Managing Individual Life Claims
Summarize
Summary of Managing Individual Life Claims
The Individual Life Claims application facilitates the management of insurance claims from the first notice of loss (FNOL) to closure. It allows claims adjusters to handle multiple policy claims efficiently through a comprehensive workflow designed for individual life claims. FNOL representatives can initiate claims, while adjusters manage case details and documentation.
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Key Features
- Workspace Utilization: Users can work on all aspects of individual life claims within a dedicated workspace, enabling them to monitor workloads, prioritize tasks, and manage multiple policies.
- Role-Specific Functions: Various roles interact with the application, including:
- Claims Admin: Configures workspace settings.
- Claims Manager: Approves reserves and payment requests, with access to analytics dashboards.
- FNOL Representative: Submits claim cases and uploads documents.
- Adjuster: Evaluates claims by reviewing relevant documents and details.
- Claims Viewer: Views all claim-related information.
- Participant Management: Users can add participants to claims, which can include entities involved in the policy or third parties, assigning them specific roles during the FNOL process.
Key Outcomes
By utilizing the Individual Life Claims application, ServiceNow customers can expect streamlined claim management, improved collaboration among roles, and enhanced tracking of critical tasks and claims data. This leads to effective handling of claims, ensuring that all necessary information is organized and accessible throughout the claims process.
Learn which roles use the Individual Life Claims application to create, investigate, and manage an insurance claim from the first notice of loss (FNOL) to the claim closure.
The Individual Life Claims application includes a death benefit claim workflow that enables your adjusters to work on multiple policy claims from a single case. FNOL representatives can submit claim requests, while adjusters can work on the cases for the individual life claims.
Workspace
Use Workspace to work on all aspects of an individual life claim case. Users with these roles can do the following tasks:- Monitor the workload and performance
- Focus on high-priority items
- Navigate across tasks
- Manage multiple policies in a claim
For more information, see Workspaces.
The following table shows which workspace users can use the Individual Life Claims application in.
| Role | Description |
|---|---|
| Claims admin |
Configures workspace according to the business requirements. For more information, see Configure Individual Life Claims and Configure CSM Configurable Workspace. |
| Claims manager | Approves the reserve and payment requests, and views the analytics dashboards. Can also access the claim workspace tab in a case and the FNOL playbook. |
| FNOL representative | Creates the claim cases on behalf of customers, and uploads the relevant documents in the FNOL playbook. |
| Adjuster | Evaluates a claim by reviewing the claim documents, coverages, reserves, and payments in the case's claim workspace tab. Can also access the FNOL playbook. |
| Claims viewer | Views the claim details, deceased details, and beneficiary details. |
Claim participants
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).
- 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).
For more information, see Insurance Claims Core tables.