Claim Statuses
Use claim statuses to monitor your claims. Each status indicates the progress of the claim from creation to settlement.
A user status can be assigned to each of the claim system status to further track the progress of the claim, based on your business practices.
|
Status |
What Happens to the Claim |
|---|---|
|
Open |
New claim |
|
Approval Pending |
Claim research is complete, with corresponding claim reason applied. The claim analyst has submitted the claim for approval, but isn't yet approved. |
|
Approval Rejected |
Claim is rejected internally. |
|
Settlement Pending |
Claim has been submitted and is pending settlement. |
|
Settled |
Claim has been updated with settlement details in the Settlement tab including:
|
|
Canceled |
Claim is canceled by the claims analyst. This action is irreversible. |
Status Transitions for Claims
The following figure shows the status transitions that can happen in a claim.
User Action and Status Transitions
|
User Action |
Source System Status |
Target System Status |
|---|---|---|
|
Submit |
Open |
Approval Pending |
|
Cancel Claim |
Open |
Canceled |
|
Approve |
Approval Pending |
Settlement Pending |
|
Reject |
Approval Pending |
Approval Rejected |
|
Return to Open |
Approval Rejected |
Open |