Managing Claims

This chapter is about managing claims in Siebel Insurance. It contains the following topics:

• About Managing Claims

• Scenario for Opening and Managing a Claim for Property Loss

• Scenario for Opening and Managing a Claim for Auto Damage

• Process of Managing Claims

• About Siebel Insurance eService Claims Center Locators

• Setting up Siebel Insurance eService Claims Center Locators

• Activating the Workflow Processes

• Administering Reserve Codes

• Administering Loss Codes

• Administering Adjusters’ Financial Limits

• Administering the Employee Hierarchy

• Integrating with the Insurance Services Office (ISO)

• Integrating with the Office of Foreign Assets Control

• Checking the Policy Validity and Coverage (End User)

• Creating First Notices of Loss (End User)

• Recording Details of Involved Parties (End User)

• Recording Insured and Adverse Claimant Property Details (End User)

• Managing Claims Events (End User)

• Assigning a Claim to an Adjuster (End User)

• Checking a Claim Against the ISO Database (End User)

• Creating an Activity Plan (End User)

• Assigning a Claim Element (End User)

• Assigning Claims to a Specialist Unit (End User)

• Adding an Appraisal (End User)

• Attaching Claims Documentation (End User)

• Tracking Police and Fire Reports (End User)

• About Coverages and Reserves

• Creating a Reserve (End User)

• About Managing Reserves

• Managing Reserves (End User)

• Tracking Demands for Payment (End User)

• Creating an Invoice Record (End User)

• Generating a Payment Record (End User)

• Tracking Payments Related to Invoices (End User)

• About Issuing a Settlement Payment (End User)

• Issuing a Settlement Payment (End User)

• Making a Bulk Payment (End User)

• Viewing the Invoices and Claims for a Payment (End User)

• Managing Recovery Information (End User)

• Creating a Recovery Payment Record (End User)

• Managing Fraud Information (End User)

• About the Business Rules Processor and Claims Logic

• Claims Workflows