Health Insurance System - SRD
Health Insurance System - SRD
Health Insurance System - SRD
Signature VS
Date 11/13/2014
Project ID: <Project ID. > <SCI.ID. > / Ver: <Ver No.>
Table of Contents
1.0 Introduction 3
1.1 About this document 3
1.1.1 Purpose & Scope of the document 3
1.1.2 Intended Audience 3
1.2 About the Software System 3
1.2.1 Purpose 3
1.2.2 Scope of the system 4
1.2.3 Exclusions 4
1.2.4 System Perspective 4
1.2.5 System diagram 5
1.2.6 System Environment 5
1.2.7 User Characteristics 5
1.2.8 Impact of the System 6
1.2.9 Assumptions, Risks / Constraints 6
1.2.10 Design Constraints 6
2.0 System Requirements 7
2.1 Functional Requirements 7
2.1.1 Customer Register Module 7
2.1.2 Policy Registration Module 10
2.1.3 Admin Approval/Rejection 14
2.1.4 Edit Requirement 17
User Interface Requirements 18
User Interface Requirements 21
2.1.5 Claiming policy Requirement 22
User Interface Requirements 24
2.2 Nonfunctional Requirements 24
2.2.1 UI Requirements: Inn 24
2.2.2 Performance Requirements: Pnn 25
2.2.3 Installation, Deployment & Operational Requirements: Onn 25
2.2.4 Maintainability & Portability Requirements: MPnn 25
2.2.5 Security Requirements Snn: 25
3.0 Requirements / Use Case Summary Table 25
5.0 Annexure 26
1.0 Introduction
The scope of this document is limited to addressing the requirements from a user,
quality, and non-functional perspective. It is recommended that design aspects are not
added in this document
Health Insurance System (HIS) policy will provide a cover to you and your family
against sudden medical contingency or bodily injury or Death.
1.2.1 Purpose
HIS is a system used for managing various activities such as customer registration,
Policy payment etc., In order to facilitate various policies to users.
a) Customer Registration.
b) Policy Registration.
c) Admin Approval/Rejection.
Customer Registration Customer should register with his details into the
system before he logs in to the application.
Edit User Details and Renew/Edit Policy : To edit existing User details or
Editing or renew the Policies.
Claiming the policy - User can claim the policy. Admin need to check the
details of correctness and approve or reject accordingly.
1.2.3 Exclusions
1. The system will operate only on the modules discussed above and will not include
any additional functionality.
Physical Architecture:
A physical architecture is an arrangement of physical elements, (system elements and
physical interfaces) that provides the designed solution for a product, service, or
enterprise. It is intended to satisfy logical architecture elements and system
requirements. Health Insurance System follows a three layered architecture namely
presentation layer, business logic layer and data access layer.
Presentation Tier is the tier in which the users interact with an application.
Presentation Tier contents Shared UI code, Code Behind and Designers used to
represent information to user.
Business Tier is mainly working as the bridge between Data Tier and
Presentation Tier. All the Data passes through the Business Tier before passing to
the presentation Tier. Business Tier is the sum of Business Logic Layer, Data
Access Layer and Value Object and other components used to add business logic.
Data Tier is basically the server which stores all the applications data. Data tier
contents Database Tables, XML Files and other means of storing Application Data.
Logical Architecture:
The Logical Architecture defines the Processes (the activities and functions) that are required to
provide the required User Services. Many different Processes must work together and share
information to provide a User Service. The Processes can be implemented via software, hardware,
or firmware. The Logical Architecture is independent of technologies and implementations
1. Client
1.2.11Design Constraints
1. The policy modules and the customer modules should remain independent, without
affecting Health Insurance System.
2. Application should have single login feature. Login functionality should be the
welcome feature for the application.
3. Only administrator and Customer can access the application with valid credentials.
Req-2.1.1.1
Functional Requirements
When the User/Customer clicks on the registration link, it should re-direct to registration form and
the HIS user need to fill some of the basic attributes/fields as mentioned below in requirement.
User Name ,Password, First Name, Last Name, Age, Gender (Male or Female) ,Contact Number
E-mail, Address, pin code, City.
At any given point of time, the user can Deselect/Reset all or can go to home page by the clicking
home.
Trigger
Customer should register into the system before he logs in to the application
Post Conditions
The system should find weightage of the customer, generate the customer id and stored along
with the customer details.
Success End Condition
On success a message should be displayed Customer Registered successfully
Normal Normal
Patient High
1.
Req-2.1.2.1
Functional Requirements
After the user log in and click the policy registration link, it should re-direct to policy registration form
where the user needs to fill some of the basic attributes/fields.
Any given point of time, the user can deselect all or can go to home page by the clicking home.
Trigger
Users triggers the functionality once he/she register his details in the system.
Pre-Conditions / Assumptions
The admin should have the details of all the client policies existing in the system.
The user should login with his credentials (Customer Id/password)
Post Conditions
The premium, discount amount and maturity date of the policy will be calculated and stored
along with the client policy details.
