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Schadenfälle & Versicherungen

claims core_platform 🛡️ RLS Protected

Schadenfälle & Versicherungen — aus Code abgeleitete Prozess- und API-Dokumentation.

Fachliche Bestimmung: Schadenfälle & Versicherungen — aus Code abgeleitete Prozess- und API-Dokumentation. Erfasst alle registrierten Prozesse, Capabilities, Zustandsmaschinen, APIs und Tabellen für Simulationen und Reviews.

⚡ Darbības plūsmas un dzīves cikļi (1) 🗄️ Datu modeļi & laukumi (2) 🔌 Izstādes punkti (UI un API) (24) 🛡️ Regulators & atbilstība

⚡ Darbības plūsmas un dzīves cikļi

Benutzerbefehl: claims agent `plan:command_claims_agent`

Pārbaudēts durabls plan (durabls_plan), sākums: manuals_command.

1. claims_agent

claims_agent

{"key": "execute_command", "label": "Befehl prüfen, ausführen oder zur Freigabe vorlegen", "adapter": "agent.execute", "agent": "claims_agent", "condition_fact": null}

Aktionen: claims_agent

🗄️ Datu modeļi & laukumi

ClaimEvents claim_events RLS Aktiv

10 Šķiet, ka tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai ir atkarīgs no tā, vai ir atkarīgs no tā, vai ir atkarīgs no tā, vai ir atkarīgs no tā vai ir no tā.

Tabelle claim_events

Feldname	Datums	Atbalsts	Schlüssel	Īpaša nozīme
`claim_id`	`UUID`	Ja *	FK ➔ claims.id	Feld claim_id
`event_type`	`VARCHAR(32)`	Ja *	-	Feld event_type
`from_status`	`VARCHAR(16)`	Nein	-	Feld from_status
`to_status`	`VARCHAR(16)`	Nein	-	Feld to_status
`note`	`TEXT`	Nein	-	Feld note
`actor`	`VARCHAR(128)`	Nein	-	Feld actor
`created_at`	`DATETIME`	Ja *	-	Feld created_at
`id`	`UUID`	Nein	PK	Feld id
`tenant_id`	`UUID`	Ja *	FK ➔ organizations.id	Feld tenant_id
`metadata`	`JSONB`	Ja *	-	Feld metadata

Claims claims RLS Aktiv

28 Šķiet, ka tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai tas ir atkarīgs no tā, vai ir atkarīgs no tā, vai ir atkarīgs no tā, vai ir atkarīgs no tā, vai ir atkarīgs no tā vai ir no tā.

Tabelle claims

Feldname	Datums	Atbalsts	Schlüssel	Īpaša nozīme
`claim_number`	`VARCHAR(64)`	Ja *	-	Feld claim_number
`claim_type`	`VARCHAR(24)`	Ja *	-	Feld claim_type
`status`	`VARCHAR(16)`	Ja *	-	Feld status
`title`	`VARCHAR(255)`	Ja *	-	Feld title
`description`	`TEXT`	Nein	-	Feld description
`occurred_at`	`DATE`	Nein	-	Feld occurred_at
`entity_type`	`VARCHAR(64)`	Nein	-	Feld entity_type
`entity_id`	`UUID`	Nein	-	Feld entity_id
`estimated_amount`	`NUMERIC(14, 2)`	Nein	-	Feld estimated_amount
`settled_amount`	`NUMERIC(14, 2)`	Nein	-	Feld settled_amount
`deductible`	`NUMERIC(14, 2)`	Nein	-	Feld deductible
`insurer_name`	`VARCHAR(255)`	Nein	-	Feld insurer_name
`insurer_ref`	`VARCHAR(128)`	Nein	-	Feld insurer_ref
`policy_id`	`UUID`	Nein	FK ➔ insurance_policies.id	Feld policy_id
`document_ids`	`JSONB`	Ja *	-	Feld document_ids
`reported_by`	`UUID`	Nein	FK ➔ organization_users.id	Feld reported_by
`submitted_at`	`DATETIME`	Nein	-	Feld submitted_at
`settled_at`	`DATETIME`	Nein	-	Feld settled_at
`notes`	`TEXT`	Nein	-	Feld notes
`id`	`UUID`	Nein	PK	Feld id
`tenant_id`	`UUID`	Ja *	FK ➔ organizations.id	Feld tenant_id
`created_at`	`DATETIME`	Ja *	-	Feld created_at
`updated_at`	`DATETIME`	Ja *	-	Feld updated_at
`created_by`	`UUID`	Nein	-	Feld created_by
`updated_by`	`UUID`	Nein	-	Feld updated_by
`source_type`	`VARCHAR(32)`	Nein	-	Feld source_type
`source_id`	`UUID`	Nein	-	Feld source_id
`metadata`	`JSONB`	Ja *	-	Feld metadata

🔌 Izstādes punkti (UI un API)

Art	Metodes	Galvenā vieta / ceļš	Titel & Zweck	Attaisnošana
⚡ REST API	GET	`/api/v1/claims`	list_claims Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/api/v1/claims/policies`	list_policies Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/api/v1/claims/policies/expiring`	expiring_policies Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/api/v1/claims/policies/{policy_id}`	get_policy Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/api/v1/claims/summary`	claims_summary Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/api/v1/claims/{claim_id}`	get_claim Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/api/v1/claims/{claim_id}/events`	list_claim_events Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/schaeden`	claims_page Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/schaeden/{claim_id}`	claim_detail_page Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	GET	`/versicherungen`	policies_page Semantic binding: inventory_only; mutation=False	`claims`
⚡ REST API	PATCH	`/api/v1/claims/policies/{policy_id}`	update_policy Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	PATCH	`/api/v1/claims/{claim_id}`	update_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims`	create_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/policies`	create_policy Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/{claim_id}/events`	add_claim_event Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/{claim_id}/reject`	reject_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/{claim_id}/reopen`	reopen_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/{claim_id}/review`	review_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/{claim_id}/settle`	settle_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/api/v1/claims/{claim_id}/submit`	submit_claim Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/schaeden/neu`	create_claim_form Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/schaeden/{claim_id}/aktion`	claim_action_form Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/schaeden/{claim_id}/notiz`	claim_note_form Semantic binding: operator_surface; mutation=True	`claims`
⚡ REST API	POST	`/versicherungen/neu`	create_policy_form Semantic binding: operator_surface; mutation=True	`claims`

🛡️ Regulators & atbilstība

Dieses Modul unterliegt folgenden gesetzlichen, regulatorischen und Revisionsstandards: