Claim Statuses in Redwood

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 is created.
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:
  • Settlement documents
  • Payment instruments
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.

This figure shows the status transitions for claim statuses.

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