ZRGg3004F: Claim Error 0057 Expected, but not Raised (Doc ID 1934935.1)

Last updated on MARCH 09, 2017

Applies to:

Oracle Health Insurance Claims Management - Version 2012.03.5 and later
Information in this document applies to any platform.

Symptoms

On production: 2012.03.5 version, Usage

When attempting to ,
the following error NOT occurs.

ERROR
-----------------------
DZV-0057 The claimant may not claim for this relation.

This error message is expected, since this condition does not apply:
"The claimant appears in the role of insured member and as such takes part in or is policyholder of a policy associated with a policy which the insured member of the claim line participates;"

STEPS
-----------------------
The issue can be reproduced at will with the following steps:
1. Process claim line for insured member with start date that is not within the period of the membership on the policy of the claimant.

BUSINESS IMPACT
-----------------------
The issue has the following business impact:
Due to this issue, claims are being payed incorrectly.

Cause

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