GWM : earned premium calculation correction for hr dashboard
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@ -214,111 +214,105 @@ SQL;
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/** Metabase #186: CLAIMS EXPERIENCE SUMMARY */
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/** Metabase #186: CLAIMS EXPERIENCE SUMMARY */
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public function claims_experience_summary(int $policyId): array
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public function claims_experience_summary(int $policyId): array
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{
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{
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$sql = <<<'SQL'
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$sql = <<<'SQL'
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SELECT
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SELECT
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/* run days */
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/* run days */
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/*
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/*
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DATEDIFF(
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DATEDIFF(
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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cp.policy_start_date
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cp.policy_start_date
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) + 1 AS run_days,
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) + 1 AS run_days,
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*/
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DATEDIFF(
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LEAST(CURDATE(), cp.policy_end_date),
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cp.policy_start_date
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) + 1 AS run_days,
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/* earned premium */
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/* earned premium */
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FORMAT(
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FORMAT(
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(prem.premium_as_on_date / 365)
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* (DATEDIFF(
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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cp.policy_start_date
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) + 1)
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, 0) AS earned_premium,
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/* claims reported */
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FORMAT(COUNT(tm.id), 0) AS claims_reported,
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\t\t/* incurred claims count */
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\tFORMAT(
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\t SUM(
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\t CASE
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\t WHEN tcs.claim_status IN ('Settled', 'Paid') THEN 1
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\t WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied') THEN 1
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\t ELSE 0
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\t END
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\t )
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, 0) AS incurred_claims,
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/* incurred amount */
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FORMAT(
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COALESCE(SUM(
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CASE
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WHEN tcs.claim_status IN ('Settled', 'Paid')
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THEN CAST(NULLIF(tm.approved_amount, '') AS DECIMAL(15,2))
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WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied')
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THEN CAST(NULLIF(tm.claim_amount, '') AS DECIMAL(15,2))
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ELSE 0
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END
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), 0)
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, 0) AS incurred_amount,
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/* incurred ratio */
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CONCAT(
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ROUND(
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COALESCE(SUM(
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CASE
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WHEN tcs.claim_status IN ('Settled', 'Paid')
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THEN CAST(NULLIF(tm.approved_amount, '') AS DECIMAL(15,2))
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WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied')
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THEN CAST(NULLIF(tm.claim_amount, '') AS DECIMAL(15,2))
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ELSE 0
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END
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), 0)
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/ NULLIF(
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(prem.premium_as_on_date / 365)
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(prem.premium_as_on_date / 365)
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* DATEDIFF(
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* (DATEDIFF(
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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cp.policy_start_date
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cp.policy_start_date
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)
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) + 1)
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, 0) * 100
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, 0) AS earned_premium,
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, 2)
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*/
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, '%') AS incurred_ratio,
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/* rejection rate */
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prem.premium_as_on_date,
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CONCAT(
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ROUND(
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SUM(CASE WHEN tcs.claim_status IN ('Rejected', 'Denied') THEN 1 ELSE 0 END)
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/ NULLIF(COUNT(tm.id), 0) * 100
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, 2)
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, '%') AS rejection_rate,
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/* projected claims */
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DATEDIFF(
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FORMAT(
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LEAST(CURDATE(), cp.policy_end_date),
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(
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cp.policy_start_date
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COALESCE(SUM(
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) + 1 AS run_days,
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CASE
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WHEN tcs.claim_status IN ('Settled', 'Paid')
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THEN CAST(NULLIF(tm.approved_amount, '') AS DECIMAL(15,2))
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WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied')
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THEN CAST(NULLIF(tm.claim_amount, '') AS DECIMAL(15,2))
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ELSE 0
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END
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), 0)
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/ NULLIF(
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DATEDIFF(
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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cp.policy_start_date
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), 0
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)
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* 365
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) * 1.10
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, 0) AS projected_claims,
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/* projected ratio */
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FORMAT(
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CONCAT(
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(prem.premium_as_on_date / 365) *
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ROUND(
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(
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(
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DATEDIFF(
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LEAST(CURDATE(), cp.policy_end_date),
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cp.policy_start_date
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) + 1
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),
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2
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) AS earned_premium,
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/* claims reported */
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FORMAT(COUNT(tm.id), 0) AS claims_reported,
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\t\t/* incurred claims count */
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\tFORMAT(
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\t SUM(
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\t CASE
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\t WHEN tcs.claim_status IN ('Settled', 'Paid') THEN 1
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\t WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied') THEN 1
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\t ELSE 0
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\t END
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\t )
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, 0) AS incurred_claims,
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/* incurred amount */
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FORMAT(
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COALESCE(SUM(
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CASE
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WHEN tcs.claim_status IN ('Settled', 'Paid')
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THEN CAST(NULLIF(tm.approved_amount, '') AS DECIMAL(15,2))
