Financial calculations

Financial calculations in ClaimCenter

In ClaimCenter, the financial management of a claim is tracked through instances of the Transaction entity. Every Transaction is associated with a claim. Every instance of Transaction is one of the following subtypes: Reserve, Payment, RecoveryReserve, or Recovery.

Every transaction has four additional values that identify its associated reserve line: CostType, CostCategory, ReservingCurrency, and Exposure. The first three must be non-null. The fourth one is either non-null (when the transaction is associated with an exposure), or null (when the transaction is claim-level).

Before any payments are made, the amount of money in a given reserve line is the sum of the appropriate transactions associated with that reserve line. For example, suppose a claim has the following reserve transactions:

For this claim:

• The first exposure (cc:22) has a $12,000 reserve for "ClaimCost - Medical". This is the sum of the first two transactions.

• The second exposure (cc:333) has a $2000 reserve for "ClaimCost - Auto parts" (the sum of the third and fourth transaction) and a $500 reserve for "Expense - A&O - Vehicle appraisal" (the fifth transaction).

• The third exposure (cc:4444) has a $1000 reserve for "ClaimCost - Auto parts) (the sixth transaction).

In order to determine certain values, such as the total reserve remaining, one must query the ClaimCenter database for the correct transactions and then perform the correct calculations against those transactions. It is too unwieldy for an insurer to execute this type of calculation directly against the database. Therefore, ClaimCenter provides a set of Gosu classes with methods you can use to retrieve specific calculations for a given claim.

gw.api.financials.FinancialsCalculations.getOpenReserves()
                        .withClaim(thisClaim)
                        .Amount

For more information on using these classes directly in ClaimCenter, see the Configuration Guide.

ClaimAmount, ReportingAmount, and ReservingAmount

When you execute a financial calculation in ClaimCenter, there are three types of amounts you can get:

• ClaimAmount - The amount expressed in the claim's currency

• ReportingAmount - The amount expressed in the reporting currency for this instance of ClaimCenter

• ReservingAmount - The amount expressed in the reserve's currency

In a mono-currency instance of ClaimCenter, these fields have the same value.

In a multicurrency instance of ClaimCenter, these fields have the same logical value. But the actual values might be different for a claim whose claim currency, reporting currency, and/or reserving currency are not the same, as each logical value is converted to the appropriate currency.

A given calculation can always return ClaimAmount and ReportingAmount. This is because, for any given claim, the relevant transactions are in a single currency. For a single claim, reserve transactions can be in different currencies. Therefore, ReservingAmount is available only if the calculation filters out transactions so that the remaining transactions all share the same currency.

Financial calculations in Cloud API

Financial calculations are exposed to Cloud API through the following endpoints:

• GET /claim/v1/claims/{claimId}/financial-calculations

• POST /claim/v1/claims/{claimId}/financial-calculations/{expression}/get-amount

The first endpoint provides a list of available financial expressions for the claim that can be used to execute calculations. The second endpoint returns the amount of a specific calculation for a specific claim.