SAIF.Data.NHibernate business rules¶

This page captures business rules enforced by this library, including rules implemented directly in .NET repository/mapping code and rules enforced by the Oracle/SQL Server stored procedures this library calls.

SDN-BR-001 Claim bill queue operations are served by the Guidewire CC Claim API, not by the legacy Oracle package¶

Field	Value
Statement	Claim bill queue operations are served by the Guidewire CC Claim API, not by the legacy Oracle package. Originating rules are in SAIF.Data (`CCClaimApiService`, SD-BR-013)
Trigger	Bill queue request
Enforcement	`ClaimBillEntryRepository`
Outcome	Delegation
SQL	SQL-050, SQL-051
Source	`Data/SAIF.Data.NHibernate/Repositories/ClaimBillEntryRepository.cs`

SDN-BR-010 Collection case payments are applied by the Oracle package APPLYPAYMENTS for the case and payment date¶

Field	Value
Statement	Collection case payments are applied by the Oracle package `APPLYPAYMENTS` for the case and payment date
Trigger	Apply payments
Enforcement	`CollectionsRepository.ApplyPayments`
Outcome	DB update
Tables	LC_TRAN_CATEGORY_CODE, LEGAL_COLLECTION_PAYMENT_REF, LEGAL_COLLECTION_TRANSACTION, LEGAL_COLLECTION_TRAN_CODE
SQL	SQL-052, SQL-053
Source	`Data/SAIF.Data.NHibernate/Repositories/CollectionsRepository.cs:131`

SDN-BR-011 SOIL debtor eligibility: balance ≥ 0, include-on-SOIL flag 'Y', no third party, worker id present¶

Field	Value
Statement	SOIL debtor eligibility: balance ≥ 0, include-on-SOIL flag 'Y', no third party, worker id present
Trigger	SOIL run
Enforcement	`Collections_getWorkerIdForSoilDebtor` (`Collections.hbm.xml`)
Outcome	Worker id list
Tables	CLM_DBA.TEMP_DATA_PERSON_ADDRESS, LEGAL_COLLECTION, LEGAL_COLLECTION_DEBTOR, PERSON, SOIL_DEBTOR_REFERENCE, THRDPARTY
SQL	SQL-002, SQL-019
Source	`Data/SAIF.Data.NHibernate/Mappings/Collections/Collections.hbm.xml`

SDN-BR-012 SOIL transactions are selected by the truncated create date¶

Field	Value
Statement	SOIL transactions are selected by the truncated create date
Trigger	SOIL run
Enforcement	`Collections_getWorkerIdForSoilTrans` (`Collections.hbm.xml`)
Outcome	Worker id list
Tables	LEGAL_COLLECTION, LEGAL_COLLECTION_DEBTOR, SOIL_DEBTOR_REFERENCE
SQL	SQL-020
Source	`Data/SAIF.Data.NHibernate/Mappings/Collections/Collections.hbm.xml`

SDN-BR-020 Claim complexity/segmentation score is computed by the SQL Server procedure bp_clm_segmntn_complexity_score¶

Field	Value
Statement	Claim complexity/segmentation score is computed by the SQL Server procedure `bp_clm_segmntn_complexity_score`
Trigger	Score request
Enforcement	`ClaimScoreRepository.GetClaimScoreCategory`
Outcome	Score category
Tables	ANALYTICS_DB.dbo.CSG_CLM_SGMNTN_REQUEST_CLAIM, EIS_PROD.dbo.WCS_POLICY, EIS_STAGING.dbo.BDS_CTL_MESSAGES
SQL	SQL-001
Source	`Data/SAIF.Data.NHibernate/Repositories/Claims/Information/ClaimScoreRepository.cs:15`

SDN-BR-030 ProvidersRepository requires a non-null unit of work¶

Field	Value
Statement	ProvidersRepository requires a non-null unit of work. Originating rule: SAIF.Framework.Core `Enforce`
Trigger	Construction
Enforcement	`ProvidersRepository` constructor
Outcome	ArgumentNullException
Tables	PROVIDER, PROVIDER_ADDRESS, PROVIDER_LOCATION
SQL	SQL-048, SQL-049
Source	`Data/SAIF.Data.NHibernate/Repositories/ProvidersRepository.cs:20`

