{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.wm-eco-003","code":"world-c8-insurance-and-risk-pooling","url":"https://ver.cy/models/world-c8-insurance-and-risk-pooling/","name":"Insurance & Risk Pooling","alternateNames":["C8"],"kind":"world-model","status":"legacy","version":"0.2.0-legacy","language":"en","classifiers":{"family":"World Models","category":"Society, people and institutions","entryKind":"standalone-mm","plane":"","domain":["SOC.ECO.INS"],"industry":["Cross-industry"],"navPath":"NAV.SOC.ECO.INS","tags":["insurance","soc.eco.ins"],"facets":{}},"whatItIs":"This meta-model describes how risks are shared: policies that promise to make losses good, premiums that fund the promise, pools and reinsurance that spread the exposure, and claims that call the promise in.","purpose":"Policies, pools, claims as value routing","scope":{"in":[],"out":[],"boundaries":[]},"distinguishingFeatures":["It is its own model because the policy is a bilateral record with a lifecycle of its own, while pooling and claims settlement follow rules that no general agreement model captures."],"structure":{"bundles":[{"id":"cover","name":"cover","description":"What is promised and at what price","layers":[{"id":"policyTerms","name":"policyTerms","description":"cover, exclusions and insured interests","findings":[]},{"id":"underwriting","name":"underwriting","description":"risk assessment and premium setting","findings":[]}]},{"id":"pooling","name":"pooling","description":"How exposure is spread","layers":[{"id":"participation","name":"participation","description":"pool membership, cessions and reinsurance","findings":[]},{"id":"reserves","name":"reserves","description":"funding, reserves and solvency snapshots","findings":[]}]},{"id":"claims","name":"claims","description":"How losses are made good","layers":[{"id":"assessment","name":"assessment","description":"notification, documentation and loss evaluation","findings":[]},{"id":"settlement","name":"settlement","description":"payout, denial and subrogation","findings":[]}]}]},"agentConduct":{"may":[],"mustNot":[],"requiresHuman":[]},"ethics":{"considerations":[],"affectedParties":[]},"owners":{"steward":"Policy and claim records are bilateral, owned jointly by insurer and insured; pool records are stewarded by the pool operator for its participants.","roles":[],"masterSystems":[]},"relations":[{"target":"world.commercialContract","type":"extends","note":"a policy is a specialized agreement with insurance-specific obligations and lifecycle."},{"target":"world.priceValuation","type":"references","note":"insured values and loss quantification rely on appraisals and indices."},{"target":"world.organization","type":"references","note":"insurers, holders and beneficiaries."},{"target":"world.person","type":"references","note":"insurers, holders and beneficiaries."},{"target":"world.landParcel","type":"references","note":"insured property interests resolve to parcels and buildings."},{"target":"world.disputeResolution","type":"references","note":"contested claims escalate there."},{"target":"world.stewardship","type":"references","note":"ownership and access grants over policy, pool and claim records."},{"target":"world.accessGrant","type":"references","note":"ownership and access grants over policy, pool and claim records."},{"target":"world.auditTrail","type":"composes","note":"audit facets on issuance, cession and settlement events."},{"target":"acord","type":"imports","note":"ALIGN: insurance data interchange vocabulary across cover, pooling and claims."},{"target":"iso-4217","type":"imports","note":"REFERENCE: currency codes on premiums, reserves and settlements."},{"target":"WM-ECO-036","type":"contains"},{"target":"vr.wm-pol-010","type":"requires"},{"target":"vr.wm-pol-014","type":"requires"}],"interaction":{"identity":{"applicability":"required","items":[]},"properties":{"applicability":"not-applicable","items":[]},"recognition":{"applicability":"optional","items":[]},"capabilities":{"applicability":"required","items":["policyIssued: cover took effect between insurer and insured.","coverAmended: interests, sums or exclusions changed mid-term.","premiumCollected: a scheduled payment was received.","riskCeded: exposure was passed into a pool or reinsurance treaty.","claimNotified: the insured reported a loss.","lossAssessed: the loss was evaluated.","claimSettled: the claim was paid, partly paid or denied.","policyLapsed: cover ended by expiry, cancellation or non-payment."]},"hazards":{"applicability":"optional","items":[]},"interfaces":{"applicability":"required","items":["policyMirror: insurer and insured hold the identical policy and claim record as a bilateral mirror.","claimsHistoryDisclosure: consented disclosure of a holder's claims experience to another insurer or broker.","poolAccounts: participants receive periodic pool composition, exposure and reserve reports.","coverCertificate: proof of cover for third parties; omits premium and underwriting detail.","claimsExperience: per-holder loss history summary; omits assessment working papers.","poolExposureView: aggregate exposure and reserve adequacy for a pool; omits individual policies."]},"context":{"applicability":"required","items":["Access is granted by the owners under the S1/S2 models of this catalogue."]}},"sources":[],"openQuestions":["Superseded by a researched world model? Map this legacy card to its successor or retire it."],"resources":{"spec":"/models/world-c8-insurance-and-risk-pooling/spec.yaml","agents":"/models/world-c8-insurance-and-risk-pooling/AGENTS.md"},"provenance":{"origin":"legacy MMAS card (world-models v0.2)","builtFrom":["models/world-c8-insurance-and-risk-pooling/spec.yaml","models/docs/economy/C8-insurance-and-risk-pooling.md"],"providers":[],"researchStatus":"legacy","generatedAt":"","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"derived","purpose":"filled","distinguishingFeatures":"derived","structure":"thin","agentConduct":"missing","ethics":"missing","owners":"filled","relations":"filled","interaction.identity":"missing","interaction.properties":"not-applicable","interaction.recognition":"missing","interaction.capabilities":"derived","interaction.hazards":"missing","interaction.interfaces":"derived","interaction.context":"filled","sources":"missing"},"notes":{"whatItIs":"First sentence of the legacy card introduction.","interaction.capabilities":"Legacy events listed as state transitions.","structure":"Legacy card: layers named, findings and questions never written.","interaction.properties":"Institutional or informational subject: no invented physical properties."},"score":0.469}}