated to the claim, 1 being the simplest and 5 the highest complexity. Complexity Rating for activities associated to an exposure will display the complexity rating of that exposure Complexity Rating for activities other than the ones associated to an exposure would display the complexity rating of the claim Create Claim number with format as 4nnnnnnnnn For a new contact saved as a 'Organisation/Company', if it equals the Organisation 'Name' and Postal Code/Zip Code (US) of an existing contact, then it is an 'exact' match identified per de-duplication process. For a new contact saved as a 'Person', if it equals 'First Name' and 'Last Name' and 'Date Of Birth' and equals either Primary Address [Address 1 and PostalCode /Zip Code (US)] or any phone field of an existing contact, then it is an exact match identified per de-duplication process. For a new contact saved as a 'Person', if it equals 'First Name' and 'Last Name' and 'NIN' of an existing contact, then it is an exact match identified per de-duplication process
For a new contact saved as a 'Organisation/Company', if it Starts with 'Name' and equals either Primary Address [Address 1 and PostalCode / Zip Code (US)] or a phone field of an existing contact, then it is a potential match identified per de-duplication process For a new contact saved as a 'Person', if it Starts with 'First Name' and equals 'Last Name' and equals either PrimaryAddress [Address 1 and PostalCode /Zip Code (US)] or 'Date of Birth' or any phone field of an existing contact, then it is a potential match identified per de-duplication process For a contact with 'CPL Reference' field not null, user should not be allowed to delete that contact. If 'Search Within' checkbox is checked against 'Name' for a contact type saved as Organisation, then user must enter either Postecode (UK)/ Zip Code (US) / City (Other) OR 'Address 1' to successfully complete the search. Minimum 3 characters should be entered for 'Search Within' search When the address is entered manually and system is updated a warning message needs to be displayed For a contact tagged as 'CPL' ('Tags' field contains CPL), user should not be allowed to edit that contact. For Outbound documents (while creating documents from template and doing template search) WHEN Line of Business = Accident THEN display All Document Templates in GWCC EXCEPT Critical Illness Letter in the search results. WHEN Line of Business = Sickness THEN display All Document Templates in GWCC in the search results. WHEN Line of Business = Travel THEN only Free Format Letter Document Template to be displayed in GWCC in the search When the user clicks results on 'Create Document', an error should be thrown for mandatory field 'To' under 'Specify Object Values' section if the value of the field is "none selected" When the user clicks on 'Relate' button, system should perform the following step: Add the contact type as a 'Related Contact' to the associated duplicate contact type with 'Relationship' set as 'Exists Across Contact Types' and vice versa If any contact that has a 'Related Contact' with a Relationship 'Exists Across Contact Types', is updated the same updates* should apply to the Related Contact * Only fields which were updated in the primary contact will be updated in the related contact, provided the same field is applicable for the related contact. Add and Remove buttons in Bank Data section will be displayed only to users with permissions to add, edit and remove bank data If 'Search Within' checkbox is checked against 'Address 1' for a contact type saved as Organisation, then user must enter 'Name' to successfully complete the search. If 'Search Within' checkbox is checked against 'Address 1' for a contact type saved as Person then user must enter 'Last Name' to successfully complete the search. User should not be allowed to create or update any contact with CPL tag from Contact Manager Each individual payment and each payment that is part of a Cheque set will need to generate a unique SBI that will be sent downstream If there is no email id captured for the party involved that needs to be sent the outbound document, an error message needs to be thrown once the user selects the Email checkbox. Navigate to Close Claim screen when the last open exposure has been closed Claims notified within 60 days of policy Inception. This should trigger Section One questions on the **** Screens Claims notified more than 30 days after loss date. This should trigger Section One questions on the **** Screens Claims notified within 28 days of policy lapse or cancellation date will trigger Section One questions on the **** Screens. This business rule will use the Notification Date located on the Basic Information Step and will use the Policy's Effective Lapse date and / or Policy Cancellation effective date. Cannot be tested until the UC is implemented on Iteration 2 of 1A
Claims where the unoccupied property flag has been used. This should trigger Section One questions on the **** Screens Claims where "items been replaced or works already completed" field has answered yes. This should trigger Section One questions on the **** Screens Claims where Suspicion of involvement by an (ex) employee, Director or Partner field has been answered yes. This should trigger Section One questions on the **** Screens If field 'Has trading been affected / could be affected in the future?' is selected as "Yes", check to see if there is a Loss of Use Exposure on the claim. If no Loss of Use Exposure found on claim, warning message is thrown once user selects Update. Upon first creating and completing all mandatory fields in an Exposure, when the user selects 'Update' on the Exposure screen, the system should save the exposure and move to the 'Set Reserves' screen. Once the Reserve has been created, or cancelled, the system should return the user to the Exposure Summary screen (in the case of Exposure creation in the FNOL New claims wizard: return the user to the 'Manage Exposures' Step of the Wizard. Rule applies when creating an Exposure during and post the FNOL Claims Wizard. [Note this rule should only run on first creation of the exposure, and not upon editing and updating an exposure] When the user selects Yes to the notification question to send outbound documents for the following claim events: Close Claim, Close Exposure, New Claim and New Exposure, system should open the document template screen in the lower half with the template already pulled from Dialogue corresponding to the claim event.
When the loss date(and time) entered is prior to policy effective date(and time) When the Loss date(and time) selected post policy cancellation (effective) date(and time) or expiration date(and time) For property the preferred supplier will be selected based on the following criteria: Instruction Type, Estimate below DA limit, Property Type [Residential or Commercial], Number of rooms affected and the Work allocation split % - Apply number of rooms affected rule after property type rule - Ignore rule if no data present for any of potential suppliers - Stop applying rules when number of potential suppliers is one - Work allocation will always be the last rule applied Work Allocation Split ratio in claims needs to be calculated for the suppliers available against the service selected. The numbers of claims appointed to a supplier are summed up and the corresponding ratio is calculated. This ratio is now compared against the Work Allocation split for the suggested suppliers and thus helps in deciding the preferred supplier. The counter for the claims should be set to zero against each supplier group for a service before calculating the work allocation ratio in case of 2 scenarios: - When a new supplier added to the group - When the allocation split % is changed If application of allocation rules result in returning more than one supplier, a warning message needs to be thrown. When the user clicks on Select button, the contact needs to be added to Parties Involved and the following 2 fields need to be updated for the contact: - Role should be populated with the Service Name against the supplier - Related To should be populated with the Exposure name against which the supplier is appointed
Workflow on Appointment Status under various operations performed should be as mentioned below Appointment: Appointment Status will be Blank unless the user has clicked on 'Appoint' button. It changes to 'Pending Appointment' when the user has clicked 'Appoint'. When the user clicks on 'Send' button for the suppliers to send the instructions the status would change from 'Pending Appointment' to 'Appointing'. When the instructions are successfully delivered to the supplier the status changes from 'Appointing' to 'Appointment Confirmed' or to 'Appointment Failed' if otherwise. Cancelling Appointment: Appointment Status changes from Appointment Confirmed to 'Pending Cancellation' when the user has clicked 'Cancel' button. When the user clicks on 'Send' button for the suppliers to send the cancellation instructions the status would change from 'Pending Cancellation' to 'Cancelling'. When the instructions are successfully delivered to the supplier the status changes from 'Cancelling' to Cancellation Confirmed' or to 'Cancellation Failed' if otherwise. Reappointment: Appointment Status changes from Cancellation Confirmed to 'Pending Appointment' when the user has clicked 'Reappoint'. When the user clicks on 'Send' button for the suppliers to send the instructions the status would change from 'Pending Appointment' to 'Appointing'. When the instructions are successfully delivered to the supplier the status changes from 'Appointing' to 'Appointment Confirmed' or to 'Appointment Failed' if otherwise. Rejected: Appointment Status changes from 'Appointing' to 'Rejected', This indicates that the supplier has rejected the Instruction that has been sent to them. Closed: Appointment Status changes from 'Appointment Confirmed' to 'Closed', This indicates that the supplier has Suppliers with Appointment Status as Pending Appointment or Pending Cancellation only will be picked to be displayed under the Instructions tab for Appointment/Reappointment/Cancellation. System should disable the supplier row under 'Instructions' tab once the instructions have been sent for that supplier.
