---
sourceDocument: Xanadu Financial Services Operations
sourceDocumentLink: https://www.servicenow.com/docs/r/xanadu/financial-services-operations

 Release :

    - xanadu

ft:locale :

    - en-US

ft:publication_title :

    - Xanadu Financial Services Operations

ft:clusterId :

    - finso

bundleId :

    - finso

workflow :

    - Customer and Industry


---

# Using Insurance claims

# Using Insurance claims {#ariaid-title1}

* Release version: Xanadu
* 
* Updated August 30, 2024
* 
* ![](https://www.servicenow.com/docs/portal-asset/ico-clock) 1 minute to read

Learn which roles use the Insurance claims application to create, investigate, and manage an insurance claim from the first notice of loss (FNOL) to claim closure.

## Overview of an Insurance claims workflow {#using-insurance-claims-flow__cf-using-parent-workflow}

Note:  
The topics in this section describe a workflow that references the included personal and commercial travel policy products. Your workspace may display differently based on your configuration and implementation.

1. Create an Insurance claims case.

   The FNOL representative (sn_ins_gen_claim.fnol_representative) creates the case and gathers the initial information on behalf of the claimant. For more information, see [Initiate an Insurance claims case](https://www.servicenow.com/docs/eXY3tVhsfwnsaiax3vurBg "Initiate an Insurance claims case on behalf of a claimant by using the Insurance claims application. When a customer calls in to report a claim, a claim intake specialist follows this procedure to capture important details and initiate a case.").
2. Process an Insurance claims case.

   Processors (sn_ins_gen_claim.processor) initiate a claim, review a claim to verify it, and complete the fulfillment tasks after an adjuster evaluates the claim. For more information, see [Process an Insurance claims case](https://www.servicenow.com/docs/4KdFKNvzMMHTDVlIvDyniQ "Process claims cases in the Insurance claims application. As a claims processor, you can review and verify insurance claims, complete the fulfillment tasks after an adjuster's evaluation, and close a claim.").
3. Work on Insurance claims adjuster tasks.

   Adjusters (sn_ins_gen_claim.adjuster) review a claim to verify documents, evaluate claim coverages, determine claim payment details, and approve a settlement. For more
   information, see [Work on Insurance claims adjuster tasks](https://www.servicenow.com/docs/~j62FAEw_bbc1sViM75deQ "Review a claim to verify the documents, evaluate the claim coverages, determine the claim payment details, and approve the settlement for a claim.").
4. Approve a reserve or payment amount for an Insurance claims case.

   If adjusters submit claim reserve or payment amounts that are higher than their approval authority, a manager (sn_ins_gen_claim.manager) receives a request to approve the amount. For more
   information, see [Approve a reserve or payment amount for an Insurance claims case](https://www.servicenow.com/docs/3nA0NsswVS7bSjUy2CRmaQ "Approve an assigned claim reserve or a payment amount that is higher than an adjuster's approval authority for Insurance claims cases. A reserve or payment may be rejected if the requested amount doesn't support the findings from the claim investigation.").
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## Claim participants {#using-insurance-claims-flow__id_nyn_ckj_qhc}

You can add any person or company as a participant for a claim. The participant can be an entity in the policy or a third-party.

The insurance processor adds participants to a claim during the First Notice of Loss activity, and can assign them a role (such as reporter or witness).  
FSO insurance applications store claim contact information in the following Insurance Claims Core tables:

* The Claim Participant table \[sn_ins_claim_profile\] stores details about all participants involved in the claims process.
* The Participant Role table \[sn_ins_claim_participant\] stores information on the participant's role in the claim (such as if they are the injured or insured).
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For more information, see [Insurance Claims Core tables](https://www.servicenow.com/docs/3pVfilQgkBf2nhE512svBQ "This section explains the insurance tables in Insurance Claims Core and how they handle insurance data.").