{ "format": "dataset-manifest/1", "slug": "insurance-sample-database", "version": 1, "seed": "flagship:insurance-sample-database:1k", "engine": 2, "engineVersion": "1.0.0", "spec": { "format": "dataset/1", "engine": 2, "slug": "insurance-sample-database", "name": "Insurance sample database", "tagline": "Policies on five lines of cover, monthly premium invoices and payments, agent commissions, claims and their payouts.", "description": "An insurer’s book from 2023 to 2025: customers holding auto, home, life, health and travel policies sold by agents in agency branches, about a year of premium installments and the payments that settle them, the selling agent’s commission, and claims from report to assessment to payout. The figures obey the policy: a premium is at least its plan’s minimum and a coverage at most its maximum, an installment bills the monthly premium and a payment pays it in full within its thirty days, a commission is the agent’s rate on a payment of the policy they sold. A claim’s incident falls inside the policy term and its estimate inside the coverage; only an approved claim is paid, its payout what the assessment approved less the deductible. An insured vehicle is always on an auto policy, a property on a home policy and a beneficiary on a life policy.", "domain": "insurance", "shape": "transactional", "useCases": [ "sql-practice", "analytics-demo", "test-fixtures" ], "keywords": [ "insurance", "policies", "claims", "premiums", "sample database" ], "locale": "en_US", "license": "CC0-1.0", "version": 1, "seed": "flagship:insurance-sample-database", "tables": { "addresses": { "description": "Rows for the addresses table.", "rows": 65, "columns": { "id": { "kind": "pk" }, "city": { "kind": "place.city" }, "country": { "kind": "constant", "value": "United States" }, "postal_code": { "kind": "place.postcode" }, "state": { "kind": "place.regionCode" }, "street": { "kind": "location.streetAddress" } } }, "adjusters": { "description": "Rows for the adjusters table.", "rows": 60, "columns": { "id": { "kind": "pk" }, "company_id": { "kind": "fk", "ref": "companies.id", "skew": "flat" }, "email": { "kind": "internet.email", "from": { "firstName": "first_name", "lastName": "last_name" }, "unique": true }, "first_name": { "kind": "person.firstName" }, "last_name": { "kind": "person.lastName" }, "license_number": { "kind": "pattern", "pattern": "[ADJ-]######", "unique": true, "description": "A made-up adjuster licence number." }, "phone": { "kind": "phone.number" } } }, "agencies": { "description": "Rows for the agencies table.", "rows": 12, "columns": { "id": { "kind": "pk" }, "address_id": { "kind": "fk", "ref": "addresses.id", "skew": "long-tail" }, "email": { "kind": "internet.email" }, "license_number": { "kind": "pattern", "pattern": "[AG-]######", "unique": true, "description": "A made-up agency licence number." }, "name": { "kind": "company.name", "unique": true }, "phone": { "kind": "phone.number" } } }, "agents": { "description": "Rows for the agents table.", "rows": 300, "columns": { "id": { "kind": "pk" }, "branch_id": { "kind": "fk", "ref": "branches.id", "skew": "flat" }, "email": { "kind": "internet.email", "from": { "firstName": "first_name", "lastName": "last_name" }, "unique": true }, "first_name": { "kind": "person.firstName" }, "hire_date": { "kind": "date", "from": "2010-01-01", "to": "2022-12-31" }, "last_name": { "kind": "person.lastName" }, "license_number": { "kind": "pattern", "pattern": "[LIC-]#######", "unique": true, "description": "A made-up producer licence number." }, "phone": { "kind": "phone.number" } } }, "beneficiaries": { "description": "Rows for the beneficiaries table.", "rows": 20, "columns": { "id": { "kind": "pk" }, "first_name": { "kind": "person.firstName" }, "last_name": { "kind": "person.lastName" }, "percentage": { "kind": "constant", "value": 