Insurance & Risk Pooling

Findings

Catalogue-native findings must describe the information grouped by each layer. This legacy version does not declare them separately.

Questions & artifacts

Questions, artifact requirements and serial naming rules are required by Vercy vNext; they remain unassigned in this reference version.

Dimension & namespace

• EXTEND `world.commercialContract` (O5): a policy is a specialized agreement with insurance-specific obligations and lifecycle.
• REFERENCE `world.priceValuation` (C7): insured values and loss quantification rely on appraisals and indices.
• REFERENCE `world.organization` (O1) and `world.person` (H1): insurers, holders and beneficiaries.
• REFERENCE `world.landParcel` (P2): insured property interests resolve to parcels and buildings.
• REFERENCE `world.disputeResolution` (A19): contested claims escalate there.
• REFERENCE `world.stewardship` (S1) and `world.accessGrant` (S2): ownership and access grants over policy, pool and claim records.
• MIX-IN `world.auditTrail` (S4): audit facets on issuance, cession and settlement events.
• imports: acord (ALIGN): insurance data interchange vocabulary across cover, pooling and claims.
• imports: iso-4217 (REFERENCE): currency codes on premiums, reserves and settlements.

Canon, patches & standards

• EXTEND `world.commercialContract` (O5): a policy is a specialized agreement with insurance-specific obligations and lifecycle.
• REFERENCE `world.priceValuation` (C7): insured values and loss quantification rely on appraisals and indices.
• REFERENCE `world.organization` (O1) and `world.person` (H1): insurers, holders and beneficiaries.
• REFERENCE `world.landParcel` (P2): insured property interests resolve to parcels and buildings.
• REFERENCE `world.disputeResolution` (A19): contested claims escalate there.
• REFERENCE `world.stewardship` (S1) and `world.accessGrant` (S2): ownership and access grants over policy, pool and claim records.
• MIX-IN `world.auditTrail` (S4): audit facets on issuance, cession and settlement events.
• imports: acord (ALIGN): insurance data interchange vocabulary across cover, pooling and claims.
• imports: iso-4217 (REFERENCE): currency codes on premiums, reserves and settlements.

Artifact formats & serial data

Format-independent core. Concrete artifact formats and naming prefixes are not declared in this legacy version.

Policies & accepted processes

• `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.

Read / add / edit / delete

CRUD procedures and interface bindings are not declared in this legacy version.

Ownership, roles & access

Policy and claim records are bilateral, owned jointly by insurer and insured; pool records are stewarded by the pool operator for its participants. Access is granted by the owners under the S1/S2 models of this catalogue.

Objects

• `policy`: the insurance promise; key attributes: line of business, inception date, expiry, status.
• `insuredInterest`: what is covered; key attributes: interest kind, sum insured, referent link, exclusion notes.
• `premiumSchedule`: the agreed payments; key attributes: amount, currency, frequency, payment status.
• `riskAssessment`: the underwriting judgment; key attributes: rated peril set, rating factors, assessment date.
• `riskPool`: a pooling arrangement; key attributes: pool kind (mutual pool, reinsurance treaty), coverage scope, period.
• `poolParticipation`: a share in a pool; key attributes: participant reference, share, attachment terms.
• `claim`: a call on the promise; key attributes: notification date, peril, claimed amount, status.
• `lossAssessment`: the evaluation of a claim; key attributes: assessed amount, assessor reference, findings summary.
• `settlement`: the resolution of a claim; key attributes: outcome (paid, partly paid, denied), amount, date, subrogation flag.

Relationships

• `policy` -> covers -> `insuredInterest` (1:n): the interests a policy protects.
• `insuredInterest` -> attachesTo -> `world.landParcel` (n:1): the external referent, for example property (P2), a person (H1) or an organization asset (O1).
• `policy` -> heldBy -> `world.organization` (n:1): the policyholder, an organization (O1) or a person (H1).
• `premiumSchedule` -> funds -> `policy` (1:1): the payment side of the promise.
• `poolParticipation` -> cedes -> `riskPool` (n:m): shares of policies or portfolios ceded into pools and treaties.
• `claim` -> madeUnder -> `policy` (n:1): the promise the claim invokes.
• `lossAssessment` -> evaluates -> `claim` (1:1): the judgment on the loss.
• `settlement` -> resolves -> `claim` (1:1): the terminal outcome of the claim.

Events

• `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.

Projections

• `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.