SAP ABAP IMG Activity SIMG_ICL_BENTPFIND_M (Define Benefit Type Determination)
Hierarchy
☛ INSURANCE (Software Component) SAP Insurance
   ⤷ FS-CM (Application Component) Claims Management
     ⤷ ICL_CUST (Package) Customizing Claims Management
IMG Activity
ID SIMG_ICL_BENTPFIND_M Define Benefit Type Determination  
Transaction Code S_ANI_08000795   (empty) 
Created on 20050316    
Customizing Attributes SIMG_ICL_BENTPFIND_M   Define Benefit Type Determination 
Customizing Activity SIMG_ICL_BENTPFIND_M   Define Benefit Type Determination 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name _ICL_BENTPFIND_M    

Use

In this IMG activity you define which benefit types and benefit catalogs are offered for selection when claim item grouping is entered. To do so, you assign a benefit type group to an internal claim type, and possibly to a subclaim type and a claim item grouping category. This means that you are able to restrict the possible benefit types and benefit catalogs in claims processing and make things easier for the claim handler.

The determination of benefit types and benefit catalogs takes place at runtime as follows:

  • Determination of benefit types:

    The possible benefit types are determined directly according to the settings defined in this IMG activity. In other words, once the claim handler has entered a claim item grouping in claims processing, the input help for the benefit types only offers those benefit types of the appropriate benefit type group defined here.

    If a clear value (in other words, a specific benefit type) emerges from this benefit type determination and contract data, the system displays this benefit type by default.

  • Determination of benefit catalogs:

    Unlike the benefit types, the possible benefit catalogs are determined indirectly. In the contract data a benefit type is always assigned to a coverage, and a benefits catalog might be assigned to a coverage. On the basis of this relationship, the system determines the permitted benefits catalog from the permitted benefit types according to the benefit type determination.

    If a clear value emerges (in other words, a specific benefits catalog), the system displays this benefits catalog by default.

Requirements

You have executed IMG activity Assign Benefit Types to a Benefit Type Group.

Standard settings

If you do not make any settings in this IMG activity, all permitted benefit types and benefit catalogs will be displayed in the input help for the benefit type and benefit catalog with all claim item groupings. No values can be defaulted.

Activities

Define the internal claim type, subclaim type, and claim item grouping category for which the benefit types of a specific benefit type group should be valid:

  • Internal claim type

    You must specify an internal claim type.

  • Subclaim type
    • You can specify a specific subclaim type.
      • The benefit types are then only valid for this subclaim type.
    • You can enter a plus (+).
      • The benefit types are then valid for all permitted subclaim types.
  • Claim item grouping category
    • You can specify a specific claim item grouping category.
      • The benefit types are then only valid for this claim item grouping category.
    • You can enter a plus (+).
      • The benefit types are then valid for all permitted claim item grouping categories.

Note: You define which subclaim types and claim item grouping categories are permitted per internal claim type in IMG activity Configure Internal Claim Types.

Example

Example for accident insurance:

When you enter disabilities, you want the system to display the matching benefit type by default. Proceed as follows:

  1. In IMG activity Define Benefit Type Groups, create a benefit type group for disability benefit types and assign the possible benefit types to this group.
  2. In IMG activity Define Benefit Type Determination, define the internal claim type, subclaim type, and claim item grouping category for which the benefit type group should be valid.

When disabilities are entered in claims processing, the system checks whether one of these benefit types is to be found in the contract data and displays this by default.

Business Attributes
ASAP Roadmap ID 203   Establish Master Data 
Mandatory / Optional 2   Optional activity 
Critical / Non-Critical 2   Non-critical 
Country-Dependency A   Valid for all countries 
Maintenance Objects
Maintenance object type C   Customizing Object 
Assigned objects
Customizing Object Object Type Transaction Code Sub-object Do not Summarize Skip Subset Dialog Box Description for multiple selections
ICL_BENTPFIND_M V - View SM30  
History
Last changed by/on SAP  20050316 
SAP Release Created in 600