100 }, "phone": { "kind": "phone.number" }, "policy_id": { "kind": "fk", "ref": "policies.id" }, "relationship": { "kind": "enum", "values": [ "Spouse", "Child", "Parent", "Sibling", "Partner" ], "weights": [ 45, 30, 10, 8, 7 ] } } }, "branches": { "description": "Rows for the branches table.", "rows": 40, "columns": { "id": { "kind": "pk" }, "address_id": { "kind": "fk", "ref": "addresses.id", "skew": "long-tail" }, "agency_id": { "kind": "fk", "ref": "agencies.id", "skew": "flat" }, "name": { "kind": "enum", "values": [ "Downtown", "Northside", "Westfield", "Riverside", "Eastgate", "Midtown", "Lakeview" ] }, "phone": { "kind": "phone.number" } } }, "claim_assessments": { "description": "Rows for the claim_assessments table.", "rows": 20, "columns": { "id": { "kind": "pk" }, "adjuster_id": { "kind": "fk", "ref": "adjusters.id" }, "approved": { "kind": "decimal", "min": 0, "max": 15790, "scale": 2 }, "claim_id": { "kind": "fk", "ref": "claims.id", "unique": true }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-03-31" }, "deductible": { "kind": "decimal", "min": 0, "max": 1000, "scale": 2 }, "notes": { "kind": "enum", "values": [ "Photos reviewed", "Repair estimate obtained", "Medical records received", "Site visit completed", "Police report on file" ] }, "status": { "kind": "enum", "values": [ "approved", "denied", "pending" ] } } }, "claim_documents": { "description": "Rows for the claim_documents table.", "rows": 30, "columns": { "id": { "kind": "pk" }, "claim_id": { "kind": "fk", "ref": "claims.id", "skew": "flat" }, "file_path": { "kind": "pattern", "pattern": "[claims/]xxxxxxxxxxxx[.pdf]" }, "name": { "kind": "enum", "values": [ "Photos of damage", "Police report", "Repair estimate", "Medical bill", "Receipt" ] }, "type": { "kind": "enum", "values": [ "pdf", "jpg", "png" ], "weights": [ 55, 35, 10 ] }, "upload_date": { "kind": "date", "from": "2023-01-01", "to": "2026-03-31" } } }, "claim_payments": { "description": "Rows for the claim_payments table.", "rows": 10, "columns": { "id": { "kind": "pk" }, "amount": { "kind": "decimal", "min": 0, "max": 15293, "scale": 2 }, "claim_id": { "kind": "fk", "ref": "claims.id", "unique": true }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-06-30" }, "method": { "kind": "enum", "values": [ "bank transfer", "check" ], "weights": [ 85, 15 ] }, "recipient": { "kind": "enum", "values": [ "Policyholder" ] } } }, "claims": { "description": "Rows for the claims table.", "rows": 20, "columns": { "id": { "kind": "pk" }, "description": { "kind": "enum", "values": [ "Rear-end collision", "Water damage from a burst pipe", "Theft from vehicle", "Hospital admission", "Storm damage to roof", "Trip cancelled for illness", "Windshield crack", "Kitchen fire", "Emergency room visit", "Lost luggage" ] }, "estimated_loss": { "kind": "decimal", "min": 0, "max": 56925, "scale": 2, "distribution": "long-tail" }, "incident_date": { "kind": "date", "from": "2023-01-01", "to": "2025-12-31" }, "number": { "kind": "pattern", "pattern": "[CLM-]#########", "unique": true }, "policy_id": { "kind": "fk", "ref": "policies.id" }, "report_date": { "kind": "date", "from": "2023-01-01", "to": "2026-01-31" }, "status": { "kind": "enum", "values": [ "approved", "denied", "under review" ], "weights": [ 72, 15, 13 ] } } }, "commissions": { "description": "Rows for the commissions table.", "rows": 80, "columns": { "id": { "kind": "pk" }, "agent_id": { "kind": "fk", "ref": "agents.id" }, "amount": { "kind": "decimal", "min": 0, "max": 119, "scale": 2, "nullable": true, "nullRate": 0 }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-01-31", "nullable": true, "nullRate": 0 }, "payment_id": { "kind": "fk", "ref": "payments.id", "nullable": true, "nullRate": 