Multiple Contract Handling

You can group multiple claims of one policyholder or one insured person in a claim bundle. The starting point is the policyholder (or insured person) and his/her contracts that are active on the relevant date of loss. This function is called “Multiple Contract Handling”.

Caution Caution

For “Multiple Contract Handling”, SAP only delivers a sample implementation for a hospital stay and death. If you want to map other coverages, you must implement your user interface accordingly.
If you use SAP Policy Management (FS-PM) as your policy management system, the minimum release that you must use is SAP Policy Management 5.3.
You can create multiple claims per contract, but a claim can only ever refer to one contract.

End of the caution.

Prerequisites

Business Functions

In the Business Function Set Insurance, you have activated the business function Insurance Claim Multiple Contract Handling (INS_FSCM_MULT_CONTR_1).

Customizing

Define Claim Bundle Types
In Customizing activity Define Claim Bundle Types, you have defined the required claim bundle types for the category of Multiple Contracts (Customizing path: Claims Management Claim Bundle Business Settings Define Claim Bundle Types .

The claim bundle types defined here appear in the input help on the initial screen for creating a claim bundle in the category of Multiple Contracts. With one of the defined claim bundle types, select the checkbox Def.Value per Cat.. This is then displayed as a prefilled value.

Note
In the sample implementation for “Multiple Contract Handling”, SAP only delivers screens for the claim bundle type CC (Person).

End of the note.
Define Subtypes per Claim Bundle Type
In Customizing activity Define Subtypes per Claim Bundle Type, you have defined the required claim bundle subtypes (Customizing path: Claims Management Claim Bundle Business Settings Define Subtypes per Claim Bundle Type ).

The claim bundle subtypes defined here appear in the input help on the initial screen for creating a claim bundle in the category of Multiple Contracts. With each permitted claim bundle type, select the checkbox Def.Value per Cat. for one of the subtypes. This is then displayed as a prefilled value.

Note
In the sample implementation for “Multiple Contract Handling”, SAP only delivers the subtypes Health and Accident, with examples for death and hospital stay.

End of the note.
Assignment of Combination of Policy Product and Incident Type
In Customizing activity Define Subtypes per Claim Bundle Type, you have assigned a combination of policy product and incident type to the relevant subtype. Only then does the system create a dummy claim in the background, allowing you to use certain Customizing settings (such as notes, structured facts capture). For more information, see Dummy Claim.

Note
From the combination of policy product and incident type, the system derives the internal claim type (for the dummy claim) assigned to the combination of policy product and incident type in Customizing activity Configure Policy Products (Customizing path: Claims Management Claim Product Configuration Configure Policy Products ).

SAP provides the internal claim type 2MCH (Multiple Contract Handling) and the policy product with the same name 2MCH in the sample Customizing. Note that you must activate both the internal claim type and the policy product.

End of the note.
Screen sequences
In Customizing activity Define Subtypes per Claim Bundle Type, you have assigned the screen sequence category to the relevant subtype.

Integration

Claim Bundle

The claim bundle concept is used to map “Multiple Contracts Handling”. The new category of claim bundle type Multiple Contracts with technical key 8 has been created for this purpose (see also “Prerequisites” above).

Policy Management System

To determine the possible contracts for the policyholder or insured person, SAP Claims Management reads the contract data from the integrated policy management system (such as SAP Policy Management) and stores this initially in the claim bundle. As soon as a claim is created on a contract, the system reads the contract data again from the policy management system and then stores it in the Policy Snapshot of the claim.

Direct Input

Relevant Direct Input Structures

You can use the direct input procedure to create claim bundles in the category of Multiple Contract Handling. For more information, see Direct Input for Multiple Contract Handling.

Automatic Creation of Claims via Direct Input

When you save a claim bundle in the category Multiple Contract Handling, the system automatically creates a claim via direct input.

The following activities are a prerequisite:

In Customizing for Claims Management under Claim Bundle Business Settings Multiple Contract Handling , execute the Customizing activity Define Structure for Creation of Claim via Direct Input.
Implement the Business Add-In BADI_ICLE_MC_DI_LOB.
In method BUILD_DI_STRUCTURES you must map the data of your own user interface to the corresponding DI structures for creating or changing a claim.

For more information, see the documentation for the Customizing activity and the BAdI.

Features

Functions Specific to “Multiple Contract Handling”

The following functions are specific to “Multiple Contract Handling”:

Display of list of contracts
You can add a contract manually
You can remove a contract.
Depending on the data that you enter, the system automatically creates a claim (see Create Claim).
You can make a setting so that when the list of contracts is displayed, there is a certain trigger that automatically selects a contract and creates a row with an incident type (see Automatic Selection of Contracts).
You can also remove an incident type that has already been created (see Remove Incident Type).
You can change the date of loss.

General Functions for Claim Bundle Processing

The following general functions for processing claim bundles are also available for “Multiple Contract Handling”:

During the creation process, the system performs a check for duplicates (see Check for Duplicates).
You can create a note (see Notes in Claim Bundle).
You can use structured facts capture to enter additional data (see Structured Facts Capture in Claim Bundle).
You can use status management for the claim bundle status (see Claim Bundle Status, in particular “Claim Bundle Status in Multiple Contract Handling”).
You can use status management for the status of claims that are assigned to the claim bundle (see Claims Status Management in Claim Bundle).
You can use the function Role-Based Performer in Claim Bundle.
You can also view a change history (see Display of Changes in Claim and Claim Bundle).
You can archive “multiple contract handling”. For this, you use archiving object ICLECCEVT (see Archiving of Claim Bundles).
The system displays an overview of payments with all claims that belong to the claim bundle (see Payment Overview in Claim Bundle).
The system displays the benefit values for a possible surrender or partial surrender (see Display of Benefit Values with Surrender or Partial Surrender).
The system displays a benefit selection for claims in the line of Accident (see Benefit Selection for Accident in Claim Bundle).

Activities

Create “Multiple Contract Handling”

On the SAP Easy Access screen, choose Insurance Claims Management Bundle Multiple Contract Handling Create .
Enter the date of loss.
The system uses this date to determine those contracts that were active at this point in time.
Enter the policyholder or insured person.
Once you have created the claim bundle, the system displays the policyholder and/or insured person on the Participants tab page.
Enter the claim bundle type.
Enter the claim bundle subtype.
Choose (Create).

Note Note

You can use the Claim Bundle field to assign an external claim bundle number.

End of the note.

Change “Multiple Contract Handling”

On the SAP Easy Access screen, choose Insurance Claims Management Bundle Multiple Contract Handling Change .
Enter the claim bundle number or use the input help to enter existing search criteria (such as claim bundle type, claim bundle subtype, date).
Choose (Change).

Display “Multiple Contract Handling”

On the SAP Easy Access screen, choose Insurance Claims Management Bundle Multiple Contract Handling Display .
Enter the claim bundle number or use the input help to enter existing search criteria (such as claim bundle type, claim bundle subtype, date).
Choose (Display).

Search “Multiple Contract Handling”

From the SAP Easy Access screen, choose Insurance Claims Management Bundle Search Search for Claim Bundle .
Enter the required search criteria (such as claim bundle type, claim bundle subtype, date, or name of policyholder).
Choose (Execute).