Difference between revisions of "Claims"

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[[Category:Policy Tasks]]
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[[Category:Training Guides]]
 
<table class="infobox" cellspacing="5" style="background-color: #FFFFFF; width:27em; text-align:left; border-spacing: 2px; line-height:1.5em;">
 
<table class="infobox" cellspacing="5" style="background-color: #FFFFFF; width:27em; text-align:left; border-spacing: 2px; line-height:1.5em;">
 
<tr>
 
<tr>
     <td>[[File:Ic_info_black_24dp.png]] Required Software Version: [[:Category:Release Notes|September 2015]]</td>
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     <td>[[File:Ic_description_black_24dp.png|link=Newton User Guide#Policy]] Newton User Guide: [[Newton User Guide#Policy|Policy]]</td>
 
</tr>
 
</tr>
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<tr>
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    <td>[[File:Ic_info_black_24dp.png]] Required Software Version: [[:Category:Release Notes|Spring 2017]]</td>
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</tr>
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<tr>
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    <td>[[File: Ic_settings_backup_restore_black_24dp.png]]  Legacy Instructions Available: [http://wiki.agencysystems.com/mediawiki/index.php?title=Claims&oldid=5020 Click Here]</td>
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</tr>
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<tr style="background-color: #bdbdbd; text-align: center; font-weight:bold;">
 
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     <td>Related Pages</td>
 
     <td>Related Pages</td>
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<td>
 
<td>
 
<ul>
 
<ul>
<li>[[Client Tab]]</li>
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<li>[[Client Tab: Client Dashboard]]</li>
<li>[[Policy Express]]</li>
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<li>[[Policy Dashboard]]</li>
<li>[[Report: Claims List Report]]</li>
 
<li>[[Training 3: Entering Policy Information]]</li>
 
 
</ul>
 
</ul>
 
</td>
 
</td>
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<td>
 
<td>
 
<ul>
 
<ul>
<li>[[:Category:Policy Tasks|Policy Tasks]]</li>
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<li>[[:Category:Training Guides|Training Guides]]</li>
 
</ul>
 
</ul>
 
</td>
 
</td>
 
</tr>
 
</tr>
 
</table>
 
</table>
Entering claims information within Agency Systems, allows tracking of claim activity, payments that have been made to the client, and [[:Category:Claims Reports|claims reports]].
+
Entering claims information provides easy tracking of claim activity, payments that have been made to the client, and [[:Category:Claims Reports|claims reports]].
==Frequently Asked Questions (FAQ)==
+
 
*[[Talk:Claims#How_do_i_add_or_edit_claim_loss_types.3F|How do I add or edit claim loss types?]]
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== Before you begin ==
*[[Talk:Claims#How_do_I_list_open_claims_by_customer.3F|How do I list open claims by customer?]]
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Access to view and create claims requires the current operator to have [[Security System|Security System: AR -> Claims Transaction -> View and Entry]] access.
== Create a New Claim ==
+
 
''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View and Entry''' access)''
+
[[File:Ic_info_black_24dp.png]]  See: [[Security System]] for more information.
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
 
#Select the (+) next to '''Policies'''. ''(To expand the band by default, see: [[Preferences]])''  
+
== Create a new claim ==
#'''Left-Click '''the desired policy number to open [[Policy Express]]. ''(Optionally, '''Right-Click''' and select '''Add Claim''' to skip to step 6.)''
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
#Select the (+) next to '''Claims'''.
+
#On the [[Client Tab: Client Dashboard|Client Dashboard tab]] select the (+) next to '''Policies'''. ''(To expand the band by default, see: [[Preferences]])''
#Select '''Create Claim''' below the '''Claims''' band header.
+
#'''Left-Click''' the desired policy number to open the [[Policy Dashboard]]. ''(Optionally, '''Right-Click''' and select '''Claim''' to skip ahead.)''
 +
#Select '''Create Item''' -> '''Claim''' within the top toolbar.  
 
#Enter the claim details and select '''Save'''.  
 
#Enter the claim details and select '''Save'''.  
#To create an [[:Category:Forms|ACORD Loss Notice]], select '''Forms''' and select the correct loss notice. Enter the details, then print or use [[Batch Send]] to [[Email Integration|email the form]].  
+
#To create an [[Forms|ACORD Loss Notice]], select '''Forms''' and select the correct loss notice. Enter the details, then print or use [[Batch Send]] to [[Email|email the form]].  
 
#Select '''Exit'''.
 
#Select '''Exit'''.
  
A claim is not required to create an ACORD Loss Notice.  Any ACORD form, including loss notices can be created from the main [[Policy Express]] interface.
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A claim is not required to create an ACORD Loss Notice.  Any [[Forms|form]] can be created from the main [[Policy Dashboard]] interface.
  
