Note: Users must have authority to add, edit and delete a claimant (Claim Detail group).
Note: If the system setting, "Insured as Claimant," (Claims / Submission folder) is set to "True" - Enable, the primary insured is automatically added as the first claimant on a new claim.
Once a claim has been submitted (using the Loss Notice screen), you may find that you need to add an additional claimant.
Select the Claimants folder on the Claims Tree View, then Add on the Claimants screen, or.
Select Add Claimant from the Quick Links section of the Navigation Pane, then Add on the Claimant screen.
After choosing one (1) of the options above, you can begin entering information on the claimant:
Claimant: Required information; select the Claimant link to enter name / address information for the claimant. Click Save when finished.
Associated: Indicate how the claimant is associated with the claim by making a selection from the combo box.
Relationship to Insured: Select from the combo box the claimant's relationship to the insured (i.e., Policyholder, No Relationship to Insured, etc.).
Nature of Involvement: Select from the combo box the claimant's involvement in the claim (i.e., Driver Insured Vehicle, Property Owner, etc.)
Listed: Indicates that this party is listed on the policy.
Injury: Click to indicate if this is an injury to the claimant.
Medicare Recipient: Select to indicate the claimant is a medicare recipient; opens the Medicare tab for entry of Medicare information.
Medicare Waiver Received: Click to indicate a Medicare Waiver has been received.
Property Damage: A free form memo field used to capture any information regarding property / vehicle damage associated with the claimant.
Contact: Select to indicate if the claimant has been contacted; enter date and time.
The New Claimant screen can also contains two (2) tabs, listed below.
When completed with the entry of all necessary claimant information, select the Save button on the Claimants screen toolbar. When the Claim Tree View and Claim Grid View display, all claimants entered are shown for further transaction processing.
Once an insured has been added as a claimant, a blue indicator "I" (Insured) is placed next to the claimant's name on the Claim Tree View. Other indicators for claimants added to the claim include: "W" (Witness - highlighted in yellow) and "3" (3rd Party).
When completed with the entry of all claimant information, select the Save button on the Claimants screen toolbar. The claimants are listed individually in the Claim Tree View on the left side.
Eight (8) new tabs are available once a claimant has been added:
Scheduled Pay: Select to enter a Scheduled Payment cycle (Home: Additional Living Expense, Auto - PIP, Auto - Bodily Injury and Workers Compensation policies).
Litigation: Process of recording loss litigation information for the selected claimant.
Activity: Lists system activity related to the claimant currently in view.
Forms: Allows for selection of forms related to the listed claimant.
Notify UW: Notify the assigned underwriter of items pertaining specifically to the listed claimant.
Attachments: Attach documents at claimant level.
Carrier Info: Allows information about the insured, relationship and nature of involvement to be added at the claimant level. (Note: Relationship and Nature of involvement may be required, depending on system settings in the System Settings Editor.)
Medical: Returns additional screens to record injury, medical provider, hospital and medical billing information.
Note: You must have the authority, "Edit Claimant," in those authorities that are available in the Claim Detail group.
Once a claimant record has been added, it may become necessary to change, correct or add information.
Select the desired claimant from the Claim Tree View (left pane).
Choose the Edit button from the Claimants screen toolbar.
Make the necessary changes (on any tab) and select the Save button when complete.
If you are in "Edit" mode, two (2) other options are shown on the toolbar:
Notes: This allows you to enter any notes at the Claimant Level for this claimant only. The number of notes entered is displayed on the Notes button
Dates: This is used for entering the claim destruction date which is state mandated. You must be in "Edit" mode to enter a date in the Destruction Date field. Select the Dates button to return the Claim Dates screen. Click in the field; defaults to the system date. Click on the down arrow to return a calendar for date selection. Select OK to save the date. If a date has been entered, an "X" is placed on the Dates button.
Note: You must have the authority, "Delete Claimant," in those authorities that are available in the Claim Detail group.
Claimants that have been incorrectly added to a claim can be deleted as long as they are not associated with any feature or coverage on the claim. Claimants that are deleted will still exist in the database but will have a claimant status_id = 3 (Deleted).
To delete a claimant:
Highlight the top level Claimant folder to display the Claimant List View on the right side of the screen.
Choose the claimant you wish to delete by highlighting it.
Click the Delete button, and answer OK to the confirmation: "Delete this claimant?"
The claimant is removed from the claim.
When selecting the top level Claimant folder on the Claim Tree View, a Claimant list view is displayed on the right side of the screen. It lists all claimants associated with the claim. Once you have chosen a claimant, other options include:
View: Select to view previously entered claimant information.
Administer: The Administer button displays activity functions, which are available only to users with the proper authority established. When left clicking on the Administer button, a drop down menu is presented with the following choices:
Open File: If the selected claimant's record is closed, click to re-open the status of the claimant. The claimant's status is changed from "Closed" to "Open."
Close Claimant: Closes / zeroes the selected claimant record. Status on the Claimant spreadsheet is changed to "Closed."
Zero Financials: Selection opens the Close Financials screen. All financial categories currently open are available for selection. Choose OK after category selection to zero and close the financials for the selected items.
Refresh Financials: Select to recalculate claim totals to reflect any new data or transactions processed.
Remember...these options affect only the selected claimant.