Hierarchy
INSURANCE (Software Component) SAP Insurance⤷
FS-CM (Application Component) Claims Management⤷
ICL_CDC (Package) FS-CM: Data Capture
Basic Data
| Data Element | ICL_WAITPERIOD |
| Short Description | Category of Probationary Period |
Data Type
| Category of Dictionary Type | D | Domain |
| Type of Object Referenced | No Information | |
| Domain / Name of Reference Type | ICL_WAITPERIOD | |
| Data Type | CHAR | Character String |
| Length | 1 | |
| Decimal Places | 0 | |
| Output Length | 1 | |
| Value Table |
Further Characteristics
| Search Help: Name | ||
| Search Help: Parameters | ||
| Parameter ID | ||
| Default Component name | ||
| Change document | ||
| No Input History | ||
| Basic direction is set to LTR | ||
| No BIDI Filtering |
Field Label
| Length | Field Label | |
| Short | 0 | |
| Medium | 15 | ProbtnPer.Cat. |
| Long | 0 | |
| Heading | 0 |
Documentation
Note: This field is only relevant for private health insurance.
Definition
Period after inception of a tariff in private health insurance in which the policyholder is not eligible for benefits. In other words the policyholder is not entitled to benefits until this probationary period has passed.
A differentiation is made between the following probationary periods:
- General probationary period
In Germany, for example, the general probationary period is three months.
- Special probationary period
In Germany, the special probationary period is eight months, for example . This special period applies to the following benefits:
- Delivery (parturition)
- Dental Restoration
- Orthodontics
- Psychotherapy
- Dental Treatment
Use
You can use this field to control which probationary periods should apply for benefit types in private health insurance.
With benefit types outside of private health insurance you should select No Probationary Periods.
Dependencies
Consideration in Compensation Calculation
When a claim is being processed, the system checks whether a probationary period has been defined for a benefit type. If a probationary period has been specified, the system checks in the policy snapshot whether an entry (such as June 30, 2004) exists in the End of Probationary Period field (or End of Special Probationary Period field) for coverage of the relevant benefit type.
If the policyholder submits a claim within the probationary period (in other words, before June 30, 2004), the benefit is not considered in the compensation calculation. This means that no payment is made, or a payment is made on the basis of the old tariff (in the event of a tariff switch).
Overruling Probationary Period
In claims processing you can specify that the probationary period should be ignored. This means that the benefit is provided even though a probationary period has been defined for the benefit type.
To make this setting, set the No Probationary Period indicator for the relevant item at the Payment Proposal level on the Items tab page.
Example
Benefit types for orthodontic treatment have the probationary period category Special Probationaly Period, for example. The probationary period after inception of the tariff is therefore eight months.
History
| Last changed by/on | SAP | 20050224 |
| SAP Release Created in | 472 |