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WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied')
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THEN CAST(NULLIF(tm.claim_amount, '') AS DECIMAL(15,2))
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ELSE 0
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END
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), 0)
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, 0) AS incurred_amount,
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/* incurred ratio */
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CONCAT(
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ROUND(
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COALESCE(SUM(
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CASE
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WHEN tcs.claim_status IN ('Settled', 'Paid')
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THEN CAST(NULLIF(tm.approved_amount, '') AS DECIMAL(15,2))
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WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied')
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THEN CAST(NULLIF(tm.claim_amount, '') AS DECIMAL(15,2))
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ELSE 0
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END
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), 0)
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/ NULLIF(
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(prem.premium_as_on_date / 365)
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* DATEDIFF(
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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cp.policy_start_date
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)
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, 0) * 100
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, 2)
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, '%') AS incurred_ratio,
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/* rejection rate */
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CONCAT(
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ROUND(
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SUM(CASE WHEN tcs.claim_status IN ('Rejected', 'Denied') THEN 1 ELSE 0 END)
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/ NULLIF(COUNT(tm.id), 0) * 100
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, 2)
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, '%') AS rejection_rate,
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/* projected claims */
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FORMAT(
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(
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(
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COALESCE(SUM(
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COALESCE(SUM(
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CASE
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CASE
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@ -337,49 +331,73 @@ SELECT
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)
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)
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* 365
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* 365
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) * 1.10
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) * 1.10
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)
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, 0) AS projected_claims,
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/ NULLIF(prem.premium_as_on_date, 0) * 100
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, 2)
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, '%') AS projected_ratio
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FROM client_policy cp
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/* projected ratio */
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CONCAT(
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ROUND(
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(
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(
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COALESCE(SUM(
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CASE
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WHEN tcs.claim_status IN ('Settled', 'Paid')
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THEN CAST(NULLIF(tm.approved_amount, '') AS DECIMAL(15,2))
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WHEN tcs.claim_status NOT IN ('Settled', 'Paid', 'Rejected', 'Denied')
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THEN CAST(NULLIF(tm.claim_amount, '') AS DECIMAL(15,2))
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ELSE 0
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END
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), 0)
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/ NULLIF(
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DATEDIFF(
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MAX(COALESCE(tm.claim_dump_date, cp.policy_end_date)),
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cp.policy_start_date
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), 0
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)
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* 365
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) * 1.10
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)
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/ NULLIF(prem.premium_as_on_date, 0) * 100
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, 2)
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, '%') AS projected_ratio
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JOIN (
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FROM client_policy cp
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SELECT
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ep2.client_policy_id,
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COALESCE(SUM(
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CASE
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WHEN e2.change_event = 'inception'
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THEN ep2.rata_premimum
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WHEN e2.change_event != 'inception'
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AND (ep2.date_of_exit IS NULL OR ep2.date_of_exit = '')
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THEN ep2.rata_premimum
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WHEN ep2.date_of_exit IS NOT NULL
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AND ep2.date_of_exit != ''
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AND ep2.claim_status = 0
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THEN -ep2.rata_premimum
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ELSE 0
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END
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), 0) AS premium_as_on_date
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FROM employee_polices ep2
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JOIN employees e2 ON e2.id = ep2.employee_id
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WHERE ep2.client_policy_id = :policy_id:
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AND ep2.is_active = 1
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GROUP BY ep2.client_policy_id
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) prem ON prem.client_policy_id = cp.id
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JOIN ticket_master tm
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JOIN (
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ON tm.client_policy_id = cp.id
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SELECT
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AND tm.is_active = 1
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ep2.client_policy_id,
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COALESCE(SUM(
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CASE
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WHEN e2.change_event = 'inception'
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THEN ep2.rata_premimum
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WHEN e2.change_event != 'inception'
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AND (ep2.date_of_exit IS NULL OR ep2.date_of_exit = '')
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THEN ep2.rata_premimum
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WHEN ep2.date_of_exit IS NOT NULL
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AND ep2.date_of_exit != ''
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AND ep2.claim_status = 0
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THEN -ep2.rata_premimum
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ELSE 0
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END
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), 0) AS premium_as_on_date
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FROM employee_polices ep2
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JOIN employees e2 ON e2.id = ep2.employee_id
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WHERE ep2.client_policy_id = :policy_id:
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AND ep2.is_active = 1
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GROUP BY ep2.client_policy_id
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) prem ON prem.client_policy_id = cp.id
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JOIN ticket_claim_status tcs
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JOIN ticket_master tm
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ON tcs.id = tm.claim_status_id
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ON tm.client_policy_id = cp.id
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AND tm.is_active = 1
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WHERE cp.id = :policy_id:
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JOIN ticket_claim_status tcs
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ON tcs.id = tm.claim_status_id
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GROUP BY cp.id, cp.policy_start_date, prem.premium_as_on_date;
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WHERE cp.id = :policy_id:
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SQL;
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return $this->runKpiQuery($sql, $policyId);
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GROUP BY cp.id, cp.policy_start_date, prem.premium_as_on_date;
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SQL;
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return $this->runKpiQuery($sql, $policyId);
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}
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}
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/** Metabase #190: Claim Amount by Gender */
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/** Metabase #190: Claim Amount by Gender */
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