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Background documentationCustomizing Settings for Accident Event

 

General Settings for Accident Event

Make the following settings in the SAP Customizing Implementation Guide (IMG) under Start of the navigation path SAP Insurance Next navigation step Claims Management Next navigation step Claim Bundle Next navigation step Business Settings End of the navigation path:

  • In Customizing activity Define Claim Bundle Types, create at least one claim bundle type in the category of Accident Event .

  • In Customizing activity Define Subtypes for Each Claim Bundle Type , create the following subtypes for the claim bundle type in the category of Accident Event :

    • Accident Questionnaire

    • Accident with Subrogation/Recovery

Settings for Dummy Claim

To be able to use accident events, you need an internal claim type for a dummy claim.

Proceed as follows:

  1. Create an internal claim type with just one subclaim type (path: Start of the navigation path SAP Insurance Next navigation step Claims Management Next navigation step Claim Next navigation step Process Control (Internal Claim Types) Next navigation step Configure Internal Claim Types End of the navigation path ).

    Note Note

    A dummy claim is only needed in the background, it does not appear on the user interface. Consequently, there is no need for any Customizing that affects the user interface (such as definition of screen sequences).

    End of the note.
  2. Assign this internal claim type to the two claim bundle subtypes Accident Questionnaire and Accident with Subrogation/Recovery (path: Start of the navigation path SAP Insurance Next navigation step Claims Management Next navigation step Claim Bundle Next navigation step Business Settings Next navigation step Define Subtypes for Each Claim Bundle Type End of the navigation path).

Rules for Existence of Accident Indicators

You can use BRFplus rules to check whether there are any indications of an accident.

The following BRFplus functions can be used:

  • ICL_DIAG01_FV (Create Diagnosis) and ICL_DIAG02_FV (Change Diagnosis)

    For both of these events you can define rules that check whether a diagnosis has the additional attribute "Suspected Accident".

    The SAP delivery Customizing contains action ICL_0AQ1_A for this purpose.

    Note Note

    • The additional attributes for diagnoses are defined in Customizing under Start of the navigation path SAP Insurance Next navigation step Claims Management Next navigation step Claim Next navigation step Business Settings Next navigation step Damaged Objects/Diagnoses Next navigation step Diagnoses Next navigation step Define Diagnosis-Specific Additional Attributes End of the navigation pathand Start of the navigation path Maintain Diagnosis Catalogs, Diagnosis Groups, Diagnoses, and Additional Attributes End of the navigation path .

    • Action ICL_0AQ1_A is of the action type Task or Log Entry.

      The associated task in Activity Management also has the key 0AQ1 (Task Text: 'Perform Search for Accident Questionnaires Already Sent'). Tasks are defined in Customizing under Start of the navigation path SAP Insurance Next navigation step Claims Management Next navigation step Claim Next navigation step Structuring Business Processes Next navigation step Activity Management Next navigation step Configure Tasks/Log Entries and Activities End of the navigation path .

    End of the note.
  • ICL_IG002_FV (Change Claim Item Grouping)

    For this function you can define rules that check whether an entry exists on a prescription in the Accident Indicator field.

Cover Letter with Accident Questionnaire

To be able to send an accident questionnaire, you must have defined the document entitled "Request Accident Questionnaire" with the application form ICLE_ACC_REQUEST. You must define this document as a permitted manual document in the internal claim type of the dummy claim (see above, "Settings for Dummy Claim").

Note Note

The claim documents are defined in Customizing under Start of the navigation path SAP Insurance Next navigation step Claims Management Next navigation step Claim Next navigation step Business Settings Next navigation step Correspondence Next navigation step Define Claim Documents End of the navigation path .

End of the note.

SFC Question Sequence for Accident Questionnaire

If you do not have the accident questionnaire in electronic form, you must enter the answers on the accident questionnaire manually in the system using a structured facts capture (SFC) question sequence.

If you want to use the SFC question sequence, you must perform the following Customizing activities:

  1. In Customizing activity Configure Structured Facts Capture, create a corresponding standard question group mapping all questions in the accident questionnaire.

    The SAP delivery Customizing contains question sequence AQ1 (accident questionnaire) for this purpose.

  2. In Customizing activity Configure Internal Claim Types, assign this question sequence to the internal claim type of the dummy claim.

    This assignment is made at the level of Start of the navigation path Claim Header Next navigation step Question Sequence for Facts Capture End of the navigation path , depending on facts capture category AQ (accident questionnaire).