Domain separation and Individual Life Claims
Summarize
Summary of Domain Separation and Individual Life Claims
Domain separation for the Individual Life Claims application allows the organization of data, processes, and administrative tasks into distinct domains. This feature enhances control over user access and visibility of data, supporting various service provider use cases. It is essential for maintaining the integrity of tenant-specific operations.
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Key Features
- Data Management: Ensures accurate data allocation into the correct domain for service provider use.
- Runtime Support: Domain separation is applied during runtime, affecting the user interface, cache keys, reporting, rollups, and aggregations.
- Domain-Separated Tables: Key tables such as Consumer, Account, and Contact are domain-separated, along with newly created tables for claims management.
Key Outcomes
By implementing domain separation, users can effectively manage claims through structured workflows. For instance:
- Case Intake: Agents can gather and manage claim information efficiently on behalf of customers.
- Claims Analysis: Specialists can review claims comprehensively, request additional documentation, and make informed decisions regarding approvals or denials.
This structured approach enhances the service delivery for both customers and service providers within the Individual Life Claims application. For more information on support levels, refer to the details on application support for domain separation.
Domain separation is supported for the Individual Life Claims application. Domain separation enables you to separate data, processes, and administrative tasks into logical groupings called domains. You can control several aspects of this separation, including which users can see and access data.
Support level: Basic
- Business logic: Ensure that data goes into the proper domain for the application’s service provider use cases.
- The application supports domain separation at run time. The domain separation includes separation from the user interface, cache keys, reporting, rollups, and aggregations.
- The owner of the instance must set up the application to function across multiple tenants.
Sample use case: When a service provider (SP) uses chat to respond to a tenant-customer’s message, the customer must be able to see the SP's response.
For more information on support levels, see Application support for domain separation.
How domain separation works in Individual Life Claims
All FSO integrations applications are built on top of and use many Customer Service Management (CSM) tables. The key reference tables are the customer tables such as Consumer, Account, and Contact, and these tables are domain-separated.
Tables
- sn_ins_claim_indl_death_case
- sn_ins_claim_indl_death_task
- sn_ins_claim_indl_rel_death_case
Use cases
- Case Intake
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The First-notice-of-loss (FNOL) intake agents can intake information for a life insurance claim (or similar product) on behalf of a customer.
When the customer calls to file a claim, the intake agent gathers important information that is related to the claim, such as a description of the loss of life incident and any supporting documentation.
After collecting the initial details, they open a claim case for a claims specialist to work on.
- Claims Analysis
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A claims specialist works on a claim that they receive through the workspace dashboard.
The specialist reviews the policy details. If necessary, they can request and review the additional information or documentation from the beneficiaries.
The specialist sets the reserve funds, modifies the coverage exposures and reserve funds over time, and can also view all activity that is associated with handling the claim.
The specialist can also make claim approval or denial decisions based on the available evidence.