Managing Individual Life Claims
Summarize
Summary of Managing Individual Life Claims
The Individual Life Claims application is designed for managing insurance claims from the initial notice of loss (FNOL) to claim closure. It facilitates multiple policy claims management through a streamlined workflow, enabling FNOL representatives to submit claims while adjusters handle case evaluations.
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Key Features
- Workspace Utilization: Users can manage all aspects of individual life claims through a dedicated workspace that enables monitoring workload, prioritizing tasks, and managing multiple policies.
- Role-Specific Access: Different roles have specific capabilities:
- Claims Admin: Configures workspace elements to meet business needs.
- Claims Manager: Approves reserves and payments and accesses analytics dashboards.
- FNOL Representative: Creates claims and uploads necessary documents.
- Adjuster: Reviews claims and evaluates documentation within the claim workspace.
- Claims Viewer: Accesses details about claims, deceased individuals, and beneficiaries.
- Claim Participant Management: Participants can be added to claims, including entities in the policy or third parties, with specific roles assigned during the FNOL process.
Key Outcomes
By utilizing the Individual Life Claims application, ServiceNow customers can efficiently handle insurance claims, ensuring all parties involved are accurately represented and informed throughout the process. The streamlined workflow enhances productivity and allows for better tracking and management of claims.
Learn which roles use the Individual Life Claims application to create, investigate, and manage an insurance claim from the first notice of loss (FNOL) to the claim closure.
The Individual Life Claims application includes a death benefit claim workflow that enables your adjusters to work on multiple policy claims from a single case. FNOL representatives can submit claim requests, while adjusters can work on the cases for the individual life claims.
Workspace
Use Workspace to work on all aspects of an individual life claim case. Users with these roles can do the following tasks:- Monitor the workload and performance
- Focus on high-priority items
- Navigate across tasks
- Manage multiple policies in a claim
For more information, see Workspaces.
The following table shows which workspace users can use the Individual Life Claims application in.
| Role | Description |
|---|---|
| Claims admin |
Configures workspace according to the business requirements. For more information, see Configure Individual Life Claims and Configure CSM Configurable Workspace. |
| Claims manager | Approves the reserve and payment requests, and views the analytics dashboards. Can also access the claim workspace tab in a case and the FNOL playbook. |
| FNOL representative | Creates the claim cases on behalf of customers, and uploads the relevant documents in the FNOL playbook. |
| Adjuster | Evaluates a claim by reviewing the claim documents, coverages, reserves, and payments in the case's claim workspace tab. Can also access the FNOL playbook. |
| Claims viewer | Views the claim details, deceased details, and beneficiary details. |
Claim participants
You can add any person or company as a participant for a claim. The participant can be an entity in the policy or a third-party.
The insurance processor adds participants to a claim during the First Notice of Loss activity, and can assign them a role (such as reporter or witness).
- The Claim Participant table [sn_ins_claim_profile] stores details about all participants involved in the claims process.
- The Participant Role table [sn_ins_claim_participant] stores information on the participant's role in the claim (such as if they are the injured or insured).
For more information, see Insurance Claims Core tables.