SAP ABAP IMG Activity SIMG_ICL_TICL160 (Configure Benefit Type Trees)
Hierarchy
☛ INSURANCE (Software Component) SAP Insurance
   ⤷ FS-CM (Application Component) Claims Management
     ⤷ ICL_CDC (Package) FS-CM: Data Capture
IMG Activity
ID SIMG_ICL_TICL160 Configure Benefit Type Trees  
Transaction Code S_KK4_08000516   IMG Activity: SIMG_ICL_TICL160 
Created on 20020814    
Customizing Attributes SIMG_ICL_TICL056   Configure Benefit Type Tree 
Customizing Activity SIMG_ICL_TICL160   Configure Benefit Type Tree 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name _ICL_TICL160    

Use

In this IMG activity you can change existing benefit type trees or create new ones.

Change Existing Benefit Type Trees:

1. On the Configure Benefit Type Trees initial screen, select the relevant benefit type tree.

2. Choose the Change button.

3. Make the required settings on the screens that follow.

Create New Benefit Type Trees:

1. On the Configure Benefit Type Trees initial screen choose @0Y@ with the quick info text Create.

2. On the following Create Benefit Type Tree dialog screen enter the following data:

3. Press Enter. The system displays the newly created benefit type tree on the Configure Benefit Type Trees screen in the list of benefit type trees.

4. The following steps are identical to the procedure for Change Existing Benefit Type Trees.

A benefit type tree can have more than one status. The system creates a new or changed benefit type tree as a suspense entry. You must activate this before you can use it. To do so, mark the benefit type tree and then choose @3C@ with the quick info text Activate.

Every time a benefit type tree is created, a new generation and thus a new version is produced. When you change benefit type trees, the following rules apply:

  • When you change a benefit type tree, a new version is always created.
  • When you change the benefit type tree with a contract renewal (in other words, you select the Immediate Change with Contract Renewal or Delayed Change with Contract Renewal button), a new generation is also created.

You can read further information on generations and versions further down in this document under the section with the heading Generations and Versions.

Settings for a Benefit Type Tree

Make the following settings for each benefit type tree:

  • At Benefit Type Tree Version level (in detail view)
    • Currency that applies to all amount fields of the benefit type tree
      • The following two settings are only relvant if the benefit type tree contains benefit types belonging to the Losses category. If the benefit type tree only contains benefit types belonging to the Expenses category, both fields are irrelevant.
    • If necessary, specify a higher-level benefit type tree. Read the documentation on the data element.
    • If necessary, set the For Coverage Type indicator. Read the documentation on the data element.

      To get to the detailed view, select the version of the benefit type tree and then choose @16@ with the quick info text Details.

  • At Benefit Type Tree level

    Here you define all the permitted benefit types for each version of the benefit type tree. You can define multi-level benefit type trees with higher-level and lower-level benefit types. This hierarchy then also applies to the limits and deductibles that you define at Limit per permitted benefit type level.

    You can make the following settings in the detailed view for each permitted benefit type:

  • At Limit per Permitted Benefit Type level

    Here you define the amount of the limits and deductibles for each permitted benefit type. The program uses the limits and deductibles to check payments that have been entered manually, to automatically create payments from claim items, and, if the appropriate settings have been made, to check reserves. Relevant payments that have already been made are considered automatically.

    In addition, you can make the following settings in the detailed view for each limit and deductible:

  • At Benefit Type Tree: Determination of Payment Reason Group level

    For each permitted benefit type you define the permitted payment reason group and thus the permitted payment reasons as well.

    You can only store payment reason groups that have been defined in IMG activity Define Payment Reasons.

  • At Benefit Type Tree: Permitted Object Type level

    For each permitted benefit type you define the following for procurement of claim items:

Generations and Versions

Note: The following describes the behavior of generations and versions for policy products. All these details also apply to internal claim types and benefit type trees.

Navigation to Generations and Versions

From the initial screen you can navigate to all previous generations and versions of the policy product.

  1. In the initial screen, select the policy product
  2. Select menu path Goto -> Details. This takes you to the level of the previous generations.
  3. Mark the relevant generation
  4. Select menu path Goto -> Details. This takes you to the level of the previous versions.

Notes on Generations Level and Versions Level:

  • To display inactive generations and/or versions as well, select menu path Policy Product -> Active <-> All.
  • At the relevant level you can change the validity period for the generation and/or version.

You can also create a new version of the policy product based on an older version. Select the desired older version and then press the Change button. The system creates a new suspense entry on the basis of the older version.

General Information on Versioning

All attributes of a policy product are time-dependent.

If the policy product that you want to change already has a suspense entry, this entry will always be changed.

If there is no suspense entry, the system inquires about the type of change, and a new suspense entry is created. Changes to claims assigned to this version during claim creation on the basis of the specific date (renewal of contract, date of loss, or period of services provided) do not become effective until you activate these suspense entries.

Suspense entries have no effect whatsoever on claim processing, meaning that you can delete suspense entries. Before suspense entries are activated, the system performs numerous consistency checks and displays them in the form of a log.

Generations and Versions of a Policy Product

You can change a contract renewal date in the following ways:

  • Changes that are to apply to all claims that occurred after a certain date lead to new versions of the policy product. The old version applies to claims before this date, and the new version to all claims after this date.
  • Changes that are to apply to all claims whose contract was renewed after a certain date lead to new generations of the policy product. The old generation applies to claims whose contract renewal date was before this date, and the new generation applies to claims whose contract renewal date was after this date.

Details on Versioning

Version and generation numbers are assigned automatically by the system. Version numbers with every new generation begin with the number one. The generation and version numbers of the policy product are not related to those of the assigned internal claim types.

If a contract is never renewed, the generation produced when the contract was created applies. The renewal date generally differs from contract to contract. In the event of a claim, the generation that is valid is determined on the basis of the last renewal date before the date of loss. The policy system must transfer the last renewal date before the date of loss to the claims system.

The user&#x

Business Attributes
ASAP Roadmap ID 204   Establish Functions and Processes 
Mandatory / Optional 1   Mandatory activity 
Critical / Non-Critical 1   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
ICLCVERM160 T - Individual transaction object ICLCVERM160  
History
Last changed by/on SAP  20050801 
SAP Release Created in