Exploring Personal Lines Claims

  • Release version: Xanadu
  • Updated August 1, 2024
  • 1 minute to read

    • Learn how the first-notice-of-loss (FNOL) representatives, processors, adjusters, special investigation agents, and managers can use the Personal Lines Claims application to create and manage personal insurance claims.

    With the Personal Lines Claims application, your organization can manage the initiation, processing, and resolving of insurance policy claims for your customers from one centralized workflow. With this application, you can coordinate with special investigation departments and offices to manage claims tasks. You can also collect and validate the required claim documentation, investigate the claim, and settle the claim.

    Key features

    • Claims data model that you can use to build any claims service
    • Claims workflows that you can manage by using cases within a dedicated application
    • Visualization of all claim records for a customer
    • Dedicated playbooks and workspaces that are built for various claim personas
    • Key statistics and performance that you can manage and track with ServiceNow® Performance Analytics and Process Mining
    • A baseline workflow where you can view the claims from the first notice of loss to the claim closure for personal auto claims

    Personal Lines Claims personas

    The following table shows which personas in your organization can use the Personal Lines Claims application.
    Table 1. Personal Lines Claims personas
    Persona Description
    Administrator Claims administrator who is responsible for configuring the application.
    First notice of loss (FNOL) representative Front office person who creates a claim case on behalf of a customer and uploads relevant documents.
    Claims processors

    Processors in the middle or back office of the insurance institutions who work with claims. They work on claims cases and tasks that come into claims services, and close the claim cases.
    Special Investigation Unit (SIU) agents Department that investigates the potential fraud claims cases.
    Claims adjuster Person who collects and verifies the documents, loss assessment details, and insurance benefits such as the expenses, deductibles, and coverages, marks whether the fraud investigation is needed, and then settles a claim.
    Claims manager Manager who approves the reserves and payment requests and can view an overview of all the claims, including the Process Mining dashboards and Performance Analytics dashboards and reports.