Starter contract

insurance_claim

15 rules · plain YAML · starts in observation mode

OpenDQV Cloud starter template (v0.1) — your tenant inherits this baseline. First customer edit creates v1.0 in your audit trail; pin by yaml_hash for replay. Insurance claim record validation aligned with FCA ICOBS (Insurance Conduct of Business Sourcebook), the Insurance Act 2015 (duty of fair presentation), and Claims Management Regulation under the Financial Guidance and Claims Act 2018. Enforces claim date monotonicity (claim must be on or after incident), claim type taxonomy, settlement status lifecycle, ISO 4217 currency, and fraud indicator classification aligned with IFB (Insurance Fraud Bureau) IFED taxonomy. Prevents claims with pre-incident claim dates, uncurrencied settlement amounts, and missing assessor assignment from entering claims management system (CMS) pipelines where FCA RMAR (Regular Reporting) and Lloyd's market data obligations apply.

These are starting points you own. Every rule below ships in the trial, starts in observation mode, and is yours to read, edit, or delete from day one. Rules that reference a lookup list (lookup_file) validate against reference data you control in your tenant.
Rules as at 29 August 2026 — starting points you own, not a maintained regulatory feed. We correct errors in these samples; tracking regulatory change in your active contracts is yours.

Rule	Field	Severity	What it enforces (the message your team sees)
claim_id_required	claim_id	error	claim_id is required
policy_number_required	policy_number	error	policy_number is required
incident_date_format	incident_date	error	incident_date must be a valid date (YYYY-MM-DD)
claim_date_format	claim_date	error	claim_date must be a valid date (YYYY-MM-DD)
claim_date_after_incident	claim_date	error	claim_date must be on or after incident_date — a claim filed before the incident indicates a data entry error or potential fraud (Insurance Act 2015, FCA ICOBS 8)
claimant_id_required	claimant_id	error	claimant_id is required
claim_type_required	claim_type	error	claim_type is required
claim_type_valid	claim_type	error	claim_type must be one of: property, liability, health, auto, life, travel, marine, cyber, professional_indemnity, employers_liability, business_interruption, other
claimed_amount_min	claimed_amount	error	claimed_amount must be > 0 — a claim with a zero amount is nonsensical and indicates a data entry or systems integration error
currency_format	currency	error	currency must be a valid ISO 4217 three-letter code (e.g. GBP, USD, EUR) — required for Lloyd's bordereaux and FCA RMAR reporting
status_required	status	error	status is required
claim_status_valid	status	error	status must be one of: submitted, under_review, pending_information, approved, rejected, settled, partially_settled, withdrawn, reopened, litigated, fraud_referred
excess_amount_min	excess_amount	warning	excess_amount must be >= 0 — negative excess values cause incorrect settlement calculation and reserve misstatement
fraud_indicator_values	fraud_indicator	warning	fraud_indicator must be one of: none, low_risk, medium_risk, high_risk, referred_to_siu, confirmed_fraud, ghost_broker, organised_fraud_ring (IFB/IFED fraud classification — confirmed_fraud requires IFED referral)
assessor_id_required	assessor_id	warning	assessor_id should be assigned to the claim

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