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Data model

Dataverse tables behind this portal
Boundary principle. VT Healthcare administers the scheme as a Managing General Agent, so its administration platform stays the system of record for policy, premium and claims financials, under the underwriting authority of CJ6 Insurance Limited. Dataverse holds the engagement layer of cases, documents and messages. The portal reads policy data through the integration layer and never becomes a second source of truth.
Contactcontact
Every person: members, covered adults, dependants, scheme administrators and their dependants. Family adults are separate contact records with their own portal identity.
Accountaccount
Organisations: corporate clients, hospitals and consultant practices.
Caseincident
Claims team and support workload. Portal submissions arrive here as cases and are worked in the Dynamics 365 model-driven app, not in the portal.
Note / Attachmentannotation
Uploaded GP referrals, clinical reports and generated authorisation letters, secured by row-level access.
Policynew_policy
Portal-side mirror of the policy record: cover type, renewal date, excess, underwriting basis. Synced from the policy administration system.
Covered Membernew_coveredmember
Joins a contact to a policy with role and benefit entitlements. Joint policyholders carry equal rights, and parental access lets either adult act for a child dependant until she reaches 18.
Everyday Health Claimnew_cashclaim
Reimbursement claims on the cash plan. Assessed against the remaining allowance on the benefit category, then paid to the member. Bank details stay in the administration platform.
Benefit Allowancenew_benefitallowance
Annual limit and amount claimed for each cash plan category. What a member can claim, and what is blocked, derives from this record and not from portal logic.
Claimnew_claim
Claim notification and pre-authorisation lifecycle. Financial settlement stays in the admin platform.
Authorisationnew_authorisation
Issued authorisation number, approved scope of treatment and the letter delivered to the member document store.
Scheme Membershipnew_schememembership
Business cover joiners, leavers and cover level per employee.
Service Requestincident (support)
Support requests raised by members and scheme administrators, classified by category and handled separately from claims.

Demo scenarios

Nine journeys across three cover types