You must have a solid working knowledge of Oracle SOA Suite, Oracle BPM Suite, and Oracle Business Rules before modifying any business rules. For information on these products, see:

- Oracle Fusion Middleware User's Guide for Oracle Business Rules
- Oracle Fusion Middleware Administrator's Guide for Oracle SOA and Oracle Business Process Management Suite

Oracle Insurance Claim Management uses Calculate Fraud For Lower Claimant Age and Calculate Fraud For Higher Claimant Age rules in the Determine Fraud Likelihood Percentage Ruleset, each of which includes a condition (IF) statement and an action (THEN) statement. By default, this ruleset determines the likelihood of fraud. If Oracle ICM is configured to use a predictive model, then the predictive model is used instead.

The condition of Calculate Fraud For Lower Claimant Age rule specifies that the claimant is under 30 years of age. The action sets the fraud likelihood to 60 percent.

The condition of Calculate Fraud For Higher Claimant Age rule specifies that the claimant is 30 or older. The action sets the fraud likelihood to 40 percent.

For example, a claimant is 25 years of age. The fraud likelihood for his claim is set to 60 percent because he us under 30 years of age.

You can modify the existing ruleset, conditions, or actions. Take caution before modifying a condition or action; it can require source code changes. Claim processing fails if this ruleset is deleted. To modify the ruleset, conditions, or actions, see "Editing Rules in an Oracle Business Rules Dictionary at Run Time," in Oracle Fusion Middleware User's Guide for Oracle Business Rules.