Claim Profile

Claim #

The claim identifier.

Line of Business

The line of insurance business, such as auto, property, general liability, workers compensation, life.

Loss Code

The code for a particular loss, for example, insurance companies can assign 100 for auto accident, 200 for theft, and so on.

Loss Type

The type of the loss, which is related to the loss code. Examples of loss type are: auto accident, theft, and so on.

Report Date

The date when the insured person reported the claim for the accident.

Loss Date and Time

The date of the accident, or the date of the loss.

Currency

The currency for the claim.

Closed Date

The date when the claim was closed.

Event #

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.

Status

The status of the claim, for example, loss report, open, or reviewed, and closed.

Claim Details

Kind of Loss

The type of loss, such as fire, theft, injury, wind, flood, hail, or other.

Category of Loss

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.

Location of Loss

The location of the loss, such as in parking garage, in shopping mall, and so on.

Amount of Loss

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.

Liability Source

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.

Amount of Liability

The amount that must be paid if there is a loss.

Relationship to Insured

The relationship of the injured to the insured. Some examples are: employer, supervisor, or colleague.

Place of Injury

The location where the injury occurred.

Date Employer Aware of Injury

The date the employer became aware of an employee injury.

Date Employer Aware of Claim

The date when the employer became aware of an employee claim.

# of People Injured

The number of people injured in the accident. Some of these people might be employees, and some might not.

# of Employee Injured

The number of employees injured in the accident.

Part of Body Injured

The part of the body that is injured, such as hand, leg, neck, and so on.

Type of Injury

The injury type, such as burn, fracture, sprain, repetitive stress.

Medical Injury Code

The code for a particular medical injury, such as IDC-9, IDC-10.

Ability to Work

Indicates whether the employee can still work because of this injury.

Class of Employee

An employee class, such as secretary, manager, and so on.

Injured During Working Hours ?

Indicates whether the injury occurred during working hours or not.

Hospital Name

The name of the hospital that treated the claimant's injury.

Time of Death

The time when the injured person died.

Police/ Coroner Report #

The report number of the police or coroner's report related to a worker’s compensation claim.

Claim Integration

External System Id

Tracks the external source ID of the external information for this claim. This field has a limit of 50 characters.

External Source

The source of the external information about the claim, for example, an application name, database name, integration name, and so on.

External Last Update

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).

Claim Policy

Policy

The insurance policy that is linked to this claim.

Reported By

The designation of the person who reported the accident. Some examples are: named insured, driver of insured vehicle, or agent.

Reporter Contact Info

The contact information of the person reporting the accident.

Conditions

The conditions when the accident occurred, such as weather conditions, for example, It was raining that day.

At Fault

Identifies who is at fault. Some examples are: insured driver and other driver.

Police/Fire Department

The police or fire station where the report was written.

Report #

The report number that is related to the accident.

Comments

The detailed description of the claim.

Loss Description

The description of the loss, for example, car hit by a truck.

Business Account

The business account that is linked to this claim.

Address

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.

City

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.

State

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.

ZIP/Postal Code

The ZIP code (in the United States) or the postal code (in other jurisdictions) of the location of the accident.