INS_Type INS_NAME
6. Identify the discount Weightage of the policy based on the policy term/duration as
follows:
PHC_001 500000 20
ACC_002 300000 15
ACC_002 500000 20
OCC_003 200000 15
OCC_003 400000 20
ERC_004 200000 10
ERC_004 400000 20
LSC_005 300000 15
LSC_005 500000 25
TRC_006 300000 15
TRC_006 500000 25
7. The premium amount will be calculated based on the policys amount, weightage and
premium type.
HY W2 2%
Y W2 4%
HY W3 3%
Y W3 5%
For Quarterly (Q) paid premium the weightage percentage is always constant at 0%.
Find the weightage percentage and Premium Type : Premium Type(Y=1, HY=2 and Q=0)
Trigger
Admin triggers the functionality when he logs into the system and views all the policies
which are yet to be approved.
Pre-Conditions / Assumptions
User should register a policy and policy id should be generated for him.
Post Conditions
The Admin should validate the policy details and approve the policy.
If Admin find the Health Insurance Policy details are incomplete or wrong information then it
will be rejected by Admin.
Health Insurance System requirement differs from person to person from various factors this is
why there are various plans that clients can avail.
User Interface Requirements
1. Insurance Name - Insurance name should be filled
2. Policy amount - Policy amount to be entered by the user
3. Policy duration - Policy duration to be entered by the user
4. Premium type - Premium type to be entered by the user
5. Policy start date -Policy start date to be entered by the user
6. Discount -Enter the Discount percentage
7. Premium Amount Enter policy Premium amount
User should select a policy and policy id should be generated for him.
Post Condition
The Admin should validate the policy details and Reject the policy.
Complete information details of entered policy no should be displayed. If the displayed data is not valid
then admin will reject the policy.
Example :
Policy_Id 1002
Physical
Ins_Name
condition
Policy_Amount 300000
Policy_Duration 15
Premium_type HF
Discount 0
Premium_amoun
300000
t
Policy_StarDate 6/10/2014
Policy_Maturity
6/10/2014
Date
Status Rejected
Note: Here Maturity date is equal to policy start Date. So the policy was rejected by admin
For completing the edit user details the following parameters needed to be updated:
Pre-Conditions / Assumptions
The User should have already entered his details and logged into the system
Post Conditions
The User can edit his name or email-id or contact no or password and save the details.
Success End Condition
On success a message should be displayed details have been saved successfully
Functional Requirements
User can only Edit the policy which is in pending status .User should not be able to edit the policies
which are approved / rejected.
User Interface Requirements
The following fields can be editable.
Trigger
Administrator triggers the functionality once he/she receives the details of the Customer.
Pre-Conditions / Assumptions
The User should have existing registered policy.
Post Conditions
The premium of the customer will be calculated and stored in the system.
Success End Condition
On success a message should be displayed Policy Updated Successfully
1. Identify the Insurance id based on the policy amount and duration details as follows:
2. Identify the discount Weightage of the policy based on the duration as follows:
DURATION DISCOUNT_WEIGHTAGE
15 W1
20 W2
25 W3
3. The premium amount calculation logic is as follows. The premium amount will be
calculated based on the policys amount, weightage and premium type
Trigger
User can Renew the policy if it policy maturity date is about to expire i.e. less than 15 days
from the current date.
Pre-Conditions / Assumptions
User should have a policy approved by admin.
Post Conditions
User policy should be renewed and should be pending for approval from admin.
Functional Requirements
User requests for claiming a policy, and then Admin verifies all the details and
approves/Rejects the claim.
Trigger
A user triggers the functionality once he/she decide to a claim policy.
Pre-Conditions / Assumptions
The user should have a policy which has been approved by the Admin.
Post Conditions
The claim amount will be calculated and stored into System
6. Calculation of Bonus:
We need to get the date when actually he bought the policy
Based on The date calculate how many years old the policy is and store in variable no of
_years;
Then Bonus is
Bonus=no_of_years*(amount * 0.01)
Claim_amount=Retrieve the amount+Bonus;
Business Rules & Validations:
Trigger
Admin triggers the functionality once he/she decide to an Approve/Reject a claim.
Pre-Conditions / Assumptions
The user should have a policy which has been approved by the Admin and opted for a claim.
Post Conditions
The admin will approve/Reject the claim based on claim amount requested by the user.
Success End Condition: On success a message should be displayed Claim Approved/Rejected
successfully
Failed End Condition
The system should throw an error message if one of the validations is wrong. The error
message and error code needs to be identified during design. The validation and business
rules are mentioned in the business rules section.
Steps and Actions
1. Admin calculates the claim amount and verifies with claim amount requested by the user if
both are same he will approve the claim or else rejects the claim.
5.0 Annexure
NA
V1.1 <If the change details are not explicitly documented in the table below,
reference should be provided here>
V1.2 <If the change details are not explicitly documented in the table below,
reference should be provided here>