SDN-BR-031 Provider payment address type = PAY, physical = PHY¶

Field	Value
Statement	Provider payment address type = PAY, physical = PHY
Trigger	Address lookup
Enforcement	`ProvidersRepository.GetProviderPaymentAddresses` / `GetProviderPhysicalAddresses`
Outcome	Filtered list
Tables	PROVIDER, PROVIDER_ADDRESS, PROVIDER_LOCATION
SQL	SQL-049
Source	`Data/SAIF.Data.NHibernate/Repositories/ProvidersRepository.cs:20`

SDN-BR-040 Group image delete is a soft delete¶

Field	Value
Statement	Group image delete is a soft delete (ImageDeleteCode = "Y", with audit stamp), applied only if not already deleted
Trigger	Delete
Enforcement	`GroupImageRepository.Delete`
Outcome	Row updated
SQL	SQL-054
Source	`Data/SAIF.Data.NHibernate/Repositories/Groups/GroupImageRepository.cs:23`

SDN-BR-041 Filter sentinels "---"¶

Field	Value
Statement	Filter sentinels "---" (all categories), "-100" (all doc types) and "" (all users) mean no filter
Trigger	Search
Enforcement	`GroupImageRepository.GetFilteredImageGroups`, `ImageFilterCriteria` (SAIF.Data)
Outcome	Filtered list
Tables	Image_Group
SQL	SQL-025
Source	`Data/SAIF.Data.NHibernate/Repositories/Groups/GroupImageRepository.cs:23`

SDN-BR-042 Deleted images are visible only to users permitted to see deleted images¶

Field	Value
Statement	Deleted images are visible only to users permitted to see deleted images
Trigger	Search
Enforcement	`GroupImageRepository.GetFilteredImageGroups`
Outcome	Filtered list (authorization)
Tables	Image_Group
SQL	SQL-025
Source	`Data/SAIF.Data.NHibernate/Repositories/Groups/GroupImageRepository.cs:23`

SDN-BR-043 Confidential images are visible only to users permitted to see confidential images¶

Field	Value
Statement	Confidential images are visible only to users permitted to see confidential images; non-confidential images are always visible
Trigger	Search
Enforcement	`GroupImageRepository.GetFilteredImageGroups`
Outcome	Filtered list (authorization)
Tables	Image_Group
SQL	SQL-025
Source	`Data/SAIF.Data.NHibernate/Repositories/Groups/GroupImageRepository.cs:23`

SDN-BR-044 Group image categories are those with file code "GROUP"¶

Field	Value
Statement	Group image categories are those with file code "GROUP"
Trigger	Lookup
Enforcement	`ImageCategoryCodeRepository.GetImageCategoryCodes`
Outcome	List
SQL	SQL-029, SQL-030, SQL-031
Source	`Data/SAIF.Data.NHibernate/Repositories/Imaging/ImageCategoryCodeRepository.cs:19`

SDN-BR-050 Investigation subject name resolves via person, company or provider location, with nvl fallbacks¶

Field	Value
Statement	Investigation subject name resolves via person, company or provider location, with `nvl` fallbacks
Trigger	Lookup
Enforcement	`InvestigationRepositoryExtensions.GetSubjectName`
Outcome	Name data
Tables	COMPANY, INVESTIGATION, PERSON, POLICY, PROVIDER_LOCATION, SUBJECT
SQL	SQL-032
Source	`Data/SAIF.Data.NHibernate/Repositories/Investigations/InvestigationRepositoryExtensions.cs:8`

