Process an Insurance claims case

  • Release version: Xanadu
  • Updated September 20, 2024
  • 2 minutes to read
  • Process claims cases in the Insurance claims application. As a claims processor, you can review and verify insurance claims, complete the fulfillment tasks after an adjuster's evaluation, and close a claim.

    Before you begin

    Role required: sn_ins_gen_claim.processor

    About this task

    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 claim case and task in one of the following ways.
      OptionSteps
      From the landing page Select an active case from the My pending tasks or My open claims list.
      From the case playbook
      • Select the lists icon (Data visualization list type - icon).
      • On the Lists tab, under Insurance claim cases (or the list category that is specific to your custom workflow), open the case list.
      • In the list, select the case that contains the task.
      • If the claim case is in the New status or not assigned to you, select Accept to be able to work on it.
      • Select the Playbook tab.
      • Under one of the following stages, select the task activity to work on.
      From an insurance claim case
      • Select the lists icon (Data visualization list type - icon).
      • On the Lists tab, under Insurance claim cases (or the list category that is specific to your custom workflow), select Assigned to me.
      • In the list, select the case that you want to open.
      • If the claim case is in the New status, select Accept to be able to work on it.
      • In the case, select the Tasks tab and select the claim task.
      From the Insurance claim case tasks list
      • Select the lists icon (Data visualization list type - icon).
      • On the Lists tab, under Insurance claim tasks (or the list category that is specific to your custom workflow), select All.
      • In the list, select the task that you want to open.
      You may need to select Accept to accept the assignment of the task, so that you can work on the task.
    3. Finish the work that is required to complete the tasks in your claims workflow.
      This work may include:
      • Completing the first notice of the loss stage tasks to initiate the claim.
      • Verifying the validity of the claim that was reported by the customer.
      • Completing and closing the claim.
    4. Optional: In the Work notes field, enter any comments that are related to your findings.
      Manually posted comments and system-generated work notes are added to the activity stream for the claim case.
    5. Close the task from the task form.