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Claim Transaction Details Levels (Claim Type, Cause Type, Claim Element and Mapping)

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

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

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:

  1. Go to Claim Settings. See Claim Settings for how to access to Claim Settings.

  2. 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

  3. On Cause Types tab, add all cause types that you need to support. See Cause Types

  4. On Cause Elements tab, add all claim elements that you need to support. SeePayment Codes (Claim Elements)

  5. On Mapping tab, you need to do mapping for each Product Cover - Claim Type - Cause Type.

  6. 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.

  1. Select a product.

  2. Select one cover from the list of covers of the selected product.

  3. Add Claim Types from Available Claim Types list to Selected Claim Types list.

  4. 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.

  5. Repeat step 4 for another claim type in Selected Claim Types list.

  6. Repeat step 3+4+5 for another cover.

  7. 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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