Claim submitted through the ENOL process is created as a new claim and routed to appropriate user through documented assignment rules. User clicks 'Next' without selecting any involved asset Duplicate Claim Check for Property should trigger based on combination of following conditions: 1. Policy # 2. Loss date (+/- 15 days) and - where asset is attached to the premises, if there exists a claim for the same premises of the selected asset OR - where assset is attached to the location, if there exists a claim for the same location of the of the selected asset OR - where asset is attached to the territory, if there exists a claim for the same territory of the selected asset In case assets selected at multiple levels (premises / location / territory), display all possible duplicates for each of these levels (premises / location / territory) Open activites, exposures, matters or claims assigned to the user should be automatically re- assigned to the supervisors pending assignment queue of the group to which the entity (claims, exposures, activities, matters) belong to when the user is being made inactive Total liability % cannot be greater than 100% Do not allow to user to refer to subro if minimum gross incurred cost is less than value set in script paramater
Do not allow to refer to subro if any of the following condtions fail: 1. status of subrogation is not 'Open' 2. there is no responsible party added to the subrogation with status 'Open' Do not allow subrogation to be completed till status of subrogation for all responsible parties is completed CHAPS - Payments from 0.00 to 49,999.99, the payment must be routed to an individual with the ability to make CHAPS payments and have the financial Authority for the total value of the payment. CHAPS - Payments from 50,000.00 to 999,999.99 must be routed to TWO individuals; One individual must have the ability to make CHAPS payments, but may have a Financial authority limit smaller than the value of the payment. The other individual must have the ability to make CHAPS payments and must have the financial Authority for the total value of the payment. CHAPS - Payments from 1,000,000.00 to 30,000,000.00 must be routed to THREE individuals; Two individuals must have the ability to make CHAPS payments, but may have a Financial authority limit smaller than the value of the payment. The other individual must have the ability to make CHAPS payments and have the financial Authority for the total value of the payment. Cheques and BACS - Payment Review Assignment: When selecting from the List or searching for a User, the individual who is being assigned to review the payment, must have the Financial Authority of equal value to the payment that needs to be reviewed. If the payment is valued below the Script Parameter value for BACS and Cheque, the approval process will be routed through the default Authority Limit approval process, which will route the approval to the next individual in the hierarchy of the User Group. If a payment is more than 30,000,000.00, the handler will not be allowed to send the payment, the system must restrict this for CHAPS Payment When the User click's 'Search Policy' on the 'Review Involved Policy Assets' screen, the system should Navigate the User to the 'Select Involved Policy Assets' screen (refer Step 2 of FNOL New Claim Wizard). After the user searches & selects further Policy Assets or cancels from the screen; the User should be returned to the 'Review Involved Policy Assets' screen. The new assets selected should display in the subsection 'Select properties on the New Policy' in the 'Review Involved Policy Assets' screen.
Payments which require authorisation will go into pending approval status until ALL relevent approvers have approved the payment. Once payment is approved by ALL approvers, payment may be sent downstream If one of the payment approval authoriser "reject" the payment If activity related to payment approval(s) not equals to Completed -"complete" Activity related to payment approval -Reject Payment -Create History Minimum Policy Search Criteria Policy search is performed only if any of the below minimum search criteria combinations are satisfied: a. Policy # b. Address (Line 1 - min 3 chars) Organisation Name (min 3 chars) c. Address (Line 1 - min 1 chars ) AND Risk PostCode(Partial Postcode min 3 chars) d. Organisation Name (min 3 chars) AND Risk PostCode (Partial Postcode min 3 chars) e. LastSelect Name button (min 1should chars) only ANDbe Risk PostCode (Partial Postcode Policy available for unverified policies min 3 chars) When loss date or loss date time later than system date or system time When the user is selecting an authoriser, they may not select themself as an authoriser in any of the dropdowns. Set the Refer to Subro as No when claim is being reassigned to another team If Property damage exposure is assigned using automated assignment option then the exposure should be assigned within the Property Group using business rules defined for automated assignment for property as per BR085 and BR085
If Bodily Injury exposure linked to Assault Coverage "CPRMAAssaultCov" is assigned using automated assignment option then the exposure should be assigned to GPA group and round robin method must be used to assign it to individual users in the team. Automated Assignment - Group Selection - When "Use automated assignment" option is selected on assignment screen, Identify and select the group based on below conditions: 1. Group attribute matches the corresponding information on the claim based on the first attribute condition that is matched, in the following order: Policy Holder Name(Insured Name), Agency Full Name and Agency Name first Alphabet Individual attributes to be created for Policy Holder Name, Agency Full Name and Agency Name first alphabet 2. If no group can be found for assignment then assign claims, exposures, activities and matter to the pending assignment queue of Support group Automated Assignment - User Selection - If group identified as per BR085 then Identify and select the user based on the combination of the following criteria: 1. user attribute matches the corresponding information on the claim based on the first attribute condition that is matched, in the following order: a.Policy Holder Name(Insured Name) - If there is match on Policy Holder name then point 2 below for complexity rating should be ignored for Handler selection. b.Agency Full Name - If there is match on Agency Full name then point 2 below for complexity rating should be ignored for Handler selection. c. Agency Name first Alphabet 2. the complexity rating of the claim/exposure less than or equal to the complexity handler can work on Handlers should only be assigned claims, expoures, activities and matter where complexity rating of Claim/Exposure is less than or equal to the complexity rating they can handle as specified in user attribute. If exposures are not present on the claim, then complexity of claim should be assumed as 1 for the purposes of claim assignment. Individual attributes to be created for Policy Holder Name, Agency Full Name and Agency Name first alphabet 3. load factor - Use OOTB load factor calculations to arrive at the overall workload 4. handler workload Workload calculations: Workload should be calculated based on the sum total of the number of claims and exposures assigned to the user. With the user having the lowest workload count to be assigned the next claim, exposure, activity or matter. 5. Handler work days - compare the work day attribute with the current day and only make them available for assignment if the handler works on the day. This is particularly important for Part time handlers. 6. If a user cannot be found based on above criteria's then it should be assigned to the pending assignment queue of the group the user is being searched in. For ENOL - Users should be selectedor based on the above If the complexity rating of the exposure exposure related to criteria the reserve is greater than the complexity rating of the handler who owns the exposure then a warning message should be displayed asking handler to assess the claim. This rule should be triggered upon update of the exposure (includes reassignment and reserve change as per BR138) . Message - "This is Level <complexity rating of the exposure>. Please refer tohandler a handler of the If Financial valueexposure of the claim is greater than Large Loss Indicator (i.e. 125000), then should be prompted to assign the claim to TCS - POST FNOL. Prompt - "Claim is above Large Loss Threshold. Do you want to assign the claim to TCS" If Financial value of the claim is greater than Large Loss Indicator (i.e. 125000), then handler should be prompted to use automated assignment option to assign the claim to TCS - FNOL Prompt - "Claim is above Large Loss Threshold. Use automated assignment to assign the claim to TCS" Automated Assignment - If the Financial value of the claim is greater than Large Loss Threshold(i.e. 125000), then claim should be assigned to TCS when Automated Assignment option is selected during FNOL assignment or for Post FNOL when handler selects "Yes" to prompt "Claim is above Large Loss Threshold. Do you want to assign the claim to TCS" when payment transaction makes the claim value above 125,000. TCS claims should be assigned to supervisor's pending assignment queue.