0 }, "policy_id": { "kind": "fk", "ref": "policies.id", "unique": true }, "rate": { "kind": "int", "min": 5, "max": 15 }, "status": { "kind": "enum", "values": [ "paid", "pending" ], "weights": [ 92, 8 ] } } }, "companies": { "description": "Rows for the companies table.", "rows": 6, "columns": { "id": { "kind": "pk" }, "email": { "kind": "internet.email" }, "name": { "kind": "enum", "values": [ "Harborline Mutual", "Crestview Assurance", "Northgate Insurance Group", "Bluepeak Underwriters", "Summit Ridge Casualty", "Lakeshore Life" ], "unique": true }, "phone": { "kind": "phone.number" }, "tax_identifier": { "kind": "pattern", "pattern": "##-#######", "unique": true, "description": "A made-up employer identification number in the ##-####### format." }, "website": { "kind": "internet.url" } } }, "customer_support_tickets": { "description": "Rows for the customer_support_tickets table.", "rows": 10, "columns": { "id": { "kind": "pk" }, "agent_id": { "kind": "fk", "ref": "agents.id" }, "customer_id": { "kind": "fk", "ref": "customers.id" }, "date": { "kind": "date", "from": "2023-01-01", "to": "2025-12-31", "dayProfile": "business" }, "description": { "kind": "enum", "values": [ "Customer called in", "Sent through the portal", "Emailed the branch", "Asked in person" ] }, "status": { "kind": "enum", "values": [ "resolved", "closed", "open" ], "weights": [ 70, 25, 5 ] }, "subject": { "kind": "enum", "values": [ "Update my address", "Question about my bill", "Add a driver", "Claim status", "Cancel my policy", "Proof of insurance" ] } } }, "customers": { "description": "Rows for the customers table.", "rows": 60, "columns": { "id": { "kind": "pk" }, "address_id": { "kind": "fk", "ref": "addresses.id", "unique": true }, "date_of_birth": { "kind": "date", "from": "1945-01-01", "to": "2004-12-31" }, "email": { "kind": "internet.email", "from": { "firstName": "first_name", "lastName": "last_name" }, "unique": true }, "first_name": { "kind": "person.firstName" }, "gender": { "kind": "enum", "values": [ "female", "male", "non-binary" ], "weights": [ 49, 49, 2 ] }, "last_name": { "kind": "person.lastName" }, "phone": { "kind": "phone.number" } } }, "documents": { "description": "Rows for the documents table.", "rows": 40, "columns": { "id": { "kind": "pk" }, "customer_id": { "kind": "fk", "ref": "customers.id" }, "file_path": { "kind": "pattern", "pattern": "[documents/]xxxxxxxxxxxx[.pdf]" }, "name": { "kind": "enum", "values": [ "Policy schedule", "Declarations page", "Signed application", "ID card", "Proof of address" ] }, "policy_id": { "kind": "fk", "ref": "policies.id", "skew": "flat" }, "type": { "kind": "enum", "values": [ "pdf", "jpg", "png" ], "weights": [ 80, 12, 8 ] }, "upload_date": { "kind": "date", "from": "2023-01-01", "to": "2025-12-31" } } }, "invoices": { "description": "Rows for the invoices table.", "rows": 1000, "columns": { "id": { "kind": "pk" }, "amount_due": { "kind": "decimal", "min": 0, "max": 901, "scale": 2 }, "due_date": { "kind": "date", "from": "2023-01-01", "to": "2026-01-31" }, "issue_date": { "kind": "date", "from": "2023-01-01", "to": "2025-12-31" }, "number": { "kind": "pattern", "pattern": "[INV-]#########", "unique": true }, "policy_id": { "kind": "fk", "ref": "policies.id", "skew": "flat" }, "status": { "kind": "enum", "values": [ "issued" ] } } }, "medical_providers": { "description": "Rows for the medical_providers table.", "rows": 80, "columns": { "id": { "kind": "pk" }, "address_id": { "kind": "fk", "ref": "addresses.id", "skew": "long-tail" }, "email": { "kind": "internet.email" }, "name": { "kind": "enum", "values": [ "Mercy General", "St. Luke Clinic", "Riverside Medical Center", "Valley Urgent Care", "Cedar Family Practice", "Hillcrest Imaging", "Bayview Physical