Processing

In this section, you execute the core functions of the model.

The starting point is the Claim data in ICLCLAIM and the further Claim data from the subsequent Model Tables.

The data is selected and matched to complete the start-to-end claim process.

Key activities are then derived both from the claims and further flow data. Each claim is assigned a unique Case ID. Lines in the final document represent activities and are marked by a timestamp as well as some additional fields, such as an automation and compliance flag. Based on the concatenation of their ordered activities ID, the cases are then grouped into different variants ranked by frequency. Next, KPIs are computed to provide useful information that helps understand the process and where, when and how it deviates from the standard variant.

It comprises the following functions as input:

  • ICLCLAIM – Claim

  • ICLSUBCL – Subclaim

  • ICLDAMOBJ – Damaged Object

  • ICLPART – Participants

  • ICLRESERVE – Single Claim Reserve

  • ICLITEM – Claim Item

  • ICLPAY – Claim Payment

  • ICLPAYI – Claim Payment Item

  • ICL_NEGS – Negotiation [Shadow Table]

  • ICL_SUBROG – Subrogation/Recovery [Header]

  • ICLLITHEADER – Litigation

  • ICLSALVI – Salvage Item

  • USR02 – Logon Data

  • Process Forecast Data

  • Process Compliance Rules

It comprises the following functions:

Join Payments Data

This function joins claim payment and the claim payment item.

The join method used is left outer join to the aggregated result of the payment amount from Payment Item data.

Join All Data

In this function, all the remaining claim-relevant tables are added to the result of the Join Payments Data function.

It includes the following tables:

  • Claim

  • Claim Item

  • Subclaim

  • Damaged Object

  • Participants

  • Single Claim Reserve

  • Negotiation

  • Subrogation/Recovery

  • Litigation

  • Salvage Item

The join method is union all because all data is needed.

Derive Activities

This Derivation function is used to derive basic activities for each claim.

Each line usually gives more than one activity. Common activities are the notification of the claim and its creation. Each rule defines an activity.

Join Variant ID to Activities

This Join function is used to compute the Variant ID.

The Variant ID field is created using string aggregation of activity IDs, ordered by Timestamp and Activity ID and grouped at Case ID level. A hash value is then produced for each unique value. Then, the Variant ID is joined via left outer join to the original input table. The join predicate is the Case ID.

Calculate KPIs

This Calculation function takes the results of the Join Variant ID to Activities join and calculates the following Key Performance Indicators (KPIs):

  • Preceding Activity ID

  • Activity Sequence

  • Right First Time Flag

  • Activity Frequency

  • Duration [Seconds]

  • Following Activity ID

  • Counter

  • Right First Time Rate

  • Duration [Days]

  • Variant Frequency

  • Variant Rank by Frequency

Determine Automation and Compliance

This function generates an automation and compliance flag in every record and user type/violation type for automation/non-compliance in each record.

There are two types of violation, sequence and outright. Sequence violation means that a particular activity sequence represents violation. Outright violation occurs when an activity by itself represents the violation. In case of non-compliant records, the compliance flag is set to value “0”; else are set to value “1”.

There are also two types of users, dialog (type “A” and “S”) and batch (type “B”). Dialog user means that the tagged activity has been processed manually, while batch user means that the tagged activity has been processed automatically. In addition to the user type, the transaction code is taken into consideration and the records are checked with an automatic transactions table to determine whether the activity was automated or not, based on user type and transaction code. In case of automation records, the automation flag is set to value “1”; else are set to value “0”.

Determine happy path

This function generates a happy path Flag for every record. Records satisfying a happy path sequence have flag value “1”; else have value “0”.

Start and End

This Join function creates new lines for each Case ID corresponding to a start and end point that is common to all. The variables Quantity Counter and Variant Frequency are only assigned to the first or the last line, providing a quick way to sum over Case IDs without multiplying by the number of activities.

The function also calculates the following Key Performance Indicators (KPIs):

  • Manual Rate

  • With Subsequent Changes Rate

  • Non-Compliance Rate