When Claim is assigned to the following Groups then it should be ring fenced and only be visible to members in the assigned groups: SIU CFIT NB: When individual exposures, activities and matters are assigned outside these group then the claim should be taken out of ringfencing and treated as normal claims Users with Role of Loss adjusters should only be able to access the claim they are a contact on or a user on and added on Parties Involved. Loss adjusters will be added as parties involved through Services functionality as contacts with the role as "Service Provider" or assigned claim/exposure where they would be added as a user on Parties Involved if working as "Claims Handlers". If Claim/exposure/activity/matters are assigned directly to the group using search by group then they should be assigned to the supervisor's pending assignment queue except when the group is Northen Ireland in which case assignment should be direct to the handler using round robin. Any claim with Special Handling Instructions will have a claim-level indicator that will be displayed on the grey claim info bar This business rule applies ONLY to Property Damage exposures with Primary Property Damage Coverages (currently these are: CPRPDAsset & CPRPDFICov) and Loss Of Use Exposures with Primary Busniness Interruption Coverages (currently these are: CPRBIInsuredProfitCov, CPRBIInsuredRevenueCov, CPRBIGrossRentalForTerrCov, CPRBIGrossRentalForTerrCov, CPRBIICOWCov, CPRBILiquatedDamagesCov, CPRBILossOfRentOrAdditAccomForTerrCov, CPRBIResearchDevelopmentCov, CPRBIRoyaltiesCov, CPRBIAddInterestDebtServiceCov, CPRBILossInterestOnCapitolCov, CPRBIGrossRentBuildingCov, CPRBILossOfRentOrAdditAccomForBuildCov). When the user creates exposure(s), the exposure with the greatest excess value should automatically result in a recovery reserve of the same value being created: 1. In the event of new exposure creation with a greater excess than a previous exposure, providing the previous excess has not been collected or assigned to a supplier, the system should null the previous excess recovery reserve and create the new greater excess recovery reserve. An Activity (recoveryreserve_changed) should be automatically created to notify the handler that the Excess Recovery Reserve has changed. 2. In the event of new exposure creation with a greater excess than a previous exposure where the previous excess has been paid or collected by the supplier, the system should create a recovery reserve based on the higher exposure for the difference between the old and new exposures. An Activity (recoveryreserve_changed) should be automatically created to notify the handler that the Excess Recovery Reserve has changed. When Excess to apply? field is populated with yes on the instruction details screen, the Excess value should automatically populate the Excess field on the same screen. Suppliers can only collect one Excess per exposure Check Attachment Size If a document (any file type) being attached to an outgoing message exceeds 10mb in size, display an error message When Topic equals Supplier, note will be sent to the Aviva Service When no other service provided is found against a specific service, default New Supplier to 100% Allocation If an exposure has had no financial activity for in excess of 13 months and the residual reserve is less than 1000, then all the reserves (including any recovery reserves )will be set to 0 and the exposure will be automatically closed. This will be run as a batch process. If an exposure has had no financial activity for in excess of 13 months and the residual reserve is equal to or greater than 1000 then a compulsory activity (review_claim_closure) is automatically created and assignted to the handler each month until there is some financial activity on the claim. This will be run as a batch process.
