Main Insurance Relationship (CH, SG) 

Definition

The Main insurance relationship indicator (M) determines which insurance relationship the system uses when carrying out price determination.

Use

Prior to payment distribution, the system carries out price determination.

If you select the Main insurance relationship indicator (M) on the Maintain Case-Related Insurance Relationship: Overview screen or on the Maintain Case-Related Insurance Relationship: Details screen, you can stipulate which insurance relationship is to be used for price determination.  In such cases, the system does not take the insurance relationship ranking order into account (see Ranking Order of Case-Related Insurance Relationships).

If you don’t set the Main insurance relationship indicator, the system uses the insurance relationship with the highest rank for price determination.

If you select the Main insurance relationship indicator (M), you must take the following into account:

If you select the Main insurance relationship indicator for a number of insurance relationships, the validity periods of the main insurance relationships cannot overlap.

If you select the Main insurance relationship indicator for an insurance relationship, this relationship must be defined for the entire validity period of the case.

All main insurance relationships must bill in the same currency.

If this is not the case, the system will issue an error message, and billing cannot be carried out for the case.

Example

Service Split with Several Main IRs

Extended Service	Start Date	End Date
AAA	02/01/2000	02/15/2000
BBB	02/10/2000	02/20/2000

 

Main IR	Start Date	End Date
IR1	02/01/2000	02/11/2000
IR2	02/12/2000	02/25/2000

The extended services are split as follows and appear as such in the invoice:

Extended Service	Start Date	End Date	Main IR
AAA	02/01/2000	02/11/2000	IR1
AAA	02/12/2000	02/15/2000	IR2
BBB	02/10/2000	02/11/2000	IR1
BBB	02/12/2000	02/20/2000	IR2

Integration

Use Within Revenue Accrual

When determining the insurance relationships relevant for price determination during revenue accrual the system proceeds as follows:

If you have not flagged an insurance relationship as the main IR, the system uses the insurance relationship with the highest rank for price determination.

If you have flagged one insurance relationship as the main IR, the system uses this for price determination.

If you have flagged several insurance relationships as the main IR, and the main insurance relationships and validity periods have been maintained completely and correctly, the system takes the respective insurance relationships into account for price determination. If this is not the case, the system uses the main insurance relationship with the highest rank for price determination, and extended services are not split.

The revenue accrual program does not issue messages relating to errors in the definition of main insurance relationships, since usually not all the data for a case is maintained when revenue accrual takes place.