The Diamond System provides customers with the option of using seven (7) financial categories. These consist of the following:
One (1) category for Loss / Indemnity,
Two (2) categories for Expenses (ALAE and ULAE)
Four (4) Categories for recoveries (Salvage, Subro, Reinsurance Loss Recovery and Reinsurance Expense Recovery)
Each of these categories is divided into two (2) sections, anticipated / reserve and recovery / payment. Customers can choose to use all of these categories or a subset of the categories.
Each of the category sections contains a list of transaction types. These types are configured based on a customer's requirements.
Each type specifies how that transaction type affects the claim financials (increase, decrease, no change). A single transaction may affect multiple claim categories (or category sections). For example, a “Loss Payment” may decrease the amount of the “Loss Reserve” category and increase the amount of the “Loss Paid” category. This increase and decrease functionality is configured based on information from the customer.
The types also contain additional information about the transaction that determines how the system processes that transaction (i.e., are payees required, do you need to enter a payment type, is this transaction allowed on a record only coverage, etc.).
The Claim Financials are stored at the Claimant, Claim Feature and Claim Level for each claim. These running totals are updated when a transaction is issued. If a transaction goes into a “Pending” status (either “Pending” issuance or “Pending” approval), the Claim Financials are not updated until that transaction is issued or approved.
When using End of Period (EOP) processing, financials are also stored at the Claim Feature level broken down by month / year and Month to Date (MTD), Year to Date (YTD) and Inception to Date (ITD) totals.