Hierarchy
INSURANCE (Software Component) SAP Insurance⤷
FS-CM (Application Component) Claims Management⤷
ICL_CDC (Package) FS-CM: Data Capture
IMG Activity
| ID | SIMG_ICL_VC_TICL055 | Configure Benefit Type Process Data |
| Transaction Code | S_ANI_08000826 | (empty) |
| Created on | 20050405 | |
| Customizing Attributes | SIMG_ICL_VC_TICL055 | Configure Benefit Type Process Data |
| Customizing Activity | SIMG_ICL_VC_TICL055 | Configure Benefit Type Process Data |
Document
| Document Class | SIMG | Hypertext: Object Class - Class to which a document belongs. |
| Document Name | _ICL_VC_TICL055 |
Use
In this IMG activity you define the attributes relevant for claims processing of benefit types in the compensation category.
Difference from Customizing of the Scenario Claim with Product Customizing
In the Claim Without Product Customizing scenario, no product data is maintained for the benefit types, just process data that refers to claims processing. All product data, such as limits and deductibles, sums insured, and calculation rules, is imported from the policy system. Benefit type trees are not required for these benefit types.
Versioning
In contrast to the Claim with Product Customizing scenario, the process data for the benefit types only has one-dimensional versioning. You can change the validity and the data of a version at any time.
To create a new version, enter a valid-from timepoint. Any version that is already valid for this timepoint is ended implicitly.
Individual Settings
Make the following settings for a benefit type:
Level Benefit Type Process Data: Definition
- Enter a key and a name for the benefit type.
- State whether the benefit type can be used across coverage types (in other words, not just within one coverage type).
- For a potential procurement process, enter a product category and a product type from the procurement system.
- You can define a default value for the category of insured object.
- You can define a default value for the type of insured object.
- You can store a disability class.
Note: This setting is only relevant for Workers Compensation.
Level Definition of Time Dependency
Enter the date and time from which the assigned benefit types should be valid.
Note:
Initially, you define the valid-from timepoint. Then you assign the required benefit types to this valid-from timepoint.
At this level you can also define whether general or special probationary periods should be considered for the benefit type.
Note: All the following settings are time-dependent.
Level Benefit Type Process Data: Time-Dependent Attributes
- Specify whether subrogation/recovery is possible for this benefit type
- Assign a transaction type for the procurement process to the benefit type.
Here you can store only those transaction types that have been defined in IMG activity Define Transaction Types for Procurement Process.
Level Subrogation/Recovery
Here you define which subrogation/recovery rules should apply for each benefit type, depending on the country and region.
Level Permitted Object Type
Here you define the permitted object types for procurement of claim items for each benefit type. You can store only those object types that have been defined in IMG activity Define Object Types of Claim Items.
Define the following for each permitted object type:
- Permitted evaluation category
You can store only those evaluation categories that have been defined in IMG activity Enhance Evaluation Categories.
- Permitted type of evaluator and thus the leading evaluation system
You can store only those types of evaluator that have been defined in IMG activity Define Types of Evaluator.
- ID of an external catalog
You can store only those external catalogs that have been defined in IMG activity Store External Catalogs.
- Permitted unit of measure for claim items
Level Permitted Payment Reason Groups
For each benefit type define the permitted payment reason group and the relevant permitted payment reason. This definition depends on the country and region.
You can store only those payment reason groups and payment reasons that have been defined in IMG activity Define Payment Reasons.
Requirements
Standard settings
Activities
In IMG activity Create Benefit Processing Profiles at Coverage Category Level, assign the benefit type process data defined here to a benefit processing profile.
Example
Business Attributes
| ASAP Roadmap ID | 204 | Establish Functions and Processes |
| 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 |
| VC_TICL055_PM | C - View cluster | SM34 |
History
| Last changed by/on | SAP | 20050405 |
| SAP Release Created in | 600 |