== View Open Claims ==
+
The [[Policy Dashboard]] can also be loaded using the [[Policy Keyword Search]].
Claims in Agency Systems are listed on both the [[Client Tab#Client Tab: Dashboard|Client Dashboard]], and the [[Policy_Express#Policy_Express:_Dashboard|Policy Express Dashboard]].  
 
  
==== View Open Claims For One Client ====
+
== View open claims ==
 +
Claims are listed on both the [[Client Tab#Client Tab: Dashboard|Client Dashboard]], and the [[Policy Dashboard]].
  
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
==== View open claims for one client ====
#Select the (+) next to '''Claims''' to view all open claims for all policies.   
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
 +
#Select the (+) next to '''Claims''' to view all open claims for all policies on the client.   
 
#:[[File:Clientbasic-claimss-closedclaims.PNG]]
 
#:[[File:Clientbasic-claimss-closedclaims.PNG]]
#:''(The claims band also contains a '''[[#View Closed Claims|Closed Claims]]''' sub-band.  When the band is expanded, all closed claims for the client will be listed.)
+
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen.
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen. ''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View''' access)''
+
#To edit or close a claim, see the [[#Edit and close claims|section below]].  
#To edit or close a claim, see the [[#Edit and Close Claims|section below]].  
+
#To create a new claim, see [[#Create a new claim|the section above]].
#To create a new claim, see [[#Create a New Claim|the section above]].  
+
 
 +
The claims band also contains a '''[[#View closed claims|Closed Claims]]''' sub-band.  When the band is expanded, all closed claims for the client will be listed.
  
==== View Open Claims For One Policy ====
+
==== View open claims for one policy ====
The list of open claims on a client can be limited to a specific policy through [[#Policy Express|Policy Express]].
+
The list of open claims on a client can be limited to a specific policy through the [[Policy Dashboard]].
  
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
#Select the (+) next to '''Policies'''. ''(To expand the band by default, see: [[Preferences]])''
+
#On the [[Client Tab: Client Dashboard|Client Dashboard tab]] select the (+) next to '''Policies'''.
#'''Left-Click''' the desired policy number to open [[Policy Express]].  
+
#'''Left-Click''' the desired policy number to open the [[Policy Dashboard]].  
#Select the (+) next to '''Claims''' to view all open claims for the selected policy.  ''(In addition, closed claims assigned to the selected policy can be viewed by expanding the '''[[#View Closed Claims|Closed Claims]]''' sub-band.)''
+
#Select the (+) next to '''Claims''' to view all open claims for the selected policy.   
 
#::[[File:Polexp-dashboard-claims.PNG]]
 
#::[[File:Polexp-dashboard-claims.PNG]]
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen. ''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View''' access)''
+
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen.  
#To edit or close a claim, see the [[#Edit and Close Claims|section below]].  
+
#To edit or close a claim, see the [[#Edit and close claims|section below]].  
#To create a new claim, select '''Create Claim''' below the '''Claims''' band header. For additional details [[#Create a New Claim|see the section above]].  
+
#To create a new claim, select '''Create Claim''' below the '''Claims''' band header. For additional details [[#Create a new claim|see the section above]].
 +
 
 +
Closed claims assigned to the selected policy can be viewed by expanding the '''[[#View closed claims|Closed Claims]]''' sub-band.
  
== Edit and Close Claims ==
+
== Edit and close claims ==
''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View, Entry, and Edit''' access)''
+
After a claim is initially saved, additional details can be added such as claims payments, additional loss details and more. (Requires [[Security System|Security System: AR -> Claims Transaction -> View, Entry, and Edit]] access.)
  
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
#Select the (+) next to '''Policies'''. ''(To expand the band by default, see: [[Preferences]])''
+
#On the [[Client Tab: Client Dashboard|Client Dashboard tab]] select the (+) next to '''Policies'''.
#'''Left-Click''' the desired policy number to open [[Policy Express]].  
+
#'''Left-Click''' the desired policy number to open the [[Policy Dashboard]].  
#Select the (+) next to '''Claims''' to view all open claims for the selected policy. ''(To view all claims for the client, see [[#View Open Claims For One Client|the section above]].)''
+
#Select the (+) next to '''Claims''' to view all open claims for the selected policy.
 
#'''Left-Click''' the claim number to open the claims maintenance screen.
 