This business rule applies only to Property Damage exposures with Primary Property Damage Coverages (currently: CPRPDAsset & CPRPDFICov) and Loss Of Use Exposures with Primary Busniness Interruption Coverages (currently these are: CPRBIInsuredProfitCov, CPRBIInsuredRevenueCov, CPRBIGrossRentalForTerrCov, CPRBIGrossRentalForTerrCov, CPRBIICOWCov, CPRBILiquatedDamagesCov, CPRBILossOfRentOrAdditAccomForTerrCov, CPRBIResearchDevelopmentCov, CPRBIRoyaltiesCov, CPRBIAddInterestDebtServiceCov, CPRBILossInterestOnCapitolCov, CPRBIGrossRentBuildingCov, CPRBILossOfRentOrAdditAccomForBuildCov) For the exposure with the highest excess value (as per BR095), the 'Excess Paid' field should display to be collected . For all other exposures with lesser excess values, the 'Excess Paid' field should refer the exposure with the highest excess value and read: Excess to be collected from Exposure XXX (where XXX is the relevant exposure name and number). In the event that an exposure with a greater excess is created, providing the 'Excess Paid?' status is not already 'YES'; the paid status of the original exposure should changerule to reference the to new greater exposure I.e. Excess toAdditional be Collected from Exposure XXX This business applies only Property Damage exposures with Commecial Property Property Damage Coverages. (currently these are: CPRPDBusinessAllRisksCov, CPRPDFrozenFoodCov, CPRPDGITCoverCov, CPRPDMachineBreakdownCov, CPRPDCompBreakdownCov, CPRPDNPTCov, CPRPDBlackFloodExcessBBCov, CPRNSACCon, CPRNSACCov) The excess value of the coverage (as sepcified in the Policy Property Damage screen's coverage section) mapped to therule exposure, 'Excess Amount' with fieldProperty of the exposure This business appliesshould only topopulate Property the Damage exposures Damage Coverages.The dropdown list for the 'Contingency' field should be dynamically populated with the Contingencies available to the Asset (Risk Unit) or Coverage mapped to the exposure (as sepecified in the Policy Property Damage Details screen). This business rule applies only to Property Damage Exposures with Primary Property Damage Coverages (currently these are: CPRPDAsset & CPRPDFICov) . When the User selects a contingency from the 'Contingency' dropdown, the system should respond by populating the 'Excess Amount' field with the corresponding excess value of that Contingency (as sepecified in the Policy Property Damage Details screen). This business rule applies only to Property Damage exposures with Additional Commecial Property Property Damage Coverages. (currently these are: CPRPDBusinessAllRisksCov, CPRPDFrozenFoodCov, CPRPDGITCoverCov, CPRPDMachineBreakdownCov, CPRPDCompBreakdownCov, CPRPDNPTCov, CPRPDBlackFloodExcessBBCov, CPRNSACCon, CPRNSACCov) when a new Exposure is created.The 'Excess Paid' field should display to be collected. Where we have created a new involved party on day x, we can only allow payments to that involved party to proceed when the current date and time is day x+1 and the time is after 15:00. Inbound CPL Payments flagged as excess should offset the Recovery Reserve related to that exposure Reserve Line dropdown should not display any reserves with Cost Type = Claim Cost AND Cost Category = Supplier When Coinsurance Strategy field is Visible and Available in the Payment wizard, the indicator must be sent to EDW. Coinsurance Strategy details will only be send Downstream when Coinsurance is flagged against an exposure. When a Discount is present under CPL Line Items, It is marked as negative CPL Line Item When CPL payment is recorded on ClaimCenter, outbound message will only go to EDW When Credit Note is received in ClaimCenter, Credit Note is recorded as negative payment and offsets the reserve accordingly CPL payments cannot be recoded to another reserve line CPL Payments cannot be transferred to another claim When "Email" is selected as the output channel, the "Main Email" field on the Parties Involved screen (for the selected recipient - i.e. The "To" field) must be populuated If Loss location on Loss Details screen is in Northern Ireland then prompt the handler to manually assign the claim to Northern Ireland group on the assignment screen both during FNOL and post FNOL. Prompt to be displayed - "Loss Location is in Northern Ireland. Check Agency office location and assign appropriately"
If the complexity rating of the exposure or exposure related to the reserve is greater than the complexity rating of the handler who owns the exposure then a warning message should be displayed asking handler to assess the claim. This rule should be fired both during FNOL and post FNOL. Message - "This exposure is Level <complexity rating of the exposure>. Please refer to an appropriate handler" When Note in PolicyCenter has Topic=Special Handling, the View Special Handling Instructions button will appear on Claim Summary screen. Click upon this button will open up Special Handling worksheet with related Notes from PolicyCenter. This Business Rule applies only to Commercial Property Property Damage Section. If a selected Risk Unit from the Policy is a Scheduled Item under Business All Risks Cover (CPRPDBusinessAllRisksCov) then the data items: 'No'., 'Item Code' & 'Item Description' should be concatenated and populated into the 'Item Description' (CC-FLS92-0520) field of the Ascociated Risks Subsection of FLS92_Policy_FLS_FNOL_Post_FNOL When payment is transferred to a different claim, the target claim must have an exposure in order to transfer the payment to the new claim. Otherwise, without an exposure, payment transfer will not be allowed. This Business Rule applies only to Commercial Property Property Damage and Business Interruption Sections. If the Policy contains 'Combined PD/BI Contingencies' then populate Coverage Terms Contingency screens' 'Applicable to' (CC-FLS92-0477) Field with 'PD/BI Combined' for each contingency (CC-FLS92-0552) Exclusions and Conditions should be displayed in a table format. Each Field that is associated with a Limit should be a seperate line Item with the parent Exclusion/ Condition name appearing in Bold type before limit only name. mock up will be provided for clarity) This Business Rule the applies to (screen Commercial Property Money & Assault Section. If a selected Risk Unit from the Policy is a Scheduled Item under Money Specified In Safe Cover (CPRMAMoneyInSpecifiedSafeCov) then the associated data items: 'Safe #', 'Safe Description' & 'Safe Grade' should be concatenated and populated into the 'Safe' (CC-FLS92-0522) field of the Ascociated Risks Subsection of FLS92_Policy_FLS_FNOL_Post_FNOL Check the entered claim number is valid Amount and Total Amount should match Validate the supplier's Invoice Amount against the Delegated Authority by the Sum of all Payments against Supplier X across all exposures Validate the supplier's Purchase Order Amount against the Delegated Authority by Sum of all Purchase Orders against Supplier X across All exposure If credit note arrives from CPL against a valid Claim / Exposure and related invoice AND the reserve does not equal to 0, then Apply a negative payment to the claim and offset the reserve by x amount If credit note arrives from CPL against a valid Claim / Exposure and related invoice, Apply a negative payment to the claim and generate an activity for the handler to update the reserve by x amount This business rule applies only to Loss of Use Exposures with Business Interruption Coverages: When the User selects a contingency from the 'Contingency' dropdown, the system should respond by populating the 'Excess Amount' field with the corresponding excess value of that Contingency (as sepecified in the Policy Business Interruption Details screen). This business rule applies only to Loss of Use Exposures with Business Interruption Coverages.The dropdown list for the 'Contingency' field should be dynamically populated with the Contingencies available to the Asset (Risk Unit) or Coverage mapped to the exposure (as sepecified in the Policy Business Interruption Details screen). Also the value 'Financial loss no damage' should always be available in the dropdown. Cannot Appoint supplier where coinsurance is flagged on the exposure Create automatic recovery reserves for each reserve line for the exposures attached to the responsible party distributing the expected recovery amount proportionately to each recovery reserve based on the net incurred for the corresponding reserve Subrogation menu should be available irrespective of the fault rating When a Recovery Reserve of Recovery Category Excess is reduced to zero because the Excess has been deducted from a Payment or has been converted into a Recovery update the 'Excess Paid' field on the corresponding Exposure to 'Paid'
