Data Flow

Insurance Claim Adjudication Level-1 DFD

Data Flow Diagrams (DFD) · made in Skemio

Level 1 Data Flow Diagram of insurance claim adjudication tracking claim intake, policy verification, and payout settlement.
Level 1 Data Flow Diagram of insurance claim adjudication tracking claim intake, policy verification, and payout settlement.
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What it shows

  • Separates raw intake validation from policy coverage rule checks
  • Deductible balances are locked transactionally before payout arithmetic
  • Adjuster overrides exist as asynchronous events rather than blocking paths

The takeaway

Adjudicate claims through sequential validation stages to prevent race conditions on deductibles.

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