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About Managing Claims

Siebel Personal Lines Claims allows agents, call center representatives, and claims adjusters to capture notice of loss information, to view claim information and activities, and to link claims to customer and policy information. Incident and claim information is used across multiple business units including claims, policy servicing, sales, and underwriting, presenting an integrated view of the customer.

Claims management is an important part of service interactions with insurance companies. Therefore, Siebel claims management can be integrated with other software components, such as legacy claims management systems, to provide an integrated solution.

End users can use the Claims screen to open and track claims, as well as to track service requests and other activities associated with claims.

The overall process of managing a claim might involve the following:

• Claims intake and First Notice of Loss (FNOL). A call center agent creates a First Notice of Loss, records the necessary details from the policy holder, and then assigns the claim to a claims adjuster.
• Review and assignment. A claims adjuster reviews the claim and assigns parts of the claim to other people or third parties. For example, the adjuster can assign an appraiser to appraise the damage, or can assign claim elements to third-party vendors, such as glass vendors.
• Reserve and adjustment. The claims adjuster creates a reserve with which the claim payment will be made.
• Settlement. The adjuster makes the necessary payment to the policy holder to settle the claim.
• Special unit investigation. Throughout the claims process, an adjuster can assign the claim to a special unit, such as a subrogation or fraud unit. An investigator in the special unit then processes the claim.