This Business Rule applies to Property Damage & Loss of Use Exposures with Commercial Property Coverages.The following steps dictate how the system should calculate the complexity rating and display it in the field 'Complexity Rating' on the exposure. 1. Each exposure cause code (See CauseCode dropdown list in Master Typelist) has a technical complexity assigned to it which is a number from 1 to 4 (See Related document: PDBICauseCode Complexity Rating Mapping.xls). 2. Each Reserve associated with an Exposure should have an Admin Screen User Customisable Financial Complexity set by the financial value of the 'Total Incurred Gross' for that exposure as follows: 0.01 - 2,500 1 2,500.01 - 10,000 2 10,000.01 - 25,000 3 25,000.01 - 50,000 4 50,000.01+ 5 3. As the exposure is created and whenever the 'Total Incurred Gross' is modified, GWCC will separately derive the technical and financial complexities 4. GWCC will record the higher of technical and financial complexity as the overall exposure complexity in the 'Complexity field The Risk Unit's Sum Insured andRating' Coverage limits as defined for the Asset and or Coverage on the Policy should be enforced in the form of Warnings appearing when the user enters Reserves or attempts Payments greater than the Limits Upon Retrieving a Policy for the first time in a given Policy Period, the system should ascertain which Annual Aggregate Limits are available on the Policy and perform the following actions depending on the types available: If Annual Aggregate Limit is:'Annual Aggregate PD/BI Combined Policy Limit' ; then create Aggregate Limit with the following values [Aggregate Type: Limit, Grouping: Policy, Limit Type: Loss Date, Amount: <As Per Policy Data>] . If Annual Aggregate Limit is: 'Annual Aggregate PD Section Limit' then create Aggregate Limit with the following values [Aggregate Type: Limit, Grouping: Policy, Limit Type: Loss Date, Amount: <As Per Policy Data>, Section Type: Property Damage] . If Annual Aggregate Limit is: 'Annual Aggregate BI Section Limit' then create Aggregate Limit with the following values [Aggregate Type: Limit, Grouping: Policy, Limit Type: Loss Date, Amount: <As Per Policy Data>, Section Type: Business Interruption] . If both: 'Annual Aggregate PD Section Limit' & 'Annual Aggregate BI Section Limit' exist then create two Aggregate Limits, one for each section as specified above. These Aggregate Limit should not be editable or removable by the user. If a Payment or Reserve results in Net Incurred Cost equals or exceeds 75% of the Aggregate Limit then generate activity (Aggregate75) to advise the handler to contact the underwriter for the Policy If a Payment or Reserve results in Net Incurred Cost breaching the Aggregate Limit then generate activity (Aggregate100) to advise the handler to contact the underwriter for the Policy
Upon Retrieving a Policy for the first time in a given Policy Period, the system should ascertain which Annual Aggregate Deductible Limits are available on the Policy and perform the following actions depending on the types available: If Annual Aggregate Deductible Limit is:'Annual Aggregate PD/BI Combined Deductible Limit' ; then create Aggregate Limit with the following values [Aggregate Type: Deductible, Grouping: Policy, Limit Type: Loss Date, Amount: <As Per Policy Data>, Non Ranking Amount: <As Per Policy Data>] . If Annual Aggregate Limit is: 'Annual Aggregate PD Section Deductible Limit' then create Aggregate Limit with the following values [Aggregate Type: Limit, Grouping: Policy, Limit Type: Loss Date, Amount: <As Per Policy Data>, Non Ranking Amount: <As Per Policy Data>, Section Type: Property Damage] . If Annual Aggregate Limit is: 'Annual Aggregate BI Section Deductible Limit' then create Aggregate Limit with the following values [Aggregate Type: Limit, Grouping: Policy, Limit Type: Loss Date, Amount: <As Per Policy Data>, Non Ranking Amount: <As Per Policy Data>, Section Type: Business Interruption] . If both : 'Annual Aggregate PD Section Deductible Limit' & 'Annual Aggregate BI Section Deductible Limit' exist then create two Aggregate Deductible Limits, one for each section as specified above. If aggregate deductible applies, For all exposures with coverages related to the section(s) to which the Aggregate Deductible Limit applies When any reserve is created / updated, Create / update a recovery reserve with recovery category as Excess with recovery reserve amount equal to the lesser of [reserve amount created/updated or {Non-Ranking Amount (sum of existing recovery reserves and recoveries with excess category = Excess)}] Create / update a recovery reserve with recovery category as Deductible with recovery reserve amount equal to the lesser of [{reserve amount created/updated - (sum of existing recovery reserves and recoveries with excess category = Excess)} or {Ranking Amount (sum of existing recovery reserves and recoveries with excess category = Deductible)}] If aggregate deductible applies, For all exposures with coverages related to the section(s) to which the Aggregate Deductible Limit applies When payment is being made Calculate the outstanding excess (sum of non-ranking and ranking sum of all recoveries with category as Excess or Deductible ) If Outstanding excess is greater than payment being made, display warning message that there is outstanding excess available (only for regular payment) If aggregate deductible applies, For all exposures with coverages related to the section(s) to which the Aggregate Deductible Limit applies When payment is being made On payment create a recovery with recovery category Excess with recovery amount equal to lesser of [Payment or (Non-Ranking Amount - Sum of recoveries with category = Excess)] On payment create a recovery with recovery category Deductible with recovery amount equal to lesser of [{Payment - (Non-Ranking Amount - Sum of recoveries with category = Excess)} OR {Ranking Amount (Sum of recoveries with category = Deductible)}] After payment, add the value of the new recovery created with recovery category = Deductible to Amount Used for the corresponding aggregate deductible
On payment, When sum of all payments for the exposure exceeds the excess amount and How Collected is Collect from Policyholder Create a recovery with recovery category Excess with recovery amount equal to Excess value The 'Apply Excess' Functionality should apply the excess as per the Excess Recovery Reserves If the reserve amount is greater than the Delegated authority limit of the supplier, then default Service Type to Loss Adjuster. If Aggregate Deductibles apply on the Policy, create Activity for Handler (Examine_Agg) When the purchase order / Delegate Authority Limit / Invoice is larger than the Authority Limit of the Handler, then assign the activity to an individual in the group with the Authority Limit. When someone with the required Authority Limit is found within the group then assign it to the handler to route it over to the handler to select someone who has the authority limit to approve the activity