#'''Left-Click''' the claim number to open the claims maintenance screen.
#Enter additional details, including claims payments.  To close the claim, set '''Status -> Closed'''.  
+
#Enter additional details, including claims payments.  To close the claim, set '''Status''' -> '''Closed'''.
#Select '''Save, then '''Exit'''.
+
#Select '''Save''', then '''Exit'''.
 +
 
 +
=== Add or edit loss types ===
 +
To create a new loss type, simply type into the '''Loss Info''' -> '''Type''' field. The system will automatically prompt to save the new type.
 +
 
 +
To edit an existing loss type:
 +
#Select the '''[>>]''' icon to the right of the '''Type''' drop-down.
 +
#Left-click to highlight the desired loss type.
 +
#Select the first '''Edit''' icon within the top toolbar.
 +
#Enter the new loss type description and select the '''Save''' icon within the top toolbar.
 +
 
 +
Claims loss types cannot be deleted once they are added, since the types have been used on previous claims.  
  
== View Closed Claims ==
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== View closed claims ==
''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View''' access)''
+
Closed claims are not deleted from the system and always available below the open claims lists.
==== View Closed Claims For One Client ====
 
  
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
==== View closed claims for one client ====
#Select the (+) next to '''Claims''' to view all open claims for the client.  
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
#Select the (+) next to '''[[#View Closed Claims|Closed Claims]]''' to list all closed claims for the client.  
+
#Select the (+) next to '''Claims''' to view all open claims for all policies on the client.
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen. ''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View''' access)''
+
#Select the (+) next to '''Closed Claims''' to list all closed claims for the client.  
 +
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen.  
  
==== View Closed Claims For One Policy ====
+
==== View closed claims for one policy ====
The list of closed claims on a client can be limited to a specific policy through [[#Policy Express|Policy Express]].
+
The list of closed claims on a client can be limited to a specific policy through the [[Policy Dashboard]].
  
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
#Select the (+) next to '''Policies'''. ''(To expand the band by default, see: [[Preferences]])''
+
#On the [[Client Tab: Client Dashboard|Client Dashboard tab]] select the (+) next to '''Policies'''.
#'''Left-Click''' the desired policy number to open [[Policy Express]].  
+
#'''Left-Click''' the desired policy number to open the [[Policy Dashboard]].  
 
#Select the (+) next to '''Claims''' to view all open claims for the selected policy.   
 
#Select the (+) next to '''Claims''' to view all open claims for the selected policy.   
#Select the (+) next to '''[[#View Closed Claims|Closed Claims]]''' to list all closed claims for the selected policy.  
+
#Select the (+) next to '''Closed Claims''' to list all closed claims for the selected policy.  
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen. ''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> View''' access)''
+
#To view additional details for a claim, '''left-click''' the claim number to open the claims maintenance screen.
 +
 
 +
== Delete a claim ==
 +
When a claim is closed, [[#Edit and close claims|the claim should be edited and the status changed]]. Deleting a claim requires requires [[Security System|Security System: AR -> Claims Transaction -> Global]] access.
  
== Delete a Claim ==
+
[[File:Ic warning black 24dp.png]] You cannot recover a deleted claim.  
''(Requires [[Security System|Security System]]: '''AR -> Claims Transaction -> Global''' access.)''
 
  
#[[Client Tab#Find a Client|Load a client]] on one of the [[Client Tab|client tabs]].
+
#[[Client_Keyword_Search#Find_a_Client|Load a Client]] on a [[Client Tab|client tab]].
#Select the (+) next to '''Policies'''. ''(To expand the band by default, see: [[Preferences]])''
+
#On the [[Client Tab: Client Dashboard|Client Dashboard tab]] select the (+) next to '''Policies'''.
#'''Left-Click''' the desired policy number to open [[Policy Express]].  
+
#'''Left-Click''' the desired policy number to open the [[Policy Dashboard]].  
#Select the (+) next to '''Claims''' to view all open claims for the selected policy. ''(To view all claims for the client, see [[#View Open Claims For One Client|the section above]].)''
+
#Select the (+) next to '''Claims''' to view all open claims for the selected policy.
#'''Left-click''' the claim number to open the claims maintenance screen.
+
#'''Left-Click''' the claim number to open the claims maintenance screen.
 
#Select '''Delete''' then '''Yes''' when prompted.  
 
#Select '''Delete''' then '''Yes''' when prompted.  
 
#Select '''Exit'''.
 
#Select '''Exit'''.

Latest revision as of 18:19, 30 August 2018

Ic description black 24dp.png Newton User Guide: Policy
Ic info black 24dp.png Required Software Version: Spring 2017
Ic settings backup restore black 24dp.png Legacy Instructions Available: Click Here
Related Pages
Related Categories

Entering claims information provides easy tracking of claim activity, payments that have been made to the client, and claims reports.

