Benefit consumption module / Enquire


  • document the benefit in a generic way

  • document the comsumption in a generic way

  • Provide a mechanism to increase the performance to calculate the balance per insuree - currently full table scans. It will be used by both modular BE and REST API.



  • benefit_provided

    • benefit_package_details_id

    • date_from

    • date_to(nullable)

    • qty

    • recipient

      • type: insuree / group / user …

      • id

  • benefit_package_details

    • type

      • numberOf

      • amount

      • periodicity

    • benefit_definition(visit hospital … )

      • Type

        • product_item

        • product_service

        • cash

        • other limits (visits, hospitals … )

      • id

        • id of item/service

        • null for other limit

    • value

    • insuree (only for limits that are personnal)/individual

    • benefit package id (policy)

    • balance (actually approved)

    • provisional (submitted claim)

    • temporary (draft claim)

    • limits


  • benefit_package_details table (existing ?) and benefit_provided should be created

  • list of benefit will come from benefit_provided

  • “hardcoding“ or rework of Benefit package definition to create the benefit_package_details with the cash benefit



Initial update

  • For all policy,

    • for all insuree covered by policy

      • get all claim details covered by policy (column in item and services)

      • update the common limits

      • update the individual limit

      • save limits for item and service that have limits (date or number , 2 limits if both)

      • save all cached enquiry

Schedule task to update

  • For all claims updates since the last run

    • get all policy details covered by claims (column in item and services)

      • get all the member of the policy

        • update the common limits

        • update the individual limits

        • save all cached enquiry

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