Owner Use Case UC 27 - Unsaved Data UC 29 - FNOL Basic Information GPA UC121 - Archive Claim UC 19 - Document - Create View Manage
Mapped Rule ID
UC 19 - Document - Create View Manage UC 10 - Admin - Metrics and Thresholds and Reinsurrance Thresholds UC 19 - Document - Create View Manage and UC21 - Notes - Create View Edit Search UC 19 - Document - Create View Manage UC39 - Incident - Injury
UC 52 Payment - Create Edit UC31 - FNOL - Policy Search / Create UC31 - FNOL - Policy Search / Create UC31 - FNOL - Policy Search / Create UC34 - Policy General Details UC38 - Policy GPA Details UC31 - FNOL - Policy Search / Create UC37 - FNOL - Loss Details GPA UC39 - Incident - Injury UC37 - FNOL - Loss Details GPA UC52 - Payment Create Edit UC28 - Workplan - View; UC18 - Desktop - View Manage; UC14 - Admin - User Group Profiles Create Edit UC28 - Workplan - View; UC18 - Desktop - View Manage; UC14 - Admin - User Group Profiles Create Edit UC28 - Workplan - View; UC18 - Desktop - View Manage; UC14 - Admin - User Group Profiles Create Edit UC60 - Assignments - Claim - Assign Reassign Manage Pending UC78 - Contact Manager - Merge Contacts UC78 - Contact Manager - Merge Contacts
UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC23 - Parties Involved - Add New Claim Contact UC79 - Contact Manager - Search View Create Edit Contact UC 19 - Document - Create View Manage
UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC52 - Payment Create Edit UC 19 - Document - Create View Manage UC59 - Claim Exposure - Close Reopen UC122 - Fraud - Investigation Details UC122 - Fraud - Investigation Details UC122 - Fraud - Investigation Details
UC122 - Fraud - Investigation Details UC122 - Fraud - Investigation Details; UC86 Property - Incident - Assessment UC122 - Fraud - Investigation Details; UC86 Property - Incident - Assessment UC86 Incident - Property - Assessment
UC44 - Exposure - General - Create View Edit, UC136 - Exposure Loss Of Use, UC42 - Exposure - Bodily Injury - Create View Edit, UC94 - Exposure - Property Damage FNOL Post FNOL Create View Edit
UC19 - Documents - Create View Manage, UC51 Reserves Create View Edit, UC59 Claim Exposure Close Reopen, UC60 - Assignments - Claim - Assign Reassign Manage Pending
UC31 - FNOL - Policy Search / Create UC31 - FNOL - Policy Search / Create UC137 - Post FNOL - Services - Property and Liability
UC137 - Post FNOL - Services - Property and Liability UC137 - Post FNOL - Services - Property and Liability
UC35 Import FNOL UC 67 - FNOL Basic Information Property UC 67 - FNOL Basic Information Property UC121 - Archive Claim
UC90 - Subrogation - Create Edit Referral UC90 - Subrogation - Create Edit Referral
UC90 - Subrogation - Create Edit Referral UC52 - Payment Create Edit UC52 - Payment Create Edit
UC41 - Policy Replace UC31 - FNOL - Policy Search Create UC52 - Payment Create Edit UC90 - Subrogation - Create Edit Referral UC60 - Assignments - Claim - Assign Reassign Manage Pending
UC60 - Assignments - Claim - Assign Reassign Manage Pending UC60 - Assignments - Claim - Assign Reassign Manage Pending
UC136 - Exposure - Loss of Use UC60 - Assignments - Claim - Assign Reassign Manage Pending UC60 - Assignments - Claim - Assign Reassign Manage Pending UC60 - Assignments - Claim - Assign Reassign Manage Pending
UC60 - Assignments - Claim - Assign Reassign Manage Pending UC119 Admin - Account SHI
UC94 - Exposure - Property Damage - Create View Edit UC137 - Post FNOL - Services - Property and Liability UC137 - Post FNOL - Services - Property and Liability UC19 - Documents - Create View Manage, UC21 - Notes - Create View Edit UC79 - Contact Manager - Search View Create Edit Contact
UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC54 - Payment - Recode UC53 - Check - Void Transfer Reissue Clone Delete UC19 - Documents - Create View Manage UC60 - Assignments - Claim - Assign Reassign Manage Pending
UC88 - Recovery - Create View Edit Manage UC88 - Recovery - Create View Edit Manage UC52 - Payment Create Edit UC51 Reserves Create View Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC136 - Exposure - Loss of Use CPL EST 6 (Activity)
UC52 - Payment Create Edit UC51 Reserves Create View Edit, UC33 - Policy - Coverage & Aggregate Limits
UC33 - Policy - Coverage & Aggregate Limits UC33 - Policy - Coverage & Aggregate Limits
UC52 - Payment Create Edit UC137 - Post FNOL - Services UC33 - Policy - Coverage & Aggregate Limits UC52 - Payments Create Edit UC51 - Reserve Create Edit
EM005
EM006
EM016
EM041
ncident - Assessment
EM043 EM044
EM064
EM068
EM069 EM070
EM071
EM072
EM074
EM075
EM077
EM080 EM081
EM095
EM082
EM088
EM089
EM093
EM091
EM092
Error Message Ref EM001 EM002 EM003 EM004 EM005 EM006 EM007
Related Aviva Use Case UC2 - Find Document UC3 - Retrieve Document UC4 - Update Document Meta Data UC2 - Find Document UC39 - Incident - Injury UC31 - FNOL - Policy Search / Create Enterprise Location Service (ELS)
Enterprise Location Service (ELS) Enterprise Location Service (ELS) Enterprise Location Service (ELS) UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC19 - Documents - Create View Manage UC19 - Documents - Create View Manage UC19 - Documents - Create View Manage Enterprise Location Service (ELS) Enterprise Location Service (ELS)
EM012
EM013
EM014 EM015 EM016 EM017 EM018 EM019 EM020 EM021 EM022 EM023 EM024 EM025
UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit
UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC52 - Payment Create Edit UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact UC79 - Contact Manager - Search View Create Edit Contact Enterprise Location Service (ELS) UC59 - Claim Exposure Close Reopen UC79 - Contact Manager - Search View Create Edit Contact UC04 -Address Book - Search View Create Edit Contact UC19 - Documents - Create View Manage UC31 - FNOL - Policy Search / Create UC31 - FNOL - Policy Search / Create UC31 - FNOL - Policy Search / Create UC84 Incident - Property - Details
EM035
EM036
EM046
EM047
EM048
EM049
EM050
EM051
EM052
EM053
EM054
EM055
EM056
EM057
EM058
EM059
EM060
EM061
EM062
EM063
UC86 Incident - Property Assessment UC137 - Post FNOL - Services Property and Liability UC137 - Post FNOL - Services Property and Liability
EM064 EM065
EM066
UC137 - Post FNOL - Services Property and Liability UC86 Incident - Property Assessment UC 67 - FNOL Basic Information Property UC90 - Subrogation - Create Edit Referral UC90 - Subrogation - Create Edit Referral UC90 - Subrogation - Create Edit Referral UC90 - Subrogation - Create Edit Referral UC52 - Payment Create Edit UC52 - Payment Create Edit
EM067
EM071
UC52 - Payment Create Edit UC52 - Payment Create Edit UC31 - FNOL - Policy Search / Create
EM078
EM079
UC31 - FNOL - Policy Search / Create UC41 - Policy Replace UC36 - Policy Refresh
UC31 - FNOL - Policy Search / Create UC52 - Payment Create Edit UC19 - Documents - Create View Manage UC94 - Exposure - Property Damage UC94 - Exposure - Property Damage UC94 - Exposure - Property Damage UC79 - Contact Manager - Search View Create Edit Contact UC137 - Post FNOL - Services Property and Liability UC137 - Post FNOL - Services Property and Liability UC84 Incident - Property - Details UC137 - Post FNOL - Services
EM087
EM091 EM092
EM093
UC88 - Recovery - Create View Edit Manage UC52 - Check Create Edit UC51 Reserves Create View Edit UC53 Payment - Transfer Clone Delete UC19 - Documents - Create View Manage UC136 - Exposure - Loss of Use
EM094
EM095
Exception Scenario 3a -Document Management System is unavailable 2a -Document Management System is unavailable 4a-Document Management System is unavailable 4a - Document Management System fails to find any documentation matching the search criteria
User tries to search for Policy without entering at least one field in search values Faultstring: Underlying system i.e. address and geocode management system not available. Error code from ELS in this scenario is 10052.