SDN-BR-060 Agency inbox: Unread = not viewed and not agency-deleted¶

Field	Value
Statement	Agency inbox: Unread = not viewed and not agency-deleted; All = not agency-deleted; Deleted = agency delete date set
Trigger	Inbox query
Enforcement	`PolicyOutputDocumentRepository.GetPolicyOutputDocumentsForInbox`, `PolicyOutputDocumentExtensions`
Outcome	Filtered list
Tables	POLICY, output_document, policy_output_document
SQL	SQL-043
Source	`Data/SAIF.Data.NHibernate/Repositories/OutputDocuments/PolicyOutputDocumentRepository.cs:38`

SDN-BR-061 Agencies see only released, agency-viewable documents¶

Field	Value
Statement	Agencies see only released, agency-viewable documents (held/pending for the specific views). Duplicates SAIF.Data SD-BR-070/SD-BR-072
Trigger	Query
Enforcement	`PolicyOutputDocumentExtensions.Released` / `AgencyViewable` / `AgencyInboxViewable`
Outcome	Filtered list
Tables	POLICY, output_document, policy_output_document
SQL	SQL-041, SQL-042, SQL-043
Source	`Data/SAIF.Data/Queries/OutputDocuments/PolicyOutputDocumentExtensions.cs`

SDN-BR-062 Category "ALL" or blank means no filter¶

Field	Value
Statement	Category "ALL" or blank means no filter
Trigger	Query
Enforcement	`PolicyOutputDocumentExtensions.ForCategory`
Outcome	Filtered list
Tables	POLICY, output_document, policy_output_document
SQL	SQL-041
Source	`Data/SAIF.Data/Queries/OutputDocuments/PolicyOutputDocumentExtensions.cs`

SDN-BR-063 Child documents are returned only for a released parent¶

Field	Value
Statement	Child documents are returned only for a released parent
Trigger	Query
Enforcement	`PolicyOutputDocumentRepository.GetReleasedAgencyViewableChildOutputDocuments`
Outcome	List or exception
Tables	POLICY, output_document, policy_output_document
SQL	SQL-046
Source	`Data/SAIF.Data.NHibernate/Repositories/OutputDocuments/PolicyOutputDocumentRepository.cs:38`

SDN-BR-070 Tri-state Y/N/NULL persistence¶

Field	Value
Statement	Tri-state Y/N/NULL persistence
Trigger	Map/load
Enforcement	`YesNoNullUserType`
Outcome	Value conversion
Source	`Data/SAIF.Data.NHibernate/CustomTypes/YesNoNullUserType.cs`

SDN-BR-071 Claim authority purpose codes 1–4, default Initiate¶

Field	Value
Statement	Claim authority purpose codes 1–4, default Initiate
Trigger	Map/load
Enforcement	`ClaimAuthorityPurposeType`
Outcome	Enum
Source	`Data/SAIF.Data.NHibernate/CustomTypes/ClaimAuthorityPurposeType.cs`

SDN-BR-072 Certificate delivery method codes¶

Field	Value
Statement	Certificate delivery method codes
Trigger	Map/load
Enforcement	`CertificateDeliveryMethodsType`
Outcome	Enum
Source	`Data/SAIF.Data.NHibernate/CustomTypes/CertificateDeliveryMethodsType.cs`

SDN-BR-073 Certificate distribution status codes, default DoNotPrint¶

Field	Value
Statement	Certificate distribution status codes, default DoNotPrint
Trigger	Map/load
Enforcement	`CertificateDistributionStatusType`
Outcome	Enum
Source	`Data/SAIF.Data.NHibernate/CustomTypes/CertificateDistributionStatusType.cs`

SDN-BR-074 Certificate renewal notification codes¶

Field	Value
Statement	Certificate renewal notification codes
Trigger	Map/load
Enforcement	`CertificateRenewalNotificationTypesType`
Outcome	Enum
Source	`Data/SAIF.Data.NHibernate/CustomTypes/CertificateRenewalNotificationTypesType.cs`

SDN-BR-075 Certificate type codes BID/OSC/STD¶

Field	Value
Statement	Certificate type codes BID/OSC/STD
Trigger	Map/load
Enforcement	`CertificateTypeType`
Outcome	Enum
Source	`Data/SAIF.Data.NHibernate/CustomTypes/CertificateTypeType.cs`

Stored procedure business rules¶

Rules enforced by stored procedures this library calls. Each rule gets its own H2 section, restated in full as this page's canonical home for the rule.

