Action Taken On ClaimFraud TypeLegal Action Start DateLegal Action TakenSeverity
| Business Data Model Data Model |
| Description | The status of a submitted claim in the context of a claim fraud investigation. |
| Attributes | |
| Action Taken On Claim |
|
| Fraud Type |
|
| Legal Action Start Date |
|
| Legal Action Taken |
|
| Severity |
|
| Relationship | |
 Claim Condition_Claim_FK |
|
| Claim Condition_Claim Fraud Investigation_FK |
|
| Dependencies | |
 NONE |
|
| Reverse Dependencies | |
| |
|
| Attribute Details |
Action Taken On Claim
| Description | Indicates the type of action taken by the organization in relation to a claim that was part of a claim fraud investigation. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Fraud Type
| Description | Indicates the nature of the fraud in relation to a claim |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Legal Action Start Date
| Description | The date upon which legal action was taken as a result of a claim fraud investigation. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Legal Action Taken
| Description | Indicates whether legal action was taken as a result of a claim fraud investigation. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Severity
| Description | Specifies the intensity of an activity, event or condition. For example: Major Moderate Minor |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Claim Condition_Claim_FK
| Is Identifying Relationship | false |
| Child Table | Claim Condition |
| Child Role Name | is for |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Claim |
| Parent Role Name | has |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Claim Condition_Claim Fraud Investigation_FK
| Is Identifying Relationship | false |
| Child Table | Claim Condition |
| Child Role Name | is result of |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Claim Fraud Investigation |
| Parent Role Name | results in |
| Parent Multiplicity | ZERO_TO_ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Business Data Model Data Model |