Setting up the policy data for Insurance claims
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Summary of Setting up the policy data for Insurance claims
This guide explains how to configure and manage insurance policy data within the Insurance claims application in ServiceNow. You can either import policy data directly into your instance or use remote tables to reference policies stored in external systems. Proper setup ensures accurate claim creation and processing based on up-to-date and historical policy information.
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Importing Policy Data
- If insurance policies are maintained in external systems, import the latest policies daily to keep your instance synchronized.
- The system uses the most recent policy records by default and generates policy snapshots during claim creation to capture relevant policy details.
- You may also import past policy coverages or historical policy data applicable to the incident date of a claim, but foundational claims data must be present to select the correct policies for claims.
Foundational Claims Data
Before creating claims, ensure the following key data is imported into ServiceNow to maintain accuracy:
- Insurance product models
- Consumers, accounts, and contacts
- Basic insurance policy information such as policy holder, participants, effective dates, and policy status
This foundational data supports accurate claims processing and enables dynamic retrieval of coverages based on incident dates without compromising data integrity.
Using Remote Tables to Search for Policies
If you have an existing policy management system, you can integrate it using APIs and remote tables. This allows searching and selecting policies during claim intake without importing full policy data. Upon selection, a policy record is created in ServiceNow linked to the claim.
For configuring remote table integrations, refer to the Developer Guide topics on remote data options and setup.
Setting Up New Policy Data
To define or customize your insurance products and policies within ServiceNow, configure the following:
- Insurance product models to represent your insurance offerings
- Coverage specifications detailing included coverages and options
- Tables to store personal and commercial insurance policies
These configurations form the foundation for policy management and claims processing within the platform.
Related Concepts
- Insurance product models
- Coverage specification
- Setting up an insurance policy for Insurance claims
- Policy snapshots in Insurance claims
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.