PROC-RULE-001 Numeric references match case id, policy number or claim number¶

Field	Value
Statement	Numeric references match case id, policy number or claim number
Trigger	reference_id_in is numeric and ≠ 0
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_cases_by_reference` — Match LEGAL_COLLECTION seq_num, policy_num or saif_claim_num
Outcome	Match LEGAL_COLLECTION seq_num, policy_num or saif_claim_num
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-002 Non-numeric references¶

Field	Value
Statement	Non-numeric references (OD claims) match the claim number only; the case description depends on the case code
Trigger	Non-numeric reference; code WRKR/FOTH/THRD/CTHRD vs POL/FPOL/CPOL
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_cases_by_reference` — Match saif_claim_num; describe as claim number, or as policy number + name
Outcome	Match saif_claim_num; describe as claim number, or as policy number + name
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-003 Payments and credit adjustments are shown negative¶

Field	Value
Statement	Payments and credit adjustments are shown negative
Trigger	Tran code PMT or CADJ
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_category_totals` — Negate the amount; RPMT is shown as Payments
Outcome	Negate the amount; RPMT is shown as Payments
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-004 Fixed display order of categories¶

Field	Value
Statement	Fixed display order of categories
Trigger	Category code
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_category_totals` — BBAL 1, COST2 2, PJFEE 2 ("Pre-Judgment Fees"), INT2 3, COST3 4, INT 5, COST 6, CADJ 7, DADJ 8, other 10
Outcome	BBAL 1, COST2 2, PJFEE 2 ("Pre-Judgment Fees"), INT2 3, COST3 4, INT 5, COST 6, CADJ 7, DADJ 8, other 10
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-005 The subtotal excludes payments¶

Field	Value
Statement	The subtotal excludes payments
Trigger	Display row 9
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_category_totals` — Sum all categories except PMT/RPMT (CADJ negated); Current Balance is row 11
Outcome	Sum all categories except PMT/RPMT (CADJ negated); Current Balance is row 11
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-006 Judgment description source¶

Field	Value
Statement	Judgment description source
Trigger	Judgment code NA
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_category_totals` — Use code_descr; otherwise JUDGMENT_DESCR
Outcome	Use code_descr; otherwise JUDGMENT_DESCR
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-007 Foreign address flag¶

Field	Value
Statement	Foreign address flag
Trigger	LOC_ADDR3 populated*
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_fraud_other_address` — ForeignAddressFlag derived from LOC_ADDR3 on LOCATION_VIEW
Outcome	ForeignAddressFlag derived from LOC_ADDR3 on LOCATION_VIEW
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-008 Debtor location precedence¶

Field	Value
Statement	Debtor location precedence
Trigger	Debtor has loc_seq_num
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_policy_address` — Use the debtor location, else the policy's active 'POL' location (rownum = 1)
Outcome	Use the debtor location, else the policy's active 'POL' location (rownum = 1)
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-009 Third-party contact sources¶

Field	Value
Statement	Third-party contact sources
Trigger	Person or firm third party
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_thirdparty_address` — UNION ALL person address and company address; phone type 'P', fax type 'F'
Outcome	UNION ALL person address and company address; phone type 'P', fax type 'F'
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-010 Closed cases are hidden unless requested¶

Field	Value
Statement	Closed cases are hidden unless requested
Trigger	show_closed_cases_in = 'N'
Enforcement	`PK80010_LEGAL_COLLECTIONS.search_collections` — Add CURRENT_BALANCE_AMT > 0 to every search branch
Outcome	Add CURRENT_BALANCE_AMT > 0 to every search branch
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-011 Search branch selection¶

