Setting up the policy data for Insurance claims
Summarize
Summary of Setting up the policy data for Insurance claims
ServiceNow’s Insurance claims application requires accurate policy data setup to efficiently manage insurance claims. This setup involves importing policy data into your instance or using remote tables to reference external policy systems. Properly configuring this data ensures claims are created with up-to-date and relevant policy information, improving claim processing accuracy and flexibility.
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Importing the policy data
If your insurance policies are managed in an external system, you should regularly import the latest policy records into your ServiceNow instance. Synchronizing daily ensures the system uses current policy information. The platform generates a policy snapshot at claim creation based on this imported data. Historical policy coverages can also be imported if they are relevant to the incident date of a claim. Importing foundational claims data is critical to correctly link claims to policies.
Foundational claims data
Before creating claims, import key foundational data to ensure accuracy, including:
- Insurance product models
- Consumers, accounts, and contacts
- Basic policy information such as policy holder, participants, effective dates, and policy status
This foundational data forms the backbone for claims processing, while policy coverages can be dynamically retrieved based on the claim’s incident date, maintaining flexibility without losing accuracy.
Using remote tables to search for policies
If you maintain an external policy management system, you can integrate it using APIs and remote tables. This approach allows you to search for policies during claim intake without importing all data. Selected policies can then be associated with claims by creating corresponding policy records in ServiceNow.
Setting up new policy data
To fully configure your insurance products and policies within ServiceNow, you should:
- Define insurance product models reflecting your insurance offerings
- Specify coverage details and options for each product
- Create tables to store personal and commercial insurance policies
These configurations ensure your policy data is structured and accessible for efficient claims management.
Set up the policy data for the Insurance claims application by importing the policy data into your instance, or by using remote tables to reference the policy data.
Importing the policy data
If you store your insurance policy data in an external system, you should bring in the latest insurance policies for all your customers from that system into your instance. Synchronize the latest insurance policies from the external system daily.
The base system, by default, uses the latest insurance policy records that are available. It generates a policy snapshot using this data during the claim creation process. For more information, see Policy snapshots in Insurance claims.
You may bring in past policy coverages or any other past policy data if those policies apply on the incident date of a claim. If you want to create a claim against these policies, you must have the foundational claims data available to select the correct policy. For more information about the foundational claims data, see the next section.
Foundational claims data
- Insurance product models
- Consumers
- Accounts
- Contacts
- Basic insurance policy information, such as the following details:
- Policy holder
- Policy participants
- Effective dates
- Policy status
This foundational data is essential for ensuring that claims are created with accurate and up-to-date policy details. The insurance product model and basic policy information act as the backbone for claims processing, while coverages can be retrieved dynamically based on the incident date when necessary. This approach ensures flexibility without sacrificing critical information during claim creation.
Using remote tables to search for policies
If you already have an existing policy management system, you can use an API and remote tables to search for policies when you’re selecting a policy during intake. When a policy is selected, you can create a policy record to associate the policy to the claim.
Setting up the new policy data
- Insurance product models: Define the product models to reflect your available insurance products.
- Coverage specification: Define the coverage specifications for your products, such as what coverage is included and any available options.
- Setting up an insurance policy for Insurance claims: Create tables to store your personal and commercial policies.