REINSURANCE · FUNCTION · 07 / SECONDARYRDM-03
SURFACE 10 / REINSURANCE / FUNCTION
CLAIMS / LOSS SCENARIO
Claims relevance is not assumed. The task is to test whether RDM-03 could create a credible loss pathway across interruption, equipment, service dependency or policy interaction, and where that pathway would terminate.- Function
- Claims / Loss Scenario
- Surface question
- Event / causation boundary. Does the event definition survive when one grid disturbance reaches several policies at once? The bounded decision boundary is owned by each institution; see its profile.
- Role classes
- Head of Claims / Head of Loss Scenario Analysis / Chief Claims Officer · decision-owning role classes, confirmed per institution from public role evidence; not title-first routing.
- Governing question
- WHAT LOSS PATHWAYS, BUSINESS-INTERRUPTION CHAINS OR CROSS-POLICY INTERACTIONS WOULD APPEAR IF THE DEPENDENCY PROPAGATED?
GUARD & CREATE
Each row shows a separate decision pathway through the dependency: what this function may need to guard from it, what the dependency could help it create, and which decision may change.
| # | Decision area | Guard from this dependency | Create with this dependency | Decision question |
|---|---|---|---|---|
| 01 | LOSS INITIATION | Observed grid and load events do not automatically imply insured loss. | A claims pathway can separate the physical event from the first potentially insured consequence. | What is the first credible insured loss event in a RDM-03 chain? |
| 02 | BUSINESS INTERRUPTION | Grid instability may affect operations without producing a covered interruption. | A pathway test can identify where interruption becomes plausible and where coverage questions arise. | Where could RDM-03 create a business-interruption pathway? |
| 03 | EQUIPMENT DAMAGE | Voltage or system disturbance may not translate into physical damage. | Engineering and claims evidence can determine whether equipment-damage scenarios are credible or speculative. | What physical conditions would be required for RDM-03 to produce equipment damage? |
| 04 | SERVICE DEPENDENCY | Loss may arise through a dependent service rather than the insured site itself. | A service-dependency map could reveal indirect pathways missed by asset-centric analysis. | Which dependent services could carry RDM-03 into an insured loss? |
| 05 | MULTI-POLICY INTERACTION | A single dependency could touch several policy types or insured entities. | Mapping policy interaction could reveal aggregation or recovery complexity before a real event. | Where could one RDM-03 event engage multiple policies or classes? |
| 06 | CAUSATION | A complex grid event may create competing causal explanations. | A bounded causal chain can identify what evidence would be needed to attribute loss to the dependency. | What evidence would be required to establish causation in a RDM-03 loss? |
| 07 | LOSS AGGREGATION | Claims may emerge across accounts that are not grouped as one event today. | A dependency-based event view could reveal where aggregation assumptions need examination. | Could RDM-03 create one loss event across accounts currently treated separately? |
| 08 | CLAIMS LEARNING | If a related event occurs, conventional claims coding may not preserve the dependency evidence. | A small set of targeted fields could turn future claims into evidence for or against RDM-03. | What should claims capture now so a future event can test RDM-03 rather than merely describe it? |
This is the governing question for this decision territory. The matrix above decomposes it into the smaller consequences, opportunities and questions that can be tested independently.
GUARD · CONSEQUENCE REPORT
Causation pathways, event-definition questions, cross-policy interactions, BI chains and loss-aggregation scenarios.
CREATE · OPPORTUNITY REPORT
New loss-pathway maps, claims scenarios, cross-policy views and response clarity.