Therapy", "Northside Dental" ] }, "phone": { "kind": "phone.number" }, "provider_type": { "kind": "enum", "values": [ "Hospital", "Clinic", "Urgent care", "Specialist", "Imaging", "Therapy" ] } } }, "medical_treatments": { "description": "Rows for the medical_treatments table.", "rows": 10, "columns": { "id": { "kind": "pk" }, "claim_id": { "kind": "fk", "ref": "claims.id" }, "cost": { "kind": "decimal", "min": 150, "max": 45000, "scale": 2, "distribution": "long-tail" }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-01-31" }, "details": { "kind": "enum", "values": [ "Outpatient visit", "Overnight stay", "X-ray and cast", "Surgery", "Physical therapy course" ] }, "diagnosis": { "kind": "enum", "values": [ "Fracture", "Sprain", "Pneumonia", "Appendicitis", "Concussion", "Laceration", "Migraine" ] }, "provider_id": { "kind": "fk", "ref": "medical_providers.id" } } }, "payments": { "description": "Rows for the payments table.", "rows": 920, "columns": { "id": { "kind": "pk" }, "amount_paid": { "kind": "decimal", "min": 0, "max": 901, "scale": 2 }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-01-31" }, "invoice_id": { "kind": "fk", "ref": "invoices.id", "unique": true }, "method": { "kind": "enum", "values": [ "card", "bank transfer", "direct debit", "check" ], "weights": [ 40, 15, 40, 5 ] }, "reference": { "kind": "pattern", "pattern": "[PAY-]##########", "unique": true } } }, "policies": { "description": "Rows for the policies table.", "rows": 80, "columns": { "id": { "kind": "pk" }, "agent_id": { "kind": "fk", "ref": "agents.id" }, "coverage": { "kind": "decimal", "min": 0, "max": 990000, "scale": 2 }, "customer_id": { "kind": "fk", "ref": "customers.id", "skew": "flat" }, "end_date": { "kind": "date", "from": "2023-01-01", "to": "2026-12-31" }, "number": { "kind": "pattern", "pattern": "[POL-]########", "unique": true }, "plan_id": { "kind": "fk", "ref": "policy_plans.id", "weights": [ 6, 12, 8, 3, 2, 5, 3, 9, 4, 2, 4, 5, 2, 2, 2, 4, 5, 3, 3, 2, 3, 3, 1, 1, 1 ] }, "premium": { "kind": "decimal", "min": 0, "max": 901, "scale": 2, "distribution": "long-tail" }, "start_date": { "kind": "date", "from": "2023-01-01", "to": "2025-06-30" }, "status": { "kind": "enum", "values": [ "issued" ] } } }, "policy_categories": { "description": "Rows for the policy_categories table.", "rows": 5, "columns": { "id": { "kind": "pk" }, "description": { "kind": "enum", "values": [ "Cars, vans and motorcycles", "Houses, condos and contents", "Term and whole life cover", "Medical and hospital cover", "Trip cancellation and medical abroad" ], "unique": true }, "name": { "kind": "enum", "values": [ "Auto", "Home", "Life", "Health", "Travel" ], "unique": true } } }, "policy_plans": { "description": "Rows for the policy_plans table.", "rows": 25, "columns": { "id": { "kind": "pk" }, "category_id": { "kind": "fk", "ref": "policy_categories.id" }, "company_id": { "kind": "fk", "ref": "companies.id", "skew": "flat" }, "description": { "kind": "enum", "values": [ "Our most popular cover", "Lower premium, higher deductible", "Broad cover with extras", "Built for families", "Essential protection" ] }, "max_coverage": { "kind": "decimal", "min": 1000, "max": 1000000, "scale": 2 }, "min_premium": { "kind": "decimal", "min": 5, "max": 500, "scale": 2 }, "name": { "kind": "enum", "values": [ "Auto Basic", "Auto Standard", "Auto Plus", "Auto Premier", "Motorcycle", "Renters", "Condo", "Homeowners Standard", "Homeowners Plus", "Landlord", "Term 10", "Term 20", "Term 30", "Whole Life", "Final Expense", "Health Bronze", "Health Silver", "Health Gold", "Dental", "Vision", "Travel Single Trip", "Travel Annual", "Travel Business", "Travel Student", "Travel Senior" ], "unique": true } } }, "policy_riders": { "description": "Rows for the policy_riders table.", "rows": 