Claim Transaction Details Levels (Claim Type, Cause Type, Claim Element and Mapping)
Table of Contents
Introduction
Claim Type, Cause Type, Claim Element are used for leveling the transaction details.
Claim Types: defines types of injury / damage. A product cover can have several claim types. Each Claim Type will be mapped to a Product Cover => a Product Cover is mapped with several Claim Types.
Cause Types: defines reasons that caused injury / damage. A claim type can have several cause types. Each Cause Type will be mapped to a Claim Type => a Claim Type is mapped with several Cause Types.
Claim Elements: defines purposes of a reserve/payment.
Example 1 - Example of Claim Type & Cause Type
Product “Moped” has 3 covers: Traffic, Collision Damage, Vehicle Damage.
Cover | Claim Type | Cause Type |
---|---|---|
Traffic | Property damage | Other |
| Personal injury | Other |
| Other | Other |
Collision Damage | Fire | Fire |
|
| Explosion |
|
| Lightning strike |
|
| Other |
| Glass | Stone strike |
|
| Other |
| Theft | Robbery |
|
| Assault |
|
| Other |
| Machine Damage | Mechanical fault |
|
| Electronic error |
Vehicle Damage | Vehicle Damage | Collision with another vehicle |
|
| Collision with other object (not vehicle) |
|
| Collision with animals |
|
| Parking damage |
|
| Intentional damage |
|
| Other |
Example 2 - Example of Claim Elements
Category | Claim Element |
---|---|
Person | Child Supplement |
| Funeral expenses |
| Death |
| Spouse Addendum |
| Future loss of income |
Thing | Fine Arts |
| Replacement |
| Restore |
| Glass |
| Rent Loss |
Other | Interruption |
| Treatment Expenses |
| Deductible |
| Compensation |
| Car rental |
How to configure detail levels for a claim transaction
To configure detail levels for a claim transaction, you need to go through these steps:
Go to Claim Settings. See Claim Settings for how to access to Claim Settings.
On Claim Types tab, add all claim types that you need to support. See https://seamlessinsure.atlassian.net/wiki/pages/createpage.action?spaceKey=SHC&title=Claim%20Types&linkCreation=true&fromPageId=8291945
On Cause Types tab, add all cause types that you need to support. See Cause Types
On Cause Elements tab, add all claim elements that you need to support. SeePayment Codes (Claim Elements)
On Mapping tab, you need to do mapping for each Product Cover - Claim Type - Cause Type.
Save the mapping, and you can use it when creating a claim transaction.
Configure Product Cover-Claim Type-Cause Type Mapping
You need to configure mapping for each product that you want to make claims on.
Select a product.
Select one cover from the list of covers of the selected product.
Add Claim Types from Available Claim Types list to Selected Claim Types list.
Select one Claim Type in Selected Claim Types list, then Add Cause Types for that selected Claim Type from Available Cause Types list to Selected Cause Types list.
Repeat step 4 for another claim type in Selected Claim Types list.
Repeat step 3+4+5 for another cover.
Repeat step 2+3+4+5+6 for another product.
Create mapping for Product “Moped” in Example 1
Add Claim Types & Cause Types for Cover Traffic
Add Claim Types & Cause Types for Cover Collision Damage
Add Claim Types & Cause Types for Cover Vehicle Damage and Save mapping
Use Product Cover-Claim Type-Cause Type Mapping and Claim Elements when creating claim transactions
Please see these topics:
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