Policy and claim systems, where the engineering difficulty is product configurability and time: effective dates, retroactive change, and a record that must be reconstructable as at any past instant.
12 published across 7 topics.
Insurance domain fundamentals58 short answers on one page, for revising rather than studying.Quote, bind, issue, endorse, renew and cancel, and the temporal data model underneath.
Separate the date a change is effective from the date the system learned about it. Store every transaction as an immutable version with both timelines, so the policy can be rebuilt as it stood on any effective date and as it was known on any past instant.
It depends on who cancelled and why: pro rata returns the unused share, short rate keeps a penalty, and which applies is set by the policy wording and the jurisdiction rather than by the system. Fees are usually not refundable, and the calculation has to be reproducible years later.
Rating engines, rules versus models, referral workflows, and rate-change governance.
In a filed environment the rate is a regulated artefact rather than a configuration value, so the change is versioned by state and effective date, applies to business written from that date rather than to everything, and must leave every existing quote and policy reproducible against the version that priced it.
Model the rating algorithm as an ordered set of steps over versioned rate tables, pin every quote to the exact rate version and input snapshot that produced it, and keep eligibility and referral rules outside the price calculation so an underwriter decision never changes the number.
First notification of loss, reserving, adjudication, payment, subrogation and recovery.
A claim moves from notification through coverage verification, adjudication, payment and closure, carrying a case reserve that is the handler's current estimate of what remains to be paid. It moves whenever information arrives, and every movement is a dated financial transaction.
A reserve is money recognised in the accounts on the strength of an estimate, so the insurer's reported result depends on it long before anything is paid. It moves as the file develops, every movement is itself reportable, and the history of movements matters as much as the current figure.
Detection at claim and application, network analysis, and investigator workflow.
Application fraud is misrepresentation of the risk and is caught by cross-checking declared facts against external and historical data at quote. Claim fraud is caught by scoring the claim and by network analysis across parties, then routing a ranked, evidenced referral into a human investigation queue.
Reserving concepts an engineer must model, triangles, and why actuarial data needs are not reporting needs.
A triangle arranges claim cost by the period the loss belongs to against how long after that period it was measured, so the pattern of development can project ultimate cost. Building one requires dated, immutable, claim-level transactions and the ability to see any past evaluation date exactly as it stood.
Reporting shows the current state of each claim, and actuaries need the state as at each past valuation date, cut by accident period and development period. That is a different shape of data, and it cannot be reconstructed from a table that overwrites a claim's figures as it develops.
Treaty and facultative arrangements, cession, bordereaux, and how risk transfer shows up in systems.
Cession allocates each payment across the treaties covering the policy, and which treaties those are depends on when the policy was written rather than when the claim happened. So a payment must stay sliceable by treaty, layer, accident date and underwriting year long after the file closed.
Treaty reinsurance covers a defined class of business automatically; facultative covers one named risk by individual negotiation. Cession is computed per risk or per loss against the treaty version in force on the governing date, and it must be stored as transactions on gross, ceded and net ledgers.
Brokers, agents, aggregators and embedded insurance, plus commission and settlement.
Brokers act for the customer, agents and coverholders act for the insurer, aggregators generate quote volume and embedded partners sell cover inside another purchase. Commission accrues from premium transactions, reverses when they reverse, and settles either gross or net of the intermediary's deduction.