Before you begin

Access to view and create claims requires the current operator to have Security System: AR -> Claims Transaction -> View and Entry access.

Ic info black 24dp.png See: Security System for more information.

Create a new claim

  1. Load a Client on a client tab.
  2. On the Client Dashboard tab select the (+) next to Policies. (To expand the band by default, see: Preferences)
  3. Left-Click the desired policy number to open the Policy Dashboard. (Optionally, Right-Click and select Claim to skip ahead.)
  4. Select Create Item -> Claim within the top toolbar.
  5. Enter the claim details and select Save.
  6. To create an ACORD Loss Notice, select Forms and select the correct loss notice. Enter the details, then print or use Batch Send to email the form.
  7. Select Exit.

A claim is not required to create an ACORD Loss Notice. Any form can be created from the main Policy Dashboard interface.

The Policy Dashboard can also be loaded using the Policy Keyword Search.

View open claims

Claims are listed on both the Client Dashboard, and the Policy Dashboard.

View open claims for one client

  1. Load a Client on a client tab.
  2. Select the (+) next to Claims to view all open claims for all policies on the client.
    Clientbasic-claimss-closedclaims.PNG
  3. To view additional details for a claim, left-click the claim number to open the claims maintenance screen.
  4. To edit or close a claim, see the section below.
  5. To create a new claim, see the section above.

The claims band also contains a Closed Claims sub-band. When the band is expanded, all closed claims for the client will be listed.

View open claims for one policy

The list of open claims on a client can be limited to a specific policy through the Policy Dashboard.

  1. Load a Client on a client tab.
  2. On the Client Dashboard tab select the (+) next to Policies.
  3. Left-Click the desired policy number to open the Policy Dashboard.
  4. Select the (+) next to Claims to view all open claims for the selected policy.
    Polexp-dashboard-claims.PNG
  5. To view additional details for a claim, left-click the claim number to open the claims maintenance screen.
  6. To edit or close a claim, see the section below.
  7. To create a new claim, select Create Claim below the Claims band header. For additional details see the section above.

Closed claims assigned to the selected policy can be viewed by expanding the Closed Claims sub-band.

Edit and close claims

After a claim is initially saved, additional details can be added such as claims payments, additional loss details and more. (Requires Security System: AR -> Claims Transaction -> View, Entry, and Edit access.)

  1. Load a Client on a client tab.
  2. On the Client Dashboard tab select the (+) next to Policies.
  3. Left-Click the desired policy number to open the Policy Dashboard.
  4. Select the (+) next to Claims to view all open claims for the selected policy.
  5. Left-Click the claim number to open the claims maintenance screen.
  6. Enter additional details, including claims payments. To close the claim, set Status -> Closed.
  7. Select Save, then Exit.

Add or edit loss types

To create a new loss type, simply type into the Loss Info -> Type field. The system will automatically prompt to save the new type.

To edit an existing loss type:

  1. Select the [>>] icon to the right of the Type drop-down.
  2. Left-click to highlight the desired loss type.
  3. Select the first Edit icon within the top toolbar.
  4. Enter the new loss type description and select the Save icon within the top toolbar.

Claims loss types cannot be deleted once they are added, since the types have been used on previous claims.

View closed claims

Closed claims are not deleted from the system and always available below the open claims lists.

View closed claims for one client

  1. Load a Client on a client tab.
  2. Select the (+) next to Claims to view all open claims for all policies on the client.
  3. Select the (+) next to Closed Claims to list all closed claims for the client.
  4. To view additional details for a claim, left-click the claim number to open the claims maintenance screen.

View closed claims for one policy

The list of closed claims on a client can be limited to a specific policy through the Policy Dashboard.

  1. Load a Client on a client tab.
  2. On the Client Dashboard tab select the (+) next to Policies.
  3. Left-Click the desired policy number to open the Policy Dashboard.
  4. Select the (+) next to Claims to view all open claims for the selected policy.
  5. Select the (+) next to Closed Claims to list all closed claims for the selected policy.
  6. To view additional details for a claim, left-click the claim number to open the claims maintenance screen.

Delete a claim

When a claim is closed, the claim should be edited and the status changed. Deleting a claim requires requires Security System: AR -> Claims Transaction -> Global access.

Ic warning black 24dp.png You cannot recover a deleted claim.

  1. Load a Client on a client tab.
  2. On the Client Dashboard tab select the (+) next to Policies.
  3. Left-Click the desired policy number to open the Policy Dashboard.
  4. Select the (+) next to Claims to view all open claims for the selected policy.
  5. Left-Click the claim number to open the claims maintenance screen.
  6. Select Delete then Yes when prompted.
  7. Select Exit.