Table 24. BRP Business Rules Processes for Claims
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FINS Claims Evaluate Subrogation Potential |
Calculates the Subrogation Real Time score. |
Evaluate Subrogation Potential button in MyClaims view |
FINS Claims Calculate Combined Score |
Calculates the Subrogation Combined score. |
Field that drives the subrogation indicator in MyClaims view |
FINS Claims Calculate Fraud Score |
Calculates the combined Fraud Potential score based on the Real time Rule score, Real time Predictive Model score, and Batch Predictive Model score. |
Field that drives the fraud indicator in MyClaims view |
FINS Claims Evaluate Fraud Potential |
Evaluates the Fraud Potential score. |
Evaluate SIU Potential button in MyClaims view |
FINS Claims Reserve Estimation Check BRP |
Compares the Total Estimation amount with the Total Reserve amount. |
Claims, then the Appraisals view |
FINS Claims Authority Limit Check |
Performs the authority limit check before the reserve is opened. |
Open Reserve button in Claims, then the Reserves view |
FINS Claims Split Limit Check |
Performs checks on the limits for reserve claims. |
Open Reserve button in Claims, then the Reserves view |
FINS Claims Calculate SIU Expenses |
Calculates the SIU Total Expenses. |
Task link in SIU dashboard view |
FINS Claims Calculate Total Conservation Amount |
Calculates the Conservation Amount. |
Task link in SIU dashboard view |
FINS Claims Calculate Total Payment Amount |
Calculates the Total Claim Payments amount. |
Task link in SIU dashboard view |
FINS Claims Create Fraud Case Assignment Alert |
Creates an alert for a fraud case assignment. |
Task link in SIU dashboard view |
FINS Claims Calculate Subrogation Expenses |
Calculates the Subrogation Total Expenses. |
Task link in Recovery view |
FINS Claims Calculate Deductible Return |
Calculates the Subrogation Deductible Return amount. |
Task link in Recovery view |
FINS Claims Create Subrogation Case Assignment Alert |
Creates a subrogation case assignment alert. |
Task link in Recovery view |
FINS Claims Set Notify Salvage |
Sets the Notify Salvage flag. |
Notify Salvage flag in Recovery view |
FINS Claims Subrogation Reassignment |
Reassigns the claim to a subrogation specialist. |
Task link in Recovery view |
FINS Claims Subrogation Update BC Fields |
Updates the subrogation fields for Recovery Potential or Update Theory of Liability tasks. |
Task link in Recovery view |
FINS Claims Fraud Litigation Assignment |
Performs the Claims fraud Arbitration Litigation assignment. |
Task link in Recovery view |
FINS Claims SIU Reassignment |
Reassigns the claim to a fraud specialist. |
Task link in SIU dashboard view |
FINS Claims Fraud Update BC Fields |
Updates business component fields when the Update Recovery Potential or Update Probability Of Resolution link is clicked. |
Task link in SIU dashboard view |
FINS Claims Subrogation Arbitration Litigation Assignment |
Assigns the claim to a subrogation arbitration or litigation unit. |
Task link in Recovery view |
FINS Claims Subrogation Collections Assignment |
Assigns the claim to a subrogation collections unit. |
Task link in Recovery view |
FINS Claims Subrogation Check State Statutes |
Checks the State Statutes. |
Task link in Recovery view |
FINS Claims Assign SIU Opportunity |
Assigns the claims to the SIU unit when the user clicks the Notify SIU button. |
Notify SIU button in MyClaims view |
FINS Claims Assign Subrogation Opportunity |
Assigns the claims to the subrogation unit when the user clicks the Notify Subro button. |
Notify Subro button in MyClaims view |
FINS Claims Invoke Assignment Manager |
Invokes the Assignment Manager component. |
All assignment buttons and assignment links. |
FINS Claims Check OFAC Status For Contact Payees |
Checks and updates the OFAC-related fields for the Contact payees during the Submit Payment processing. |
Submit Payment button in Claims, then the Payments view |
FINS Claims Check OFAC Status For Vendor Payees |
Checks and updates the OFAC-related fields for the Vendor payees during the Submit Payment processing. |
Submit Payment button in Claims, then the Payments view |
FINS Claims Payment Update Reserves |
Updates the Reserve fields during the Submit Payment processing. |
Submit Payment button in Claims, then the Payments view |
FINS Claims Payment Validate Reserves |
Validates the Reserve fields during the Submit Payment processing. |
Submit Payment button in Claims, then the Payments view |
FINS Claims Reserve Adjustment |
Changes the Status from Pending - Open to Open when a user clicks the Reserve Adjustment button. |
Reserve Adjustment button in Claims, then the Reserves view |
FINS Claims Add Reserve Position to Claim Team |
Adds the Reserve position to the Claim team. |
Open Reserve button in Claims, then the Reserves view |
FINS Claims Manual Override Flag |
Sets the Manual Override flag. If the reserve is of type Factor and the Allow Override flag is set, and if the reserve amount is changed, the Manual Override flag is set to true. |
Claims, then the Reserves view |
FINS Claims Void Payment Reserves Process |
Cancels the submitted payment. |
Void payment button in Claims, then the Payments view |
FINS Claims Apply Deductible For Reserve |
Applies the deductible flag for the reserve across payments. |
Apply Deductibles flag in Claims, then the Payments view |