Configure claim workflow
- Anne Vu: Insurance-VN
To configure a workflow to handle claims, you need to complete these steps:
Setup workflows for claim handling.
Setup queues.
Setup case types.
Create a case and attach to a claim.
Advance: Use claim fields in workflow setup. Coming soon.
Advance: Create an automatic workflow to automatically create case when a new claim is registered. Coming soon.
Setup workflows for claim handling
If claim workflow is existing, you just need to click on the workflow to view/update.
If claim workflow is not setup, you need to create a workflow from scratch.
In claim context, if you want to handle a claim from end to end, for ex: from claim registration to claim recovery, you need to put all of necessary tasks in one claim workflow.
Go to menu WORKFLOWS, select Workflow Setup.
This will open the Workflow list.
Click on Create button if you want to create a workflow from scratch or click on one existing workflow to open workflow details.
After you’re done updating, click on Save button.
Then, you are required to Activate the workflow in order to use it.
Setup queues
Queue is a group of users that will handle a specific type of case.
In claim context, you can create a queue to handle Motor claims and another queue to handle Non-motor claims.
You need to setup queue in order to create a Case Type or Case.
To setup queue, go to Cogwheel icon, select Queue.
On Queue list, you can create a new queue or update the existing queue.
If you need to add more users to the queue into the existing queue, you will need to update the existing queue.
User can be assigned as Supervisor who has all permissions on cases or as Member who has limited permissions on cases.
Setup case types
Case type is a quick setup for a case creation where you define the default workflow, queue to be used when creating a new case.
In claim context, you can create one case type to handle Motor claim case and another one to handle Non-motor claim case.
You need to setup case type in order to create a Case.
To setup case type, go to Cogwheel icon, select Module Configuration.
Select Seamless Flow, then click on Settings under Case Management.
On Case Types list, click on Create button if you want to create a new case type or click on one existing case type to update details.
On Case type details, you need to specify:
Case Type Code: must be in lowercase and no special characters or spaces.
Case Type Name: a friendly name for case type.
Workflow: select the claim workflow that you has setup.
Queue: select the queue that you has setup.
Create a case and attach to a claim
Go to menu WORKFLOWS, select Case Management.
This will open the Case list.
Click on Create button if you want to create a new case or click on Edit to update an existing case to open case details popup.
On case details popup, please pay attention to these 2 fields:
Case Type: you need to select correct case type that has the workflow setup that you want to use.
Business Record: you need to select the correct Claim reference number that you want to apply the workflow.
Click on Save to create/update the case.
On Case details view, click on Claim reference number to navigate to claim details.
On claim details view, now you can use the workflow to handle the claim. See Claim handling with custom workflow
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