30, "columns": { "id": { "kind": "pk" }, "coverage_limit": { "kind": "decimal", "min": 1000, "max": 50000, "scale": 2, "distribution": "long-tail" }, "description": { "kind": "enum", "values": [ "Optional add-on", "Extends the base cover", "Lowers the out-of-pocket cost" ] }, "name": { "kind": "enum", "values": [ "Roadside assistance", "Rental reimbursement", "Flood cover", "Jewellery cover", "Accidental death", "Waiver of premium", "Trip interruption" ] }, "policy_id": { "kind": "fk", "ref": "policies.id", "skew": "flat" }, "premium": { "kind": "decimal", "min": 2, "max": 25, "scale": 2 } } }, "properties": { "description": "Rows for the properties table.", "rows": 20, "columns": { "id": { "kind": "pk" }, "address_id": { "kind": "fk", "ref": "addresses.id" }, "policy_id": { "kind": "fk", "ref": "policies.id" }, "square_footage": { "kind": "int", "min": 450, "max": 5200, "distribution": "normal" }, "type": { "kind": "enum", "values": [ "Single-family house", "Townhouse", "Condo", "Apartment", "Duplex" ], "weights": [ 45, 15, 20, 15, 5 ] }, "value": { "kind": "decimal", "min": 90000, "max": 1500000, "scale": 2, "distribution": "long-tail" }, "year_built": { "kind": "int", "min": 1920, "max": 2024, "distribution": "high" } } }, "reinsurance_claims": { "description": "Rows for the reinsurance_claims table.", "rows": 10, "columns": { "id": { "kind": "pk" }, "claim_id": { "kind": "fk", "ref": "claims.id", "unique": true }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-06-30" }, "paid": { "kind": "decimal", "min": 0, "max": 5180, "scale": 2 }, "reinsurance_contract_id": { "kind": "fk", "ref": "reinsurance_contracts.id" }, "requested": { "kind": "decimal", "min": 0, "max": 6316, "scale": 2 }, "status": { "kind": "enum", "values": [ "settled" ] } } }, "reinsurance_companies": { "description": "Rows for the reinsurance_companies table.", "rows": 5, "columns": { "id": { "kind": "pk" }, "address_id": { "kind": "fk", "ref": "addresses.id", "skew": "long-tail" }, "email": { "kind": "internet.email" }, "name": { "kind": "enum", "values": [ "Atlas Re", "Meridian Reinsurance", "Keystone Re", "Polaris Risk Partners", "Orion Re" ], "unique": true }, "phone": { "kind": "phone.number" } } }, "reinsurance_contracts": { "description": "Rows for the reinsurance_contracts table.", "rows": 12, "columns": { "id": { "kind": "pk" }, "company_id": { "kind": "fk", "ref": "companies.id", "skew": "flat" }, "coverage_percentage": { "kind": "decimal", "min": 20, "max": 50, "scale": 2 }, "end_date": { "kind": "date", "from": "2025-12-31", "to": "2025-12-31" }, "number": { "kind": "pattern", "pattern": "[RC-]####", "unique": true }, "premium": { "kind": "decimal", "min": 250000, "max": 4000000, "scale": 2, "distribution": "long-tail" }, "reinsurer_id": { "kind": "fk", "ref": "reinsurance_companies.id", "skew": "flat" }, "start_date": { "kind": "date", "from": "2023-01-01", "to": "2023-01-01" } } }, "renewals": { "description": "Rows for the renewals table.", "rows": 30, "columns": { "id": { "kind": "pk" }, "date": { "kind": "date", "from": "2023-01-01", "to": "2026-12-31" }, "end_date": { "kind": "date", "from": "2023-01-01", "to": "2028-12-31" }, "policy_id": { "kind": "fk", "ref": "policies.id", "unique": true }, "premium": { "kind": "decimal", "min": 0, "max": 436, "scale": 2 }, "start_date": { "kind": "date", "from": "2023-01-01", "to": "2027-12-31" }, "status": { "kind": "enum", "values": [ "renewed", "declined", "lapsed" ], "weights": [ 78, 12, 10 ] } } }, "underwriters": { "description": "Rows for the underwriters table.", "rows": 40, "columns": { "id": { "kind": "pk" }, "certification_level": { "kind": "enum", "values": [ "Associate", "Senior", "Chartered" ], "weights": [ 45, 35, 20 ] }, "company_id": { "kind": "fk", "ref": "companies.id", "skew": "flat" }, "email": { "kind": "internet.email", "from": { "firstName": "first_name", "lastName": "last_name" }, "unique": true }, "first_name": { "kind": "person.firstName" }, "last_name": { "kind": "person.lastName" }, "phone": { "kind": "phone.number" } } }, "underwriting_assessments": { "description": "Rows for the underwriting_assessments table.", "rows": 80, "columns": { "id": { "kind": "pk" }, "date": { "kind": "date", "from": "2022-12-01", "to": "2025-06-30" }, "decision": { "kind": "enum", "values": [ "approved", "approved with conditions" ], "weights": [ 85, 15 ] }, "notes": { "kind": "enum", "values": [ "Standard risk", "Prior claims reviewed", "Inspection waived", "Credit check passed", "Higher deductible agreed" ] }, "policy_id": { "kind": "fk", "ref": "policies.id", "unique": true }, "risk_score": { "kind": "int", "min": 1, "max": 100, "distribution": "normal" }, "underwriter_id": { "kind": "fk", "ref": "underwriters.id" } } }, "vehicles": { "description": "Rows for the vehicles table.", "rows": 30, "columns": { "id": { "kind": "pk" }, "license_plate": { "kind": "pattern", "pattern": "AAA-####", "unique": true }, "make": { "kind": "enum", "values": [ "Toyota", "Ford", "Chevrolet", "Honda", "Nissan", "Hyundai", "Kia", "Subaru", "Jeep", "Tesla", "BMW", "Mazda" ], "weights": [ 16, 14, 12, 11, 8, 7, 6, 5, 6, 4, 4, 7 ] }, "model": { "kind": "enum", "values": [ "Sedan", "Hatchback", "SUV", "Pickup", "Minivan", "Coupe" ] }, "policy_id": { "kind": "fk", "ref": "policies.id" }, "value": { "kind": "decimal", "min": 4000, "max": 85000, "scale": 2, "distribution": "long-tail" }, "vin": { "kind": "vehicle.vin", "unique": true }, "year": { "kind": "int", "min": 2008, "max": 2025, "distribution": "high" } } } } }, "counts": { "addresses": 65, "agencies": 12, "branches": 40, "agents": 300, "companies": 6, "adjusters": 60, "customers": 60, "customer_support_tickets": 10, "medical_providers": 80, "policy_categories": 5, "policy_plans": 25, "policies": 80, "beneficiaries": 20, "claims": 20, "claim_assessments": 20, "claim_documents": 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"violations": 0 }, { "name": "What is insured fits the line of cover: a vehicle on an auto policy, a property on a home policy, a beneficiary on a life policy, a medical treatment on a health claim", "violations": 0 }, { "name": "A claim happens inside the policy term, is reported within thirty days with an estimate inside the coverage, and its assessment carries its decision", "violations": 0 }, { "name": "Only an approved claim is paid, and it is paid what its assessment approved: part of the estimate less the deductible, never below nothing", "violations": 0 }, { "name": "A renewal starts the day after the term ends and costs 3-10% more; reinsurance asks for its contract’s share of an approved payout", "violations": 0 } ] } }, "rules": [ { "name": "A premium is one to two and a half times its plan's minimum and a coverage at most its maximum; a policy runs a year and was underwritten before it began", "sql": "SELECT (SELECT count(*) FROM policies p JOIN policy_plans pl ON pl.id = p.plan_id WHERE p.premium < pl.min_premium OR p.premium > round(pl.min_premium * 2.5, 2) OR p.coverage > pl.max_coverage OR p.end_date <> p.start_date + 365) + (SELECT count(*) FROM underwriting_assessments u JOIN policies p ON p.id = u.policy_id WHERE u.date >= p.start_date) + (SELECT count(*) FROM policies p LEFT JOIN underwriting_assessments u ON u.policy_id = p.id WHERE u.id IS NULL) AS violations" }, { "name": "An installment bills the monthly premium inside the term and falls due thirty days later; a payment pays one in full within those thirty days", "sql": "SELECT (SELECT count(*) FROM invoices i JOIN policies p ON p.id = i.policy_id WHERE i.amount_due <> p.premium OR i.issue_date < p.start_date OR i.issue_date > p.start_date + 334 OR i.due_date <> i.issue_date + 30) + (SELECT count(*) FROM payments pa JOIN invoices i ON i.id = pa.invoice_id WHERE pa.amount_paid <> i.amount_due OR pa.date < i.issue_date OR pa.date > i.issue_date + 30) AS violations" }, { "name": "A commission goes to the agent who sold the policy, on a payment of that policy, at the agent's rate", "sql": "SELECT count(*) AS violations FROM commissions c JOIN policies p ON p.id = c.policy_id LEFT JOIN payments pa ON pa.id = c.payment_id LEFT JOIN invoices i ON i.id = pa.invoice_id WHERE c.agent_id <> p.agent_id OR (c.payment_id IS NOT NULL AND (i.policy_id <> c.policy_id OR c.amount <> round(pa.amount_paid * c.rate / 100.0, 2) OR c.date < pa.date))" }, { "name": "What is insured fits the line of cover: a vehicle on an auto policy, a property on a home policy, a beneficiary on a life policy, a medical treatment on a health claim", "sql": "SELECT (SELECT count(*) FROM vehicles v JOIN policies p ON p.id = v.policy_id JOIN policy_plans pl ON pl.id = p.plan_id JOIN policy_categories pc ON pc.id = pl.category_id WHERE pc.name <> 'Auto') + (SELECT count(*) FROM properties x JOIN policies p ON p.id = x.policy_id JOIN policy_plans pl ON pl.id = p.plan_id JOIN policy_categories pc ON pc.id = pl.category_id WHERE pc.name <> 'Home') + (SELECT count(*) FROM beneficiaries b JOIN policies p ON p.id = b.policy_id JOIN policy_plans pl ON pl.id = p.plan_id JOIN policy_categories pc ON pc.id = pl.category_id WHERE pc.name <> 'Life') + (SELECT count(*) FROM medical_treatments m JOIN claims c ON c.id = m.claim_id JOIN policies p ON p.id = c.policy_id JOIN policy_plans pl ON pl.id = p.plan_id JOIN policy_categories pc ON pc.id = pl.category_id WHERE pc.name <> 'Health') AS violations" }, { "name": "A claim happens inside the policy term, is reported within thirty days with an estimate inside the coverage, and its assessment carries its decision", "sql": "SELECT (SELECT count(*) FROM claims c JOIN policies p ON p.id = c.policy_id WHERE c.incident_date < p.start_date OR c.incident_date > p.start_date + 364 OR c.report_date < c.incident_date OR c.report_date > c.incident_date + 30 OR c.estimated_loss > p.coverage) + (SELECT count(*) FROM claim_assessments a JOIN claims c ON c.id = a.claim_id WHERE a.status <> CASE c.status WHEN 'under review' THEN 'pending' ELSE c.status END OR a.date <= c.report_date) AS violations" }, { "name": "Only an approved claim is paid, and it is paid what its assessment approved: part of the estimate less the deductible, never below nothing", "sql": "SELECT (SELECT count(*) FROM claim_assessments a JOIN claims c ON c.id = a.claim_id WHERE (c.status <> 'approved' AND a.approved <> 0) OR a.approved < 0 OR a.approved > c.estimated_loss) + (SELECT count(*) FROM claim_payments cp JOIN claims c ON c.id = cp.claim_id JOIN claim_assessments a ON a.claim_id = c.id WHERE c.status <> 'approved' OR cp.amount <> a.approved) AS violations" }, { "name": "A renewal starts the day after the term ends and costs 3-10% more; reinsurance asks for its contract’s share of an approved payout", "sql": "SELECT (SELECT count(*) FROM renewals r JOIN policies p ON p.id = r.policy_id WHERE r.start_date <> p.end_date + 1 OR r.end_date <> r.start_date + 365 OR r.premium < round(p.premium * 1.03, 2) OR r.premium > round(p.premium * 1.10, 2)) + (SELECT count(*) FROM reinsurance_claims rc JOIN claims c ON c.id = rc.claim_id JOIN claim_assessments a ON a.claim_id = c.id JOIN reinsurance_contracts k ON k.id = rc.reinsurance_contract_id WHERE c.status <> 'approved' OR rc.requested <> round(a.approved * k.coverage_percentage / 100.0, 2) OR rc.paid > rc.requested) AS violations" } ] }, "publishedAt": 1791385384951, "updatedAt": 1791385384951 }