Claim Actions Widget

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The Claim Actions widget lists the available actions that can be taken on the claim in its current status. Below are some general descriptions of each action.

The available actions are determined by the type of transaction, the status of the transaction, the availability of items to work with (such as e-mails and documents), and the user's security roles.

If no actions are available for the current claim, the Claim Actions widget is not displayed.

Assign Adjuster	Click Assign Adjuster to select or replace the adjuster for the claim. See Assigning an Adjuster for details.
	Depending on workflow configuration and certain claim details, an adjuster may be assigned automatically.
Copy Claim	Click Copy Claim to select the claim data to be duplicated in a new claim transaction. See Copying a Claim for details.
Create Associated Claim	Click Create Associated Claim to copy the claim information of the current claim and create a new claim transaction. See Associating a Claim for details.
Create Payment	Click Create Payment to enter payment details for policy participants or claim parties. This is the same as entering a payment on the Payments screen. At least one policy participant or claim party must be attached to the claim for this option to be available. See Adding a Payment to a Claim for details.
Select Policy	Once the Date of Loss has been specified for the claim, click Select Policy to choose the appropriate policy for the claim. The Policy Selection window opens. See Selecting the Policy for a Claim for details.
Submit Claim	Once all necessary claim information has been provided, click Submit Claim to submit the claim for processing. See Submitting a Claim for details.
Delete Claim	Click Delete Claim to delete the claim. See Deleting a Claim for details.

Assigning an Adjuster

Submitting a claim may automatically assign an adjuster, replacing any previous adjuster assignment. The adjuster may be changed manually after automatic assignment if necessary.

If an adjuster has not already been assigned to a claim, click Assign Adjuster to add an adjuster. The Adjuster window opens.

Adjuster

Select the adjuster to attach to the claim. The list includes all available users that have been defined as adjusters.

Click Save & Close to save the selection and close the window, or click Close to close the window without saving.

Copying a Claim

Creates a copy of the current claim transaction and creates a new claim submission in Notice of Intent status. Users can modify the copied information as necessary. All custom data included in the current claim is copied, including selected core system data. Claim data can also be copied based on custom validations and workflow events when configured to do so. For additional information, see the Configurations - Workflow Events section.

Associating a Claim

When multiple participants are involved in an incident, related claims can be associated. Associating a claim allows the user to copy select data of the current claim, and creates a new claim submission in Notice of Intent status. Only users with the appropriate security roles can associate claims and modify the information.

From the claim submission screen, click Create Associated Claim in the Claim Actions widget. The Copy Claim window opens.

By default, all available data is selected to be copied into the new transaction. Users can deselect unnecessary data by removing one or more checkboxes. All custom data included in the current claim is automatically copied.

The Associate Claim panel appears indicating that the link between claims is active.

Click Confirm to complete the claim association. A new claim submission will open in Notice of Intent status and users can modify the information as necessary.

Viewing and Modifying Associated Claims

Once the initial claim information has been copied and the link is created, users with the appropriate security rights can view and modify associated claims.

From within the claim, click Associated Claims in the Common Screens widget. The Associated Claims window opens.

To view an associated claim, click on the link in the System Number column. The claim opens in a separate window.
To add a new associated claim from the Claims list, click Add. The Associate Claim window opens.
Select the claims to be associated.
Click Save and Close to save the selected claims and return to the Associated Claims window, or click Close to return to the window without associating any claims.
Click Close to exit the Associated Claims window.

Deleting an Associated Claim

Associated claims can be deleted from the Associated Claims window.

From within the claim, click Associated Claims in the Common Screens widget. The Associated Claims window opens.

Select the associated claims to be deleted.
Click Delete. The claim will be removed from the list.
Click Close to return to the claim submission page.

Creating a Payment

Claim payments can be added directly from the Claims Actions widget, or added through the Payments screen that is automatically included in the published claim workflow. For information on the Payments screen, see the Managing Claim Payments section.

From within the claim, click Create Payment in the Claim Actions widget. The Payment window opens.
Complete the necessary information. Fields marked with a red asterisk * are required.
Click Add & New to save the payment and clear the form for a new entry, click Add & Close to save the payment and return to claim submission form, or click Close to close the window and return to the submission form without saving the payment.

