Insurance Data Model (2024)

Learning Objectives

After completing this unit, you’ll be able to:

  • Describe entity relationship diagram notation.
  • Understand the key considerations for reviewing the data model.

Prerequisites

Before you start this module, consider the recommended prerequisite to best prepare you to learn.

Recommended

Completion of this module:

  • Financial Services Cloud Data Modeling to understand how to structure your financial services data with objects, fields, and relationships.

Introduction

As an insurance provider, you have your hands full: You need to track your agents, your policyholders, and the insurance coverage you provide for your clients and their assets. The insurance business is a complex enterprise because of what you need to insure. You can’t assume anything or take anything for granted. In fact, you must record and track every single aspect of the business, because it’s not just money at stake, but human life itself. This is why a thoughtful and comprehensive insurance data model is an essential success enabler.

The Insurance Data Model

In this module, you learn how the insurance data model empowers you to track the key information related to your business and the activities of important users like your sales and service reps.

Insurance Data Model (1)

The insurance data model helps bring all the information related to insurance policies and claim summaries to Salesforce, so you have a 360-degree view of your policyholders. In the diagram, policyholders and agents can contact the call center of the insurance carrier for many reasons, so the customer data has to be accurate and comprehensive. For instance, they may need help getting a quote or they may have questions about their coverage. With Salesforce Customer 360, agents have all the information they need to resolve policyholder and agent queries by phone, text, chat, and more. Behind the scenes, the insurance data model makes all this possible.

Built-in collaboration with Salesforce partners and customers, the insurance data model provides out-of-the-box functionality to organize your data in Salesforce. It enables insurance companies of all sizes to connect with their clients, sales reps, and service agents. And it helps independent insurance agencies and brokerages track policies and claims on behalf of their customers.

Think of the data model as a huge pantry with loads of different things inside. But in the data model pantry, all your ingredients are perfectly organized. This way, when you need something, you know exactly where and how to find it. Now who wouldn’t want a pantry like this?

Insurance Data Model (2)

Before the insurance data model, admins had to spend several months—and devote heavy IT resources—getting their pantry in order. They needed to create similar data architectures by hand and from scratch because no standard was available. Now, with the insurance data model, an admin can get up and running in half the time it normally takes to set up a traditional Salesforce deployment. Pretty amazing.

We go into more detail about the insurance data model in the next unit. For now, know that this data model uses standard Salesforce objects and standard Insurance objects to track all kinds of connections. These tracked and organized connections make it simple to find the information you need in Salesforce.

Let’s say that you want a consolidated view of all the insurance policies related to a particular household. You can use the insurance data model to easily create this view.

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But wait, there’s more! The insurance data model also keeps track of a client’s premium payment history and all claims made against a policy. Want to know everyone who’s authorized to sell collision insurance? Want to find out what happened to the eye witness of an accident scene? You can do all this and more with the insurance data model.

While the model gives you objects and fields out of the box, it also lets you define the relationships between different sets of data. It’s not a one-size-fits-all data model. Instead, it’s flexible and helps you manage enterprises, both large and small, based on business requirements. Multiple clouds can implement the insurance data model. Both Financial Services Cloud and Health Cloud can take advantage of the same awesome and flexible solution.

We know that, at a glance, the insurance data model can seem a bit overwhelming. So let’s follow the staff at Cumulus Insurance, a nationwide insurance company that’s working to optimize its digital-transformation journey.

Cumulus Insurance provides a variety of insurance offerings, like group health benefits and auto insurance. Since it’s a commercial insurance company, Cumulus uses Financial Services Cloud to support the business. This is just one implementation scenario.

Insurance Data Model (4)

Entity Relationship Diagram Notation

An entity relationship diagram (ERD) or model is a visible representation of an information system. An ERD depicts the relationships among people, objects, places, concepts, and events in a system. The diagrams are logical models that don’t necessarily reflect the precise underlying data model. ERDs use consistent shapes and notation. Let’s define some of the core components.

Entity

This icon denotes an entity.Insurance Data Model (5)

A box with rounded corners represents an entity in the diagram. Entity boxes may also list one or more attributes of the entity.

Subtype

This icon denotes a subtype.Insurance Data Model (6)

A subtype of an entity is a subset of its occurrences represented within a supertype entity. Subtype entities define attributes and relationships specific to each subtype.

One or More

This icon denotes one or more occurences.

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A crow’s foot indicates that one or more entity occurrences on the divergent endcan relate to each occurrence on the other end.

One and Only One

This icon denotes one and only one occurrence.

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The lack of a crow’s foot on one end indicates that only one entity occurrence on that end can relate to each occurrence on the other end.

Recursive Relationship

This icon denotes a recursive relationship.

Insurance Data Model (9)

A recursive relationship is one between two occurrences of the same entity. A curved relationship line connecting an entity to itself denotes a recursive relationship. The line has a crow’s foot on one end, representing “child of”, and the end without a crow’s foot means “parent of”.

User-Key Relationship

This icon denotes a user-key relationship.

Insurance Data Model (10)

A bar across the crow's foot end of a relationship means that it participates in the user primary key of the entity on that side. A required user-key relationship is arguably the strongest of relationships.

Key Considerations

Data model objects associate with each other in numerous ways. Objects represent database tables that contain data. A record describes a particular occurrence of an object or a row in a database table, like in the following example.

Object

Record 1

Record 1 Attribute

Record 2

Record 2 Attribute

What’s important to keep in mind is that not all scenarios require all associations. It depends on the scale of business, the operations you want to perform, and the kind of products or services you address. Business architects at Cumulus can keep the insurance operation flexible by choosing the object associations that work best for Cumulus.

