COB Tester · coverage-router-ksa

1 Input

Beneficiary

Class

Nationality (ISO-2)

Age

Employment sector

GOSI-registered (or within registration grace window)

Eligible for closed-system facility

CCHI cooperative coverages

Special-case scheme (if any)

Beneficiary also has other coverage (e.g., home-country international insurance) — triggers Visitor Art. 6

Billing mode (diplomats / IO only)

Case

Case type

Najm/Muroor report ID (RTA only)

Is emergency (treat-first applies)

Commute-related — accident on regular route between residence and workplace (SIL M/273 Art. 30(1) makes this a work injury; if it's also an RTA with Najm report, both carve-outs apply)

CCHI policy cap exhausted (Annex 66 Art. 5(a) cascade)

Service is excluded by the CCHI policy (Annex 66 Art. 5(b) cascade)

Facility

Facility type

Facility system (if closed-system or university)

2 Verdict

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COB decision engine — interactive tester

1 Input

Beneficiary

Case

Facility

2 Verdict