Field	Value
Statement	Search branch selection
Trigger	policy_name_in supplied vs not
Enforcement	`PK80010_LEGAL_COLLECTIONS.search_collections` — Policy/company name search (POLICY_SEARCH types LEGAL/TRD with DBA labelling, third-party companies); else worker name via CLM_DBA.TEMP_DATA_PERSON_ADDRESS (run_id), worker SSN, affiliate, third-party person, fraud-other
Outcome	Policy/company name search (POLICY_SEARCH types LEGAL/TRD with DBA labelling, third-party companies); else worker name via CLM_DBA.TEMP_DATA_PERSON_ADDRESS (run_id), worker SSN, affiliate, third-party person, fraud-other
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-012 Debtor name resolution order¶

Field	Value
Statement	Debtor name resolution order
Trigger	First match (rownum ≤ 1)
Enforcement	`PK80010_LEGAL_COLLECTIONS.getDebtorName / getPrimaryDebtorName` — Affiliate → policy name → third-party person → third-party company → fraud-other (FOTH, suffix included)
Outcome	Affiliate → policy name → third-party person → third-party company → fraud-other (FOTH, suffix included)
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-013 Debtor SSN source¶

Field	Value
Statement	Debtor SSN source (PII)
Trigger	Debtor type
Enforcement	`PK80010_LEGAL_COLLECTIONS.getDebtorSSN` — Affiliate match, third-party person TAX_ID, or FOTH debtor SSN
Outcome	Affiliate match, third-party person TAX_ID, or FOTH debtor SSN
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-014 'ALL' selects every case¶

Field	Value
Statement	'ALL' selects every case
Trigger	legal_collection_seq_num_in = 'ALL'
Enforcement	`PK80010_LEGAL_COLLECTIONS.interest_calc_select` — Convert to '%' LIKE pattern
Outcome	Convert to '%' LIKE pattern
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-015 Monthly interest accrues only after a full prior month¶

Field	Value
Statement	Monthly interest accrues only after a full prior month
Trigger	Interest option MTH
Enforcement	`PK80010_LEGAL_COLLECTIONS.interest_calc_select` — ROUND(outstanding × rate / 12 × (1 if days since interest start ≥ days in prior month else 0), 2)
Outcome	ROUND(outstanding × rate / 12 × (1 if days since interest start ≥ days in prior month else 0), 2)
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-016 Daily interest¶

Field	Value
Statement	Daily interest
Trigger	Interest option DAY
Enforcement	`PK80010_LEGAL_COLLECTIONS.interest_calc_select` — outstanding × rate × days / 365.25, rounded; only INTEREST_FLAG = 'Y', outstanding > 0, rate > 0; only interest > 0 returned
Outcome	outstanding × rate × days / 365.25, rounded; only INTEREST_FLAG = 'Y', outstanding > 0, rate > 0; only interest > 0 returned
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-017 Interest start date and statement balance¶

Field	Value
Statement	Interest start date and statement balance
Trigger	Case transactions
Enforcement	`PK80010_LEGAL_COLLECTIONS.get_interest_start_date / get_last_statement_balance` — Start = TRUNC(MAX(date)) where REFERENCE_TEXT = 'LCB00003', else MIN(date), else SYSDATE; statement balance = sum to date with PMT/CADJ negated, NO_DATA_FOUND → 0
Outcome	Start = TRUNC(MAX(date)) where REFERENCE_TEXT = 'LCB00003', else MIN(date), else SYSDATE; statement balance = sum to date with PMT/CADJ negated, NO_DATA_FOUND → 0
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-018 Unposted payments for open cases¶

Field	Value
Statement	Unposted payments for open cases
Trigger	Case balance > 0
Enforcement	`PK80010_LEGAL_COLLECTIONS.getPolicyPayments / getThirdPartyPayments` — Policy financial trans with trans_amt < 0 on/after date and no matching LC transaction; third-party distributions created after date
Outcome	Policy financial trans with trans_amt < 0 on/after date and no matching LC transaction; third-party distributions created after date
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-019 Statement and follow-up selection¶

