Note: Prior to use the system setting, "Use SIU Score," (Claims folder) must be set to "True" (Enabled).
This function allows a company to score a claim on an SIU (Special Investigative Unit) using a list of questions or attributes. Prior to use, you will need to determine the criteria and scoring.
Here is an example of how this works. Using a scale of 1 through 10, point allocation can be based on a company's request where criteria such as a claim submitted within 15 days of a new policy would be an eight (8) and when there is no police report, it would score a two (2). The scores are then added together and if the score is above an eight (8), the supervisor on the claim receives a notification. If it is above ten (10), the claim would be assigned to an SIU Queue.
On the Claim Detail, the SIU Score field is used to track the points assigned. If it is above the total allocated, a check mark is placed in the SIU field. A Task is then created and assigned to an SIU Queue. When the task is opened, users can see why the claim has been assigned to the SIU Queue.