Initiate an Insurance claims case

  • Versão de lançamento: Australia
  • Atualizado 12 de mar. de 2026
  • 2 min. de leitura

    • Initiate an Insurance claims case on behalf of a claimant by using the Insurance claims application. When a customer calls in to report a claim, a claim intake specialist follows this procedure to capture important details and initiate a case.

    Antes de Iniciar

    Role required: sn_ins_gen_claim.fnol_representative

    Por Que e Quando Desempenhar Esta Tarefa

    This procedure references service definitions and products that are used in the included travel insurance claim line of business. Your workflow may vary depending on your configuration.

    Procedimento

    1. Navigate to All > Financial Services Operations > Workspace.
    2. Select Report a claim.
    3. In the Create new case dialog box, select the service definition (for example, Report travel claim) in the Services list.
    4. Select Create case.
    5. In the Select policy activity, search for the client's policy in the Account or Consumer fields and the Insurance policy field.
    6. In the Incident date field, enter the date of the incident.
    7. In the Report date and Incident description fields, add any necessary information.
    8. Confirm that the policy details are correct, and then select Continue.
    9. In the Add claim participants activity, add a claim participant by selecting Add claim participant.
    10. In the Add claim participant form, enter the details of the participant, and then select Save.
      Reporter statusSteps
      Is a policy participant
      • Select the Select from policy participants check box.
      • In the Type field, select whether the reporter is a person or a company.
      • In the Consumer (person) or Account (company) field, use the search function to search for policy participants. The contact details populate after selecting the participant.
      • Enter how the participant is related to the insured in the Relationship to insured field.
      Is not a policy participant
      • In the Type field, select whether the reporter is a person or a company.
      • On the Details form, enter the reporter's details.
    11. Confirm that all claim participants are added, and then select Continue.
    12. In the Incident details activity, add an incident that is related to the claim by selecting the add () icon.
    13. For each incident, fill in the incident form with the details of the incident.
      New incidents appear in the incident list for each incident type.
    14. If the incident supports itemizing losses and expenses, select the Itemized loss/expense tab and create an entry for each one by selecting New.
    15. Confirm that all incident details are recorded, and then select Continue.
    16. In the Upload documents activity, upload any supporting documentation that was provided by the claimant.
    17. Confirm that all required documents are uploaded, and then select Continue.
    18. In the Submit claim activity, enter any additional comments, and then select Submit.

    Resultado

    A claim case is created in the New state and the workflow is triggered. The cases are assigned to an assignment group that is based on the defined assignment rules.

    O que Fazer Depois

    Processors and adjusters assign cases to themselves and start working on them. For more information, see Process an Insurance claims case and Work on Insurance claims adjuster tasks.