Field	Value
Statement	Statement and follow-up selection
Trigger	Balance and hold flags
Enforcement	`PK80010_LEGAL_COLLECTIONS.getDebtorsWithoutPayments / getDebtorsWithExpiredLocs / getBalanceBroughtToMinAmount` — No DPMT after date with HOLD_STATEMENT_FLAG = 'N'; expired policy location updated after date; balance < 100 whose latest transaction is DPMT after date
Outcome	No DPMT after date with HOLD_STATEMENT_FLAG = 'N'; expired policy location updated after date; balance < 100 whose latest transaction is DPMT after date
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-020 Each request gets a new model sequence number¶

Field	Value
Statement	Each request gets a new model sequence number
Trigger	Every call
Enforcement	`bp_clm_segmntn_complexity_score` — NEXT VALUE FOR dbo.CSG_ModelSeqNum
Outcome	NEXT VALUE FOR dbo.CSG_ModelSeqNum
Origin	`bp_clm_segmntn_complexity_score`
Source	Oracle DBA_SOURCE / retrieved package source: `bp_clm_segmntn_complexity_score`

PROC-RULE-021 The request is persisted before scoring¶

Field	Value
Statement	The request is persisted before scoring
Trigger	Every call
Enforcement	`bp_clm_segmntn_complexity_score` — INSERT into ANALYTICS_DB.dbo.CSG_CLM_SGMNTN_REQUEST_CLAIM with rtrim'd text parameters and PLCY_ID from EIS_PROD.dbo.WCS_POLICY
Outcome	INSERT into ANALYTICS_DB.dbo.CSG_CLM_SGMNTN_REQUEST_CLAIM with rtrim'd text parameters and PLCY_ID from EIS_PROD.dbo.WCS_POLICY
Origin	`bp_clm_segmntn_complexity_score`
Source	Oracle DBA_SOURCE / retrieved package source: `bp_clm_segmntn_complexity_score`

PROC-RULE-022 Current model scores¶

Field	Value
Statement	Current model scores; 2026 model runs silently
Trigger	After insert
Enforcement	`bp_clm_segmntn_complexity_score` — EXEC _dtl (result) then _dtl_2026 (silent mode)
Outcome	EXEC _dtl (result) then _dtl_2026 (silent mode)
Origin	`bp_clm_segmntn_complexity_score`
Source	Oracle DBA_SOURCE / retrieved package source: `bp_clm_segmntn_complexity_score`

PROC-RULE-023 The primary injury type code is stored only¶

Field	Value
Statement	The primary injury type code is stored only
Trigger	@primaryInjuryTypeCode
Enforcement	`bp_clm_segmntn_complexity_score` — Saved on the request row; not passed to the model
Outcome	Saved on the request row; not passed to the model
Origin	`bp_clm_segmntn_complexity_score`
Source	Oracle DBA_SOURCE / retrieved package source: `bp_clm_segmntn_complexity_score`

PROC-RULE-024 Failure notification¶

Field	Value
Statement	Failure notification
Trigger	CATCH block
Enforcement	`bp_clm_segmntn_complexity_score` — Read BDS_CTL_MESSAGES MSG_ID = 28 and EXEC eis_staging.dbo.bp_send_message; RETURN error number
Outcome	Read BDS_CTL_MESSAGES MSG_ID = 28 and EXEC eis_staging.dbo.bp_send_message; RETURN error number
Origin	`bp_clm_segmntn_complexity_score`
Source	Oracle DBA_SOURCE / retrieved package source: `bp_clm_segmntn_complexity_score`

PROC-RULE-025 Only unapplied payments are applied¶

Field	Value
Statement	Only unapplied payments are applied
Trigger	Payment tran PAY_DOWN_ORDER = 0 and outstanding > 0 (inSeqNum = 0 → all cases)
Enforcement	`PK80010_LEGAL_COLLECTIONS.applyPayments` — Process in date order
Outcome	Process in date order
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-026 Pay-down order¶

