ORM Verbiage: Insurer | Claim | Policy Holder | Contract | Contract Claim

Insurer and Policy Offerings

An insurer provides policies that are distributed through agents. For specific insurers and policies, the same policy may be distributed by multiple agents. Additionally, an insurer may offer multiple policies through a single agent. Conversely, a specific policy may be offered by multiple insurers through the same agent. Each unique combination of insurer, policy, and agent occurs only once in the dataset. This framework forms the preferred identification system for contracts.

Contracts and Policy Holders

Contracts are owned by policy holders, with each contract belonging to a single policy holder. However, a policy holder may own multiple contracts.

Claims and Contract Coverage

Claims are linked to contracts, with each claim associated with one contract. A contract can cover multiple claims. This relationship establishes the primary identification system for contract claims.

Policy Holder Claim Filing

Policy holders file claims, and each claim is filed by a single policy holder. Nevertheless, a policy holder may file multiple claims.

Insurer Claim Payments

Insurers are responsible for paying claims, with each claim being paid by only one insurer. However, an insurer may pay for multiple claims.

Policy Holder Premium Payments

Policy holders pay premiums to insurers. It is possible for an insurer to receive premiums from multiple policy holders, and a policy holder may pay premiums to more than one insurer. Each unique insurer-policy holder pairing for premium payments occurs only once within the data. This association forms the preferred identification scheme for policy holder premium payments to insurers.

Insurer offers Policy sold by Agent.
It is possible that for some Insurer and Policy, that Insurer offers that Policy sold by more than one Agent
and that for some Insurer and Agent, that Insurer offers more than one Policy sold by that Agent
and that for some Policy and Agent, more than one Insurer offers that Policy sold by that Agent.
In each population of Insurer offers Policy sold by Agent, each Insurer, Policy, Agent combination occurs at most once.
This association with Insurer, Policy, Agent provides the preferred identification scheme for Contract.

Contract owned by Policy_Holder.
Each Contract owned by at most one Policy_Holder.
It is possible that more than one Contract owned by the same Policy_Holder.

Claim covered by Contract.
Each Claim covered by at most one Contract.
This association with Claim provides the preferred identification scheme for Contract_Claim.
It is possible that more than one Claim covered by the same Contract.

Policy_Holder files Claim.
For each Claim, at most one Policy_Holder files that Claim.
It is possible that some Policy_Holder files more than one Claim.

Insurer pays Claim.
For each Claim, at most one Insurer pays that Claim.
It is possible that some Insurer pays more than one Claim.

Policy_Holder pays premium to Insurer.
It is possible that for some Insurer, more than one Policy_Holder pays premium to that Insurer
and that some Policy_Holder pays premium to more than one Insurer.
In each population of Policy_Holder pays premium to Insurer, each Insurer, Policy_Holder combination occurs at most once.
This association with Insurer, Policy_Holder provides the preferred identification scheme for PolicyHolderPaysPremiumToIns