| Label | Type | Description | Mandatory |
| Updated On | CURAM_DATETIME | The date on which the last update was made to the evidence. | No |
| Effective Date of Change | CURAM_DATE | Date which the evidence becomes effective | No |
| Approval Requested | CURAM_INDICATOR | Approval Requested | No |
| Relationship To Policyholder/ Employee | EVD_RSHIP_TO_POLICY_HOLDER | The type of relationship between the household member and the policyholder/employee from the drop-down list of relationships, e.g., child, self. | No |
| Premium | CURAM_AMOUNT | The monetary value of the total premium amount paid for the medical insurance cover. | No |
| Start Date | CURAM_DATE | Date the record begins. | No |
| End Date | CURAM_DATE | Date the record ends. | No |
| Coverage Exhausted | CURAM_INDICATOR | Indicator to show whether the maximum claimed benefit limit under the medical insurance policy has been reached. | No |
| Coverage End Reason | EVD_COVERAGE_END_REASON | Indicator to show whether the maximum claimed benefit limit under the medical insurance policy has been reached. | No |
|
| Updated By |
| Label | Type | Description | Mandatory |
| Updated By | USER_NAME | | No |
|
|
|
| Coverage Details |
| Label | Type | Description | Mandatory |
| Household Member | FULL_NAME | Name of the household member who is covered by the medical insurance policy from the drop-down list of household members. | No |
|
| Comments |
| Label | Type | Description | Mandatory |
| Comments | COMMENTS | | No |
|
