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Legacy stored procedure | uspSSRSDerivedIndicators1 |
Comments about the report
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This report handles claims and products. Every report that handles claims with a specific product will not produce 100% reliable data. Due to architectural choices, claims are only linked to a specific product if they have already been submitted and if they have not been automatically rejected. For a given product, it is currently impossible to know:
Any “rejected” or “total” numbers of claims - if a specific product is given - will never include these two cases. |
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There are a lot of differences between the documentation on readthedocs and the actual report (if you manage to generate one).
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How it works
For each requested month, 3 queries will fetch data (premium, claim, policy) with the requested criteria:
The amount allocated in a given period is based on premium data.
The total claim count, the total remunerated amount and the promptness are based on claim data.
The total number of new/renewed/expired policies, as well as the number of insurees in each policy is based on policy data.
Then, ratios are calculated with these various figures:
The promptness is the average number of days between entering a claim and paying it back to the health facility (batch run)
The incurred claim ratio is the ratio of remunerated amount to allocated amount.
The renewal ratio is the ratio of renewed policies to expired policies
The growth ratio is the ratio of new policies to total policies
The insuree per claim ratio is the ratio of total claims to the number of insureee in each policy ⚠️ not 100% reliable - see above warning.