Field	Value
Statement	Pay-down order
Trigger	Cost transactions PAY_DOWN_ORDER > 0
Enforcement	`PK80010_LEGAL_COLLECTIONS.applyIt` — Apply to costs ordered by pay_down_order, date; reduce outstanding, increment update_num
Outcome	Apply to costs ordered by pay_down_order, date; reduce outstanding, increment update_num
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-027 Every application is recorded¶

Field	Value
Statement	Every application is recorded
Trigger	Amount applied to a cost
Enforcement	`PK80010_LEGAL_COLLECTIONS.legalcol_payment_ref_insert` — INSERT LEGAL_COLLECTION_PAYMENT_REF
Outcome	INSERT LEGAL_COLLECTION_PAYMENT_REF
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-028 The payment keeps the unapplied remainder¶

Field	Value
Statement	The payment keeps the unapplied remainder; the payment date is ignored
Trigger	After applyIt
Enforcement	`PK80010_LEGAL_COLLECTIONS.applyPayments` — UPDATE payment outstanding = remainder; pmt_date unused (date filter commented out)
Outcome	UPDATE payment outstanding = remainder; pmt_date unused (date filter commented out)
Origin	`PK80010_LEGAL_COLLECTIONS`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80010_LEGAL_COLLECTIONS`

PROC-RULE-030 SOIL eligibility¶

Field	Value
Statement	SOIL eligibility
Trigger	Balance ≥ 0 and INCLUDE_ON_SOIL_FLAG = 'Y'
Enforcement	`PK80011_LEGALCOL_SOIL.create_reference_records` — INSERT SOIL_DEBTOR_REFERENCE from non-worker debtors (debtor_ssn without '-'), worker debtors (TEMP_DATA_PERSON_ADDRESS by run_id) and third-party debtors (TAX_ID)
Outcome	INSERT SOIL_DEBTOR_REFERENCE from non-worker debtors (debtor_ssn without '-'), worker debtors (TEMP_DATA_PERSON_ADDRESS by run_id) and third-party debtors (TAX_ID)
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-031 Audit user¶

Field	Value
Statement	Audit user
Trigger	Insert
Enforcement	`PK80011_LEGALCOL_SOIL.create_reference_records` — update_user = 'LCB0006'
Outcome	update_user = 'LCB0006'
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-032 Balances are summed per SSN¶

Field	Value
Statement	Balances are summed per SSN
Trigger	Reference rows for the run date
Enforcement	`PK80011_LEGALCOL_SOIL.create_SOIL_transactions` — Cursor ordered by SSN; accumulate balances
Outcome	Cursor ordered by SSN; accumulate balances
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-033 No prior DOR balance sentinel¶

Field	Value
Statement	No prior DOR balance sentinel
Trigger	No DEPT_REVENUE_SOIL_BALANCE row
Enforcement	`PK80011_LEGALCOL_SOIL.find_DOR_balance` — Use -.33
Outcome	Use -.33
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-034 Transaction code¶

Field	Value
Statement	Transaction code
Trigger	Prior balance and new sum
Enforcement	`PK80011_LEGALCOL_SOIL.insert_soil_tran` — 'A' if prior -.33 or 0 and sum > 0; 'D' if sum = 0; else 'C'
Outcome	'A' if prior -.33 or 0 and sum > 0; 'D' if sum = 0; else 'C'
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-035 Zero-balance debtors leave SOIL¶

Field	Value
Statement	Zero-balance debtors leave SOIL
Trigger	Trans code 'D'
Enforcement	`PK80011_LEGALCOL_SOIL.remove_soil_flag` — UPDATE LEGAL_COLLECTION_DEBTOR include_on_soil_flag = 'N'
Outcome	UPDATE LEGAL_COLLECTION_DEBTOR include_on_soil_flag = 'N'
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-036 Only changes are sent¶

