Approve a reserve or payment amount for an Insurance claims case

  • Release version: Xanadu
  • Updated September 19, 2024
  • 1 minute to read

    • Approve an assigned claim reserve or a payment amount that is higher than an adjuster's approval authority for Insurance claims cases. A reserve or payment may be rejected if the requested amount doesn't support the findings from the claim investigation.

    Before you begin

    Role required: sn_ins_gen_claim.manager

    About this task

    If an adjuster assigns a reserve or creates a payment amount that's higher than their approval authority, the claims manager receives a request to approve the amount.

    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.

    Procedure

    1. Navigate to All > Financial Services Operations > Workspace.
    2. Open the task in one of the following ways.
      OptionDescription
      From the landing page Select the task from the My pending tasks list.
      From the Insurance claims approvals list
      1. Select the lists icon (Lists icon.).
      2. On the Lists tab, under Insurance claim flow approvals (or the list category that is specific to your custom workflow), select one of the following options:
        • My approvals - Reserves
        • My approvals - Payments
      3. In the list, select the task that you want to work on.
    3. Close the task from the Claim reserve or Claim payment task form.
      Approval taskAction
      Submit an approval Approve the reserve or payment amount by selecting Approve.
      Submit a rejection
      1. In the Comments field, enter comments with your recommendation.
      2. Reject the reserve or payment amount by selecting Reject.
      Your manually posted comments and system-generated work notes are added to the activity stream for the task and claim case.

    Result

    • If the claims manager approves the reserve or payment amount, the claim reserve task returns to the adjuster to proceed with the claim payment evaluation or settlement.
    • If the claims manager rejects the reserve or payment amount, the manager provides another recommendation. A notification of the rejected status triggers to the adjuster.
    • System-generated entries for the reserve or payment amount approval or rejection are added to the activity stream. These automated entries support auditing and tracking.