Use the Claim Edit page to add a new claim, or to update details for an existing claim. The Claim Edit page shows the complete set of fields for a claim.
The following table provides additional information regarding some fields.
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Field
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Description
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Claim Profile
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Claim #
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The claim identifier.
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Line of Business
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The line of insurance business, such as auto, property, general liability, workers compensation, life.
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Loss Code
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The code for a particular loss, for example, insurance companies can assign 100 for auto accident, 200 for theft, and so on.
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Loss Type
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The type of the loss, which is related to the loss code. Examples of loss type are: auto accident, theft, and so on.
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Report Date
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The date when the insured person reported the claim for the accident.
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Loss Date and Time
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The date of the accident, or the date of the loss.
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Currency
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The currency for the claim.
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Closed Date
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The date when the claim was closed.
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Event #
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The number that identifies an event. Insurance companies typically categorize a catastrophic event. Some examples of event numbers are: 1002 for Hurricane Ike, 1003 for Hurricane Andrew, and so on.
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Status
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The status of the claim, for example, loss report, open, or reviewed, and closed.
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Claim Details
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Kind of Loss
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The type of loss, such as fire, theft, injury, wind, flood, hail, or other.
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Category of Loss
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The category of loss that most insurance companies use to categorize the loss. Some examples are: A. dwelling; B. other structures; C. personal property; D. loss of use.
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Location of Loss
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The location of the loss, such as in parking garage, in shopping mall, and so on.
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Amount of Loss
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The loss amount that the customer has incurred. If the total of a given loss exceeds the liability amount, the customer might have to pay the rest.
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Liability Source
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The source of the liability that caused this claim. Some examples are: injured employee, property of employee damaged, injured private person, property of private person, slip and fall, or vehicular injury.
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Amount of Liability
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The amount that must be paid if there is a loss.
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Relationship to Insured
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The relationship of the injured to the insured. Some examples are: employer, supervisor, or colleague.
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Place of Injury
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The location where the injury occurred.
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Date Employer Aware of Injury
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The date the employer became aware of an employee injury.
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Date Employer Aware of Claim
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The date when the employer became aware of an employee claim.
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# of People Injured
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The number of people injured in the accident. Some of these people might be employees, and some might not.
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# of Employee Injured
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The number of employees injured in the accident.
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Part of Body Injured
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The part of the body that is injured, such as hand, leg, neck, and so on.
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Type of Injury
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The injury type, such as burn, fracture, sprain, repetitive stress.
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Medical Injury Code
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The code for a particular medical injury, such as IDC-9, IDC-10.
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Ability to Work
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Indicates whether the employee can still work because of this injury.
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Class of Employee
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An employee class, such as secretary, manager, and so on.
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Injured During Working Hours ?
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Indicates whether the injury occurred during working hours or not.
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Hospital Name
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The name of the hospital that treated the claimant's injury.
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Time of Death
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The time when the injured person died.
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Police/ Coroner Report #
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The report number of the police or coroner's report related to a worker’s compensation claim.
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Claim Integration
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External System Id
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Tracks the external source ID of the external information for this claim. This field has a limit of 50 characters.
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External Source
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The source of the external information about the claim, for example, an application name, database name, integration name, and so on.
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External Last Update
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Tracks the date and time of the last external update of data of this claim. The date and time when the data for this policy was last updated (from the external source).
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Claim Policy
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Policy
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The insurance policy that is linked to this claim.
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Reported By
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The designation of the person who reported the accident. Some examples are: named insured, driver of insured vehicle, or agent.
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Reporter Contact Info
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The contact information of the person reporting the accident.
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Conditions
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The conditions when the accident occurred, such as weather conditions, for example, It was raining that day.
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At Fault
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Identifies who is at fault. Some examples are: insured driver and other driver.
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Police/Fire Department
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The police or fire station where the report was written.
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Report #
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The report number that is related to the accident.
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Comments
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The detailed description of the claim.
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Loss Description
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The description of the loss, for example, car hit by a truck.
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Business Account
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The business account that is linked to this claim.
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Address
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The address where the claim occurred. The address might be different from any other address in Oracle CRM On Demand, and is not related to a contact or business address, or a property address. This address is required and is relevant and appropriate only for this claim record.
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City
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The city where the claim occurred. The city might be different from any other city in Oracle CRM On Demand, and might not be related to a contact or business city record, or property city. The city name is required and is relevant and appropriate only for this claim record.
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State
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The state (in jurisdictions such as the United States that use states) or province (in jurisdictions such as Canada that use provinces) where the claim occurred. For example, CA for California, or ON for Ontario.
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ZIP/Postal Code
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The ZIP code (in the United States) or the postal code (in other jurisdictions) of the location of the accident.
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