Type	Select the type of payment. The following options are available.
Expense	An expense payment to a Claim Party attached to the claim.
Indemnity	An indemnity payment to the Claimant.
Recovery	A recovery payment received from a Claim Party attached to the claim.
Recovery Disbursement	A payment made from recovery values.
Salvage	A salvage payment received from a Claim Party attached to the claim.
Salvage Disbursement	A payment made from salvage values.
From/To Party	Select the company making or receiving the payment. The company must first be attached to the claim as a Claim Party.
Payment Amount	Enter the amount of the payment and select the currency. If any currency other than U.S. Dollars is selected, the Different Billing Currency box must be checked and a Billing Amount must be provided.
Payment Currency	Select the Payment Currency of the amount entered.
Different Billing Currency	If the Payment Amount is provided in any currency different from the currency configured for the From/To Party, check this box to display the Billing Amount field and provide the converted amount.
Billing Amount	This field is available when Different Billing Currency is checked. This is the amount that will be tracked in the billing module and used to make any adjustments to the reserves and estimates.
Date	Enter the date of the payment, or select the date from the calendar lookup .
Coverage	If a policy has been selected for the claim, a premium type from that policy can be associated to the payment.
Category	Select a category for the payment.
Check Number	If the payment is by check, enter the check number.
Reference Number	Enter any necessary reference information.
Description	Enter a description.
Status	Select the status of the payment.
Approval Required	Marks the payment as ready for review and approval.
Approved	Marks the payment as approved and submits the information for accounting. The payment can no longer be edited or deleted once it has been saved with this status.
Approved - Processing	Marks the payment as approved but still requiring processing time.
Draft	This is the default status for new payments.
Error	This status is applied when the payment does not successfully integrate with the billing module. The payment will not be included in billing calculations. The payment can no longer be edited or deleted once it has been saved with this status, or when the status has been applied automatically.
Paid	The payment has been made. If the payment type has been configured for integration with the billing module, the payment details are transferred for processing. The payment can no longer be edited or deleted once it has been saved with this status.
Rejected	Marks the payment as reviewed and rejected. The payment can still be edited and re-submitted for review and approval.
Void	The payment is no longer valid, and will not be included in payment calculations. The payment can no longer be edited or deleted once it has been saved with this status.
Final Payment	When selected, the system marks the payment as final and depletes the remaining balance from the payment plan. At this point, the status can be changed to Paid.

Selecting the Policy for a Claim

Once the Date of Loss has been provided it is displayed in the Claim Information widget and the option to Select Policy now becomes available in the Claim Actions widget. This option opens the Policy Selection window.

Date of Loss	This field displays the date of loss provided for the claim.
Date Reported	This field displays the date reported provided for the claim
Policy Number	To select the appropriate policy for the claim, enter a minimum of three characters of the policy number or assured name.
	Note: If the system locates one or more policy terms with an Effective Period that includes the displayed Date of Loss or Date Reported, a list of these policies is returned. When the Date Reported is specified, the system returns all policy terms available for the Assured. If the system is unable to locate a policy term with an Effective Period that includes the reported Date of Loss or Date Reported, the system returns a complete list of policy terms that match the specified criteria. Once the appropriate policy term has been selected by the user, the system attaches the claim to the latest Bound transaction from that policy term that is not a Cancellation transaction.

Click Save & Close to save the policy selection and close the window, or click Close to close the window without selecting a policy.

Once a policy has been selected, the Policy No is displayed in the Policy Information widget.

Submitting a Claim

Once all information has been entered for the submission , click Submit Claim in the Claims Action widget. The system remains on the same page, but the action will drive any configurations that rely on this action, such as a Workflow Event, Adjuster Auto-Assignment configuration or Automatic Claim Payment Rule.

Deleting a Claim

If a claim was entered incorrectly or simply needs to be removed from the system, click Delete Claim in the Claims Action widget. The system deletes the current claim and redirects the user to the Claims Search / List. When deleting a claim, any links to Associated Claims are deleted. With the exception of Notes & Tasks, all resources associated to the deleted claim (such as Attachments, Documents, and E-mails) are also deleted. Even after a claim has been deleted, associated Notes & Tasks may still be accessible through downstream systems such as Client Center and/or SmartView.

Note: The option to delete a claim is only available when there are no payments associated to the claim, or if existing payments have been deleted. The claim can not be deleted if it has a Reserve amount that is greater than zero.