Set Up Claim Models

A claim product model is the foundation of your entire claims process. When a claim is filed, the claim is created using the claim product spec as its definition and using the policy to identify available coverages and insured items. A well-planned claim model provides a variety of flexible options for customers, and intuitive and efficient tools for claims adjusters.

• Create Claim Product Models
  A claim product model describes a claim that an insurance policyholder can file against an insurance policy.
• Policy Terms as Power Attributes
  Enforce policy terms such as limits and deductibles by using power attributes. The "power" in power attributes comes from the extra metadata that you can configure for them. Insurance uses this metadata to track attributes as policy terms, from the product model to the policy record, and then on to claims against the policy.
• Configure Rolling or Lifetime Policy Limits and Deductibles
  Track policies that cap a benefit over a rolling time period. For example, set a limit of two cleanings every 12 months for dental coverage.
• Customize the Claim Loss Payment Detail Form
  Each line of business can involve different processes and data entry requirements. Account for these differences by configuring payment detail processes at the coverage spec level. Corresponding payment detail forms can then guide claims adjusters through expected interactions logically and consistently.
• Customize the Claim Expense Payment Detail Form
  Each line of business can involve different processes and data entry requirements. Account for these differences by configuring payment detail processes at the coverage spec level. Corresponding payment detail forms can then guide claims adjusters through expected interactions logically and consistently.