The architects consider a few points before working with the data model.

  • Comprehensiveness: An insurance policy has many stakeholders beyond just the policyholder. The policy can even cover casual bystanders, such as witnesses to a road accident. This means the data model must work for all insurance scenarios.
  • A 360-degree view: Agents at Cumulus need ways to organically grow the business and excel at their jobs. The data model must give agents a 360-degree view of policyholders. Insights resulting from this can drive upselling and cross-selling opportunities for agents, and more.
  • Agile: The data model must account for the complex ways in which people engage with risk protection. A client may want insurance for some of their assets but not others. Even when all assets are insured, they may want different types of coverage for specific assets, all under the same policy.
  • Customer-centric: For an insurance sales agent, nothing is more valuable than being able to tie their sales pitch to a big event in their client’s life. And that’s the power behind the Salesforce Insurance solution. Utilize these capabilities to deliver details of clients’ life events to agents in a seamless manner to maximize new business potential.

Realizing the significant task at hand, Cumulus reaches out to a star consultant, Justus Pardo, to start their journey with the Salesforce insurance data model.

Insurance Data Model (11)

Cumulus struggles to adapt and deliver new products in their current legacy systems because the architecture behind the products is too complex and unorganized. They need an army of developers to create and change the products, policies, and processes.

They hope Justus can organize clusters of data to work cohesively. They have no doubt that with this insurance data model, Justus can help Cumulus, sales agents, and service reps achieve maximum business efficiency. Who knows, Cumulus may even become the new industry leader.

Resources

Insurance Data Model (2024)

FAQs

What is the acord data model? ›

The Data Model is a logical level entity-relationship structure, generated from the Information Model, which can be utilized in any database implementation. Some of the many uses of the Data Model include designing physical data models and data warehouses, or validating your own data models.

What type of data do insurance companies use? ›

Financial information: This includes income, assets, debts, and credit scores. This information is important for assessing risk and determining premiums. Medical information: This includes health history, current health status, and any pre-existing conditions. This information is important for underwriting purposes.

How is data analytics used in insurance? ›

There are many practical applications for data analytics in insurance. These include mapping risks, setting pricing, targeting prospects, tracking sales and service, analyzing claims, detecting fraud and studying consumer behavior.

What does ACORD stand for in insurance? ›

ACORD (Association for Cooperative Operations Research and Development) is the global standards-setting body for the insurance and related financial services industries.

What is the ACORD standard format? ›

The ACORD messaging standard defines the structure and content of messages that are exchanged between companies in the insurance industry. ACORD AL3 text messages can be modeled by using DFDL or MRM Tagged/Delimited String Format (TDS). ACORD XML messages can be modeled by using XML schemas.

How does the insurance model work? ›

Insurers use risk data to calculate the likelihood of the event you are insuring against happening. This information is used to work out the cost of your premium. The more likely the event you are insuring against is to occur, the higher the risk to the insurer and, as a result, the higher the cost of your premium.

What are the three 3 main types of insurance? ›

Although there are many insurance policy types, some of the most common are life, health, homeowners, and auto. The right type of insurance for you will depend on your goals and financial situation. Consumer Financial Protection Bureau.

What are the 4 healthcare models? ›

There are four basic designs healthcare systems follow: the Beveridge model, the Bismarck model, the national health insurance model, and the out-of-pocket model. The U.S. uses all four of these models for different segments of its residents and citizens.

What is structured data in insurance? ›

As long as they are housed within a shared database, structured data can include formulaic data points that are easily labeled, like customer names, addresses, important dates, car makes and models, and insurance claims history.

What business model do insurance companies use? ›

The essential insurance model involves pooling risk from individual payers and redistributing it across a larger portfolio. Most insurance companies generate revenue in two ways: Charging premiums in exchange for insurance coverage, then reinvesting those premiums into other interest-generating assets.

How do insurance companies use databases? ›

A centralised database is used to manage the data of an entire insurance office. For instance, insurers use application database management systems to track workforce, claims, user policies, premium payments, and more.

Do insurance companies need a data analyst? ›

Data analytics create new capabilities that empower insurers to optimize every function in the insurance value chain with the help of data-driven decision-making. It can also analyze a customer's risk and determine which client is trustworthy or may cause great loss.

What is data visualization in insurance? ›

Loss Forecasting: Data visualization tools enable insurers to forecast potential losses based on historical claims data and predictive modeling techniques. By visualizing loss distributions, loss trends, and loss ratios, insurers can estimate future claim payouts, reserve amounts, and reinsurance needs more accurately.

What is predictive modeling in insurance? ›

In other words, insurance predictive modeling analyzes historical costs, claims, expenses, risks, and profits and then projects them into the future, allowing insurers to dynamically adjust quoted premiums.

What are the ACORD global data standards? ›

What are ACORD Data Standards? ACORD is an international insurance data standards body which provide technical data standards to the global insurance industry. The London market will utilise ACORD's global technical standards to enable digital processing.

What are ACORD forms used for? ›

An ACORD certificate of insurance is typically a one-page document summarizing key information about your business insurance policy.

What is the Accord capability framework? ›

The ACORD Framework provides standards for the insurance industry that model key capabilities and concepts. It includes five models: a business dictionary, capability model, information model, data model, and component model.

What is ACORD 23 used for? ›

The ACORD 23 form is also known as the Vehicle or Equipment Certificate of Insurance or Automobile Certificate of Insurance. Generally, it covers physical damage and/or liability insurance coverage to lessors or loss payers of leased vehicles.

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