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Example: Claim Transition from Draft to Payment Processing
This example demonstrates how a Product Admin can configure conditions to transition a claim from Draft to either Payment Processing or Under Review.
Scenario: A claim is filed for a damaged vehicle.
Condition: If the Claim Amount < $100, then open Rental Car Collision coverage and change status to 'Payment Processing', else open Rental Car Collision coverage and change status to 'Under Review'.
Automated Actions (if true):
- Open a new claim coverage (Example: Rental Car Collision).
- Send claim evaluation successful email notification.
- Transition the claim's status from Draft to Payment Processing.
Automated Actions (if false):
- Open a new claim coverage (Example: Rental Car Collision).
- Send a claim under review email notification.
- Transition the claim's status from Draft to Under Review.
To enable the transition from Draft to Payment Processing, the Product Admin sets up a rule with these conditions on the Rental Car product:
| Stage Transition | Product Criteria | Action |
|---|---|---|
| Draft to Payment Processing | Claim amount < $100 |
True evaluation: Send Email False evaluation: Move Claim to Under Review stage and send email about moving the claim to Under Review stage. |
When insurance reps trigger the claim workflow rule:
- If the product meets the criteria and satisfies the rule group condition logic, the claim transitions to the Payment Processing stage. The rule triggers the confirmation email to users.
- If the product doesn’t meet the criteria, the rule initiates a flow that transitions the claim to the Under Review stage. Also, the rule triggers an email to the user stating the claim stage change to Under Review.
