Graph-based policy refresh

During the FNOL process, ClaimCenter makes a copy of the relevant policy and stores it in ClaimCenter. For most claims, this policy copy remains as is for the life of the claim.

However, it is possible for the initial copy of the policy to have issues. For example, suppose you have a claim for collision damage done to a Ford Fiesta. The policy erroneously does not have the collision coverage for the vehicle. When the claim is created, the erroneous policy is copied to ClaimCenter. It is then discovered that the relevant coverage is missing from the policy. The policy is corrected, but the copy of the policy in ClaimCenter still lacks the coverage.

In situations like this, insurers may choose to implement functionality for policy refresh. This is the process of recopying a policy for an existing claim.

Policy refresh and the IPolicySearchAdapter

The IPolicySearchAdapter has two methods relevant to policy refresh:

retrievePolicyFromPolicy - This retrieves a new copy of the policy from the existing policy copy. This is used for situations where ClaimCenter does not need to execute a search for the policy a second time.
retrievePolicySummaryFromPolicy - This retrieves a PolicySummary from the PAS that corresponds to the existing policy, which can then be used to recopy the policy. This is used for situations where ClaimCenter does need to execute a search for the policy a second time.

For more information on the difference between these two methods, see the Plugins, Prebuilt Integrations, and SOAP APIs.

The IPolicySearchAdapter also has a plugin parameter named useGraphBasedPolicyRetrieveForRefresh. This parameter identifies whether your instance makes use of graph-based retrieval for policy refresh.

If your instance uses graphs during policy refresh for at least some policy types, set this to true.
If your instance uses graphs for policy retrieval, but never for policy refresh, set this to false.

Note that graph-based retrieval can only be used for policy refresh scenarios that refresh the policy directly and do not require a second PAS search. Therefore, any refresh scenario that involves the retrievePolicySummaryFromPolicy method must be done using traditional policy retrieval approaches.

Policy refresh scenarios (without search)

For policy refresh situations that do not involve an additional search in the PAS, there are several different scenarios.

1: The traditional scenario (graphs are never used)

In this scenario, policy retrieval and refresh use traditional approaches only.

In this scenario:

Only the IPolicySearchAdapter plugin is relevant.
The useGraphBasedPolicyRetrieveForRefresh plugin parameter value is irrelevant

When policy refresh is initiated, ClaimCenter calls the IPolicySearchAdapter plugin and executes the retrievePolicyFromPolicy and/or retrievePolicySummaryFromPolicy methods as needed.

This is depicted in the following diagram.

Policy refresh scenario 1 - no graphs used

2: Graphs are used for policy retrieval, but never for refresh

In this scenario:

All three plugins are relevant
The useGraphBasedPolicyRetrieveForRefresh plugin parameter is set to false.

To execute the refresh, ClaimCenter first checks the value of the useGraphBasedPolicyRetrieveForRefresh plugin parameter. It sees that it is set to false. Therefore, it calls the IPolicySearchAdapter plugin's retrievePolicyFromPolicy method, which calls the IFallbackPolicySearchPlugin plugin's retrievePolicyFromPolicy method.

This is depicted in the following diagram. (In this scenario, the ICloudRetrievePolicyPlugin is relevant for policy retrieval, but not policy refresh.)

Policy refresh scenario 2 - useGraphBasedRetrieve is false

3: Graphs are used for refresh some or all of the time

In this scenario:

All three plugins are relevant
The useGraphBasedPolicyRetrieveForRefresh plugin parameter is set to true.

When policy refresh is initiated, ClaimCenter checks the value of the useGraphBasedPolicyRetrieveForRefresh plugin parameter. It sees that it is set to true. Then, to determine whether or not to use graph-based retrieval for the given policy type, ClaimCenter calls the ICloudRetrievePolicyPlugin plugin's shouldUseGraphRetrieveForPolicyType method. This method returns false or true.

Scenario 3A: The given policy type does not make use of graphs

If the shouldUseGraphRetrieveForPolicyType method returns false, ClaimCenter falls back to the traditional policy refresh approach by calling the IFallbackPolicySearchPlugin plugin's retrievePolicyFromPolicy method.

This is depicted in the following diagram.

Policy refresh scenario 3A - useGraphBasedRetrieve is true, LOB is false

Scenario 3B: The given policy type makes use of graphs

If the shouldUseGraphRetrieveForPolicyType method returns true, ClaimCenter calls the ICloudRetrievePolicyPlugin plugin's convertPolicyToSummary method, which takes a Policy and returns a PolicySummary. It then calls getPolicyGraph to re-retrieve the policy.

This is depicted in the following diagram.

Policy refresh scenario 3B - useGraphBasedRetrieve is true, LOB is true

Policy refresh scenarios (with search)

For policy refresh situations that do involve an additional search in the PAS, there is one additional scenario.

4: Policy refresh that requires a second policy search

In this scenario:

The IPolicySearchAdapter plugin and IFallbackPolicySearchPlugin plugin are relevant.
The useGraphBasedPolicyRetrieveForRefresh plugin parameter value is irrelevant

When policy refresh is initiated, ClaimCenter calls the IPolicySearchAdapter plugin and executes the retrievePolicySummaryFromPolicy method. This always calls the IFallbackPolicySearchPlugin plugin's retrievePolicySummaryFromPolicy method.

This is depicted in the following diagram.