Faultstring: Insufficient information provided to perform location search. Error code from ELS in this scenario is 10053. Faultstring: Message data validation failed. Error code from ELS in this scenario is 10051. This would just be a warning message - When the address is entered manually and system is updated When number of characters entered against 'Search Within' search field is less than 3.
When the user search the templates from 'Create from a template' search screen and dialogue live application is not available because of any technical failure. When the user search the templates from 'Create from a template' search screen and dialogue live application is not installed on local machine. When the user clicks on 'Create Document', an error should be thrown for mandatory field 'To' under 'Specify Object Values' section if the value of the field is "none selected". Faultstring: Unexpected error in Address and Geocode Management System. Error code from ELS in this scenario is 10054. Faultstring: Unexpected error in ESB Error code from ELS in this scenario is 10055. No Claim Number returned from Claim Number look up from ClaimCenter reference table Warning is coming from Bank Wizard: FORNCURRACNT Warning is coming from Bank Wizard: BRNCHNOTSUPPDRCR Warning is coming from Bank Wizard: ACNTNOTSUPPDRCR Warning is coming from Bank Wizard: SCODENOSTERCHAPS Warning is coming from Bank Wizard: SCODENOEURCHAPS Warning is coming from Bank Wizard: RLNREQD
Error is coming from Bank Wizard: BRNCHCLOSE Error is coming from Bank Wizard: SCODEBADFMT Error is coming from Bank Wizard: SCODENOTALLOC Error is coming from Bank Wizard: ACNBADFMT Error is coming from Bank Wizard: MODFAILED Error is coming from Bank Wizard: RLNBADFMT Error is coming from Bank Wizard: OTHER Warning is coming from Bank Wizard: 10101, 10102, 10110, 10111, 10112, 10113, 10114, 10115, 10116, 10117, INT1000 When BR037 fails
This would just be a warning message. When the postcode entered is not per the following format: [A-Za-z][0-9A-Za-z][0-9A-Za-z]?[0-9A-Za-z]? [0-9][A-Za-z]{2}[0-9A-Za-z]? This would just be a warning message. When partial payments exist on the claim, warning message appears upon closing the claim. This error would be displayed when the user is not allowed to a delete a contact from Contact Manager becuase the contact is attached to a claim in ClaimCenter or when the Contact Manager application is unable to connect to Claimcenter All Contact Manager errors being displayed in ClaimCenter will be prefixed with OOTB message and when Contact Manager application fails to respond. When BR041 fails When there are no policy search results found for the search criteria provided When the loss date(and time) entered is prior to policy effective date(and time) When the loss date(and time) entered is after the policy expiry date(and time) or policy cancellation effective date(and time) This is just a warning message. When a value is selected in the Hazardous Material field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "Yes" for 'Has trading been affected/could be affected in the future?' field, and no Loss of Use Exposure on the claim, warning message appears on Incident screen upon updating incident. (see BR050) This is just a warning message. When value selected is "No" for 'Is the Policyholder legally responsible for the repairs?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "No" for 'Is the property habitable?' field, warning message appears on Incident screen upon updating incident.
This is just a warning message. When value selected is "Yes" for 'Do the underground services serve more than one property and/or does the damage to underground service impact anyone else?' field, warning message appears upon updating incident. The warning message during FNOL would be displayed at the last step of FNOL wizard when the claim is CREATED, as these are triggered by rules. During Post FNOL, the warning message would be displayed when the User updates the Loss Details screen. This is just a warning message. When value selected is "No" for 'Is this the first instance of Subsidence at the property?' field, warning message appears upon updating incident. The warning message during FNOL would be displayed at the last step of FNOL wizard when the claim is CREATED, as these are triggered by rules. During Post FNOL, the warning message would be displayed when the User updates the Loss Details screen. This is just a warning message. When value selected is "Yes" for 'Has notification of subsidence damage been received within 12 months of inception?' field, warning message appears upon updating incident. The warning message during FNOL would be displayed at the last step of FNOL wizard when the claim is CREATED, as these are triggered by rules. During Post FNOL, the warning message would be displayed when the User updates the Loss Details screen. This is just a warning message. When value selected is "No" for 'Do you have a copy of the Works Contract?' field, warning message appears on Incident screen upon updating incident.
This is just a warning message. When value selected is "No" for 'Do you have a copy of the Equipment Hire Contract?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "Yes" for 'Was an Employee, Director or Partner assaulted or coerced to gain access?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "Yes" for 'Has damage occurred while intrusted to a Courier or under the terms of the carriage?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "Yes" for 'Caused by failure of main supply?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "Yes" for 'Loss includes vaccines or other medical supplies?' field, warning message appears on Incident screen upon updating incident.
This is just a warning message. When integer entered for 'Age of the Refrigerator' field is greater than or equal to 5, or less than or equal to 9, warning message appears on Incident screen upon updating incident. This is just a warning message. When integer entered for 'Age of the Refrigerator' field is greater than or equal to 10, warning message appears on Incident screen upon updating incident.
This is just a warning message. When value selected is "No" for 'Does the Policyholder own the items (or are they employees personal belongings?)' field, warning message appears on Incident screen upon updating incident.
This is just a warning message. When value selected is "No" for 'Have the details of the stolen Plant been logged with PANIU & 'The Equipment Register'?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "Yes" for 'Is there a seasonal trading trend to consider? (i.e. busy at Christmas, etc.)' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When value selected is "No" for 'Was the deposit withheld?' field, warning message appears on Incident screen upon updating incident. This is just a warning message. When system is not able to identify any preferred supplier based on the allocation business rule BR055 When user tries to do either of the following operations: - Tries to appoint a non preferred supplier - Tries to cancel the supplier appointment - Tries to reappoint the supplier The Actor has not reviewed all the related exposures that are associated to the supplier. The user is only allowed to proceed sending the Instructions when the actor has reviewed all the exposures This is just a warning message. When value selected is "No" for 'Have all policy conditions been complied with?' field, warning message appears on Incident screen upon updating incident. The actor has not selected any invovled asset and clicks next Sum of liability % entered for responsible and party and insured party exceeds 100% Gross Incurred cost is <250 (script parameter) and refer to subro is set as 'Yes'
When subrogation is created: 1. status of subrogation is not 'Open' 2. there is no responsible party added to the subrogation with status 'Open' Subrogation is marked 'Complete' with one or more responsible parties status as 'Open' If the Pay to the Order of field is populated with more than 40 characters, an error should be thrown and the handler should not be able to proceed until the field is updated If the user selects a reviewer who does not have the Financial Authority Limit to review the value of the payment that is to be submitted, then it must throw an error to the handler to select a different reviewer User attempts to make a payment is that larger than 30,000,000.00, this must be restricted Password Entered on Step 3 of 3 of payment wizard is incorrect User attempts to search for a policy without entering the minimum search criteria
If policy system is down while performing policy search while creating a new claim, or while doing a policy replace If policy system is down while performing policy refresh
If loss date entered later than system date If the user selects himself as the authoriser If the document, (any file type) being attached to the outgoing message exceeds 10mb in size This is just a warning message. If Contingency=Accidental Damage and Cause Code=Underground Services, warning message appears upon update of Exposure This is just a warning message. If Contingency=Subsidence, warning message appears upon update of Exposure This is just a warning message. If Contingency=Malicious Damage, warning message appears upon update of Exposure If the sume allocation does not equal to 100%, then error message must be displayed
This is just a warning message. When the reserve is greater than all the DA limits related to all potential suppliers listed for that Service. We cannot find any suppliers listed for a specific service/instruction type "Update" has been selected on Property Incident screen but user hasn't selected Property Assessment tab. This is just a warning message. When user attempts to close an exposure with a supplier appointed on it that has status as Pending Appointment, Appointed, or Appointed, must warn user that there is a supplier appointed against this exposure. When entered claim number is not valid
The Risk Unit's Sum Insured and Coverage limits as defined for the Asset and or Coverage on the Policy should be enforced in the form of Warnings appearing when the user enters Reserves or attempts Payments greater than the Limits When payment is transferred to a different claim, the target claim must have an exposure in order to transfer the payment to the new claim. Otherwise, without an exposure, payment transfer will not be allowed. "Email" has been selected as the output channel, but there is no email address present for the recipeient in Parties Invo
If the complexity rating of the exposure or exposure related to the reserve is greater than the complexity rating of the ha
Error Message Function is unavailable. Function is unavailable. Function is unavailable. Search returned no results. Detailed Injury Type Selected as 'Not Yet Known' in Injury Incident At least one field must be completed prior to Search Please try again to find the address. If you get this message again, please enter the address manually.