Field	Value
Statement	Only changes are sent
Trigger	sum ≠ DOR balance
Enforcement	`PK80011_LEGALCOL_SOIL.create_SOIL_transactions` — INSERT DEPT_REVENUE_SOIL_ADJUSTMENT change_amt = sum − balance
Outcome	INSERT DEPT_REVENUE_SOIL_ADJUSTMENT change_amt = sum − balance
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-037 Name split¶

Field	Value
Statement	Name split
Trigger	first_name = 'REPLACE'
Enforcement	`PK80011_LEGALCOL_SOIL.create_SOIL_transactions` — Split the name on a comma
Outcome	Split the name on a comma
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-038 Dropped debtors are deleted at DOR¶

Field	Value
Statement	Dropped debtors are deleted at DOR
Trigger	DOR balance > 0 (latest received) with no reference row for the run date
Enforcement	`PK80011_LEGALCOL_SOIL.create_SOIL_transactions` — Insert 'D' adjustment; errors raise -20000 with the SSN
Outcome	Insert 'D' adjustment; errors raise -20000 with the SSN
Origin	`PK80011_LEGALCOL_SOIL`
Source	Oracle DBA_SOURCE / retrieved package source: `PK80011_LEGALCOL_SOIL`

PROC-RULE-040 Standard premium from the latest premium-history set¶

Field	Value
Statement	Standard premium from the latest premium-history set
Trigger	Policy + period effective date
Enforcement	`PK72846_VIEW_POLICY.SP73111_GET_WCIS_STD_PREMIUM` — RETURN pk73059_prem_hist_summary.get_standard_premium(get_max_ph_set_id(in_policy_num, in_pol_per_eff_date)) (pk73059 not retrieved**)
Outcome	RETURN pk73059_prem_hist_summary.get_standard_premium(get_max_ph_set_id(in_policy_num, in_pol_per_eff_date)) (pk73059 not retrieved**)
Origin	`PK72846_VIEW_POLICY`
Source	Oracle DBA_SOURCE / retrieved package source: `PK72846_VIEW_POLICY`

PROC-RULE-041 Shared logic with BDS¶

Field	Value
Statement	Shared logic with BDS
Trigger	Any change
Enforcement	`PK72846_VIEW_POLICY.SP73111_GET_WCIS_STD_PREMIUM` — Header comment: changes must be coordinated with BDS
Outcome	Header comment: changes must be coordinated with BDS
Origin	`PK72846_VIEW_POLICY`
Source	Oracle DBA_SOURCE / retrieved package source: `PK72846_VIEW_POLICY`

PROC-RULE-045 Procedure wrapper exists for NHibernate¶

Field	Value
Statement	Procedure wrapper exists for NHibernate
Trigger	NHibernate cannot call a VARCHAR2 function
Enforcement	`PK73101_IMAGE.track_in_report (procedure)` — Call wcis_dba.pk73101_image.track_in_report@POLDB and discard the arrears flag
Outcome	Call wcis_dba.pk73101_image.track_in_report@POLDB and discard the arrears flag
Origin	`PK73101_IMAGE`
Source	Oracle DBA_SOURCE / retrieved package source: `PK73101_IMAGE`

PROC-RULE-046 Temporary until Guidewire¶

Field	Value
Statement	Temporary until Guidewire
Trigger	Header comment
Enforcement	`PK73101_IMAGE.track_in_report (procedure)` — Wrapper can be removed once Guidewire implements the function
Outcome	Wrapper can be removed once Guidewire implements the function
Origin	`PK73101_IMAGE`
Source	Oracle DBA_SOURCE / retrieved package source: `PK73101_IMAGE`

Notes¶

Statements marked with * were inferred from code structure, naming conventions, or contextual evidence where direct confirmation was not available in source artifacts.
Statements marked with ** could not be confirmed from available source and should be treated as unknown until verified.

Note: Statements marked with * were inferred from code structure, naming conventions, or contextual evidence where direct confirmation was not available in source artifacts. Statements marked with ** could not be confirmed; treat as unknown until verified.

Sources¶

Data/SAIF.Data.NHibernate/Repositories/**
Data/SAIF.Data.NHibernate/Mappings/**