Work on Insurance claims adjuster tasks
Review a claim to verify the documents, evaluate the claim coverages, determine the claim payment details, and approve the settlement for a claim.
Before you begin
Role required: sn_ins_gen_claim.adjuster
Important: To access the Claim workspace, and Summary adjuster workspace related tabs, you must activate the CSM default record page. By default, the page is set to inactive. To determine the default page for displaying records in CSM Configurable Workspace, see CSM Configurable Workspace record pages .
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
Navigate to All > Financial Services Operations > Workspace.
Open the task in one of the following ways.
| Option | Steps |
|---|---|
| From the landing page | From the All open claims list, select a task. |
| From the Insurance claim adjuster task list |
|
- Work on the adjuster task by completing actions from the claim workspace.
| Claim task | Claim workspace actions |
|---|---|
| Add a document verification task |
|
| Verify a document | In a Submitted document task, select Verify to verify the submitted document. |
| Reject a document | In a Submitted document task, select Reject to reject the submitted document. |
| Add claim coverage |
|
| Add a reserve or payment |
|
| Add an ad-hoc claim task |
|
| Submit a reserve or payment amount for approval | If the reserve or payment amount is above your approval threshold, an approval task is created and assigned to your manager when you submit the amount. |
| Submit a claim settlement decision |
|
Within a task, in the Work notes field, enter any comments that are related to your findings.
Manually posted comments and system-generated work notes add to the activity stream for the task and claim case.
Result
- When you accept the task, the task status is set to Work in progress.
- When you submit a reserve or payment amount within your authorization limit, it’s auto-approved.
- If a claim validation is rejected, the claim case closes with a case status of Closed rejected. System-generated work notes about the rejection are automatically added to the activity stream for the task and claim case.
- If you settle the claim, the claim case automatically closes, with the case status set as Closed complete.