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Insufficient or incorrect information. Please try again Sorry,we can't find your Address. Please correct and try again or enter the address manually. Please note that the address is not verified by the Enterprise Location Service. Minimum 3 characters required in <name of field> for Search within Maximum search breached. Please refine search
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Please enter atleast one of <Postal Code (UK)/ Zip Code (US/ City (Other))> or 'Address 1' System not available You need to have Dialogue Live installed on your local. Please contact helpdesk To' field cannot be "none selected". Please try again to find the address. If you get this message again, please enter the address manually. Please try again to find the address. If you get this message again, please enter the address manually. "Claim Number generation failed, claim cannot be saved. Please contact IT Helpdesk" Warning: Foreign Currency is not supported. Warning: Branch will not support Direct Credit transactions Warning: Account will not support Direct Credit transactions Warning: CHAPS payments not supported. Warning: CHAPS payments not supported. Warning: Payment cannot be made because system does not support accounts that require reference or roll number.
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Error: Bank Details Validation failed to find the associated Branch for this account. Error: Sort Code format is incorrect Error: Sort Code not allocated to any bank branch Error: Account Number format incorrect Error: Validation Failed, payment cannot proceed. Error: Validation Error, payment cannot proceed. Error: Validation Error, payment cannot proceed. Warning: Bank details could not be validated, press next to proceed without validation. Please enter Name
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The postcode entered is not in the correct format There are partial payments outstanding on this claim. <Contact Name> cannot be deleted because the contact may currently be in use in ClaimCenter or PolicyCenter (or ClaimCenter or PolicyCenter failed to respond) The Address Book encountered an error: Problems were encountered communicating with Contact Manager No email address present for recipient <Recipient Name (be it 'To' or 'CC')> The search returned zero results This policy is not in force for the claim loss date. Please create the claim as unverified policy This policy is not in force for the claim loss date. Please create the claim as unverified policy You have selected that a Hazardous Material is involved. Have you contacted the Environmental Claims Team? You have selected that insured is not able to trade, have you considered Business Interruption cover?
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You have selected that policyholder is not responsible for repairs, therefore, no insurable interest
You have selected that the property is not habitable, therefore, check cover for LOR/AA
You have selected that the underground services affect other parties, lease obtain all the involved parties' contact details
You have selected that this isn't the first instance of subsidence; have you contacted the underwriters to confirm they were aware of this material fact?
You have selected that the subsidence was in the first 12 months of policy inception; please review ABI Subsidence Agreement
Please ask insured for copy of Hire Contract for each item of hired plant
You have selected that there was an assault or coercion used; do you wish to add an Assault exposure to the claim?
Have you added the couriers details to Parties Involved and requested a copy of the terms of carriage contract?
Please obtain details of utilities suppliers involved, including any reference number they may have Check that loss does not include any controlled substances and that a safe disposal document has been obtained for the medical supplies You have indicated that the age of refrigerator is 5 or more years. Is a maintenance agreement required?
You have indicated age of refrigerator is 10 or more years, consult the policy wording to ensure there is cover
You have selected that the policyholder does not own the items, therefore, there is no insurable interest
Please contact both PANIU and The Equipment Register and register the details of plant
You have indicated a seasonal trading trend; have you adjusted for this variation?
Please document the reasons why the deposit was not withheld
System has not identified a preferred supplier, please select from the list below. Please enter reason
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Please review all the associated exposures to the Supplier before sending the instructions. You have selected that not all policy conditions have been complied with; check if this is material to the loss and take appropriate steps At least one covered item must be selected Total liability % cannot be greater than 100% Claim cannot be referred to subrogation team as gross incurred cost is less than required minimum . Please create subrogation without referral Status for subrogation and at least one responsible party should be open Status for all responsible parties should be Completed before completing the subrogation Pay to the Order of field contains more than 40 characters, please update field to 40 Character Length. Selected user does not have financial authority limit to review this payment, please select a different user Payment is larger than 30,000,000.00, please submit this payment outside of ClaimCenter The submitted Password is invalid Please enter either Policy # OR Organisation Name(min 3 chars) OR Address and Post Code(min 3 chars) OR Last Name(Min 3 chars) and PostCode (Partial Postcode min 3 chars) The policy search failed - Problems were encountered communicating with policy system Problems were encountered communicating with policy system
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Loss Date: Date and Time must be in the past The payment authoriser and requester cannot be the same user Attachment exceeds the maximum size liimit (of 10mb). Please send the document via an alternative output channel Should other parties be contributing to shared underground services? Is this the first instance of subsidence? Did the subsidence occur within the first 12 months of the policy inception? If the malicious damage was carried out by a tenant, was the deposit withheld? Check for exclusions. Sum of Allocation for a service must equal to 100%
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No Suppliers available for this Service / Instruction Type You must first visit the Assessment tab before updating the Incident Active Supplier is appointed on this exposure. Do you still want to close this Exposure? Claim Number <Entered Number> was not found One or more payments exceed the Sum Insured or Coverage Limit for the Insured Asset and or Coverage No exposures are found on the claim you are trying to transfer the payment to. Please transfer to another claim or add an Exposure to the desired claim. There is no Email address present for the recipient. Please input an Email address via Parties Involved or select an alternative output chanel This exposure is Level <complexity rating of the exposure>. Please refer to a handler of the appropriate level
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