Edit Claim Detail

Edit an existing claim to keep the details of an insured’s covered loss up to date. You can edit open claims throughout your claims management process and edit closed claims to maintain accurate records. These instructions will guide you through the process of editing a claim.

4. Click the claim in the list.
5. Do one of the following:
   • Click the Edit button on the Claims screen.
   • Click File > Open on the menubar.
   • Double click the claim.
   • Press [Ctrl]+O.
6. The Claim Detail screen displays. The navigation panel expands to show the available categories for the selected claim. Click a category to show its specific sections on the claim. Click a section to view or fill in the information related to that section.

7. All claims contain the following screens:
   

   • Summary

     1. Change the Date of loss if necessary and enter a time of loss in the next field, if known. If the date and time of loss cannot be established, select the Cannot be determined checkbox.
     2. Enter or revise the loss Description.
     3. Enter the Insurer claim # if known.
     4. Enter an Estimate amount if it is available.
     5. In the CAT code field, optionally enter the catastrophe code.
     6. Enter a name in the Reported by field. To locate the Reported by contact, click the lookup button to display a list of contacts for the account. Double click the appropriate contact or click once on the contact and click Finish or press [Enter].
     7. Change the Date reported and/or time reported if applicable.
     8. Enter a name in the Reported to field. To locate the Reported to contact, click the lookup button to display a list of employees, enter all or part of the employee lookup code, click Locate, choose the appropriate employee, and click Finish.

     9. Enter or change the Date and time below the Reported to selection if necessary.

     10. Select any checkboxes that apply to the claim:

     • Record only

     • Previously reported

     • Chargeable

     • Suit pending

     • Subrogation

     11. This screen contains two tabs:

     • Policy

       The policy or line of business to which the claim applies displays in the list. To add a different policy or line, click the Add button to the left of the list.

       1. In the Add Policy/Line window that displays, choose the Claim type.
       2. Click to select the desired policy/line.
          
          Note: Select the Include history checkbox to display history policies in the list.
       3. Choose a Service summary.
       4. To select a Risk, click the lookup button to the right of the field. In the Available Risks window, choose a risk Type. Click to highlight the appropriate risk and click Finish.
       5. To select a Sub risk, click the lookup button to the right of the field. In the Available Risks window, choose a risk Type. Click to highlight the appropriate risk and click Finish.
       6. Select a Claim type if it does not default based on the associated line of business. See Claim Type Configuration for instructions on adding, editing, and deleting claim types.

       To remove a policy or line from the claim, click the item in the list and click Delete . You are prompted, "Do you wish to delete this record?" Click Yes.

     • Reporting/History

       Claim codes associated with the claim display in the list. To add a claim code, click the Add button to the left of the list. In the Add Claim Code window that displays, choose a Claim Code. Click Add to add another code to this claim, or click Finish if there are no more codes to add.

       Note: The Claim Code options available in the dropdown menu are specific to your Claim Type selection for the associated policy/line. See Claim Code Configuration for instructions on adding, editing, and deleting claim codes.

       To remove a code from the claim, click to highlight the correct item in the list and then click Delete.
       
       Add additional information about the claim in the Comments field, such as notes about the claim’s progress (beyond its Open or Closed status). These comments also display when you select this claim in the Claims list.

       History and Closed information cannot be revised.

   • Servicing

     Enter servicing information for the claim on this screen. Select a specific Employee for each employee type, entering Descriptions to the right as necessary.

   • Insured/Contact

     1. Enter an Insured loc code and Report purpose code if applicable.
     2. Select the Jurisdiction.
     3. Enter a Jurisdiction log number if known.
     4. Optionally enter an Insured report number.
     5. Enter an OSHA case number if applicable.
     6. The screen contains the following tabs:
     • Insured
       1. If the insured Name is incorrect, click the lookup button to the right of the field. Click on the appropriate contact in the window that displays and click Finish.
       2. To change the address, click in the large field in the Address/Phone Number section. Enter the Street, City, State/Province, and County (if applicable) in the highlighted fields that display.
       3. Enter the ZIP/Postal code, or click the lookup button to look up the code.
          1. Make a selection from the Search where dropdown to indicate your preferred search method.
          • If you selected ZIP Code/Postal Code or City:
          1. From the second dropdown, select Begins with or Contains.
          2. Enter at least one character of the desired zip code or city and click Locate or press [Enter]. If more than 500 results are found, you must enter more than one character.
          • If you selected State Code or Province Code, the second dropdown defaults to Equals and cannot be changed. Enter the two-character abbreviation for the state/province and click Find or press [Enter].
          2. Click to highlight the appropriate zip code in the list and click OK or press [Enter].
       4. Enter the Site ID if applicable.
       5. Enter or update the Residence, Mobile, Business, and Fax numbers as necessary.
       6. Enter or update the Primary email and/or Secondary email address.
       7. Enter or update the Website associated with the insured.
       8. Enter the Date of birth.
       9. Select the Marital status.
       10. Enter the FEIN if applicable.
     • Contact

       1. Select the Contact insured checkbox if applicable. If you do not select this checkbox, fill in the fields on this tab.

       2. If the contact Name is incorrect, click the lookup button to the right of the field. Click on the appropriate contact in the window that displays and click Finish.

       3. To change the address, click in the large field in the Address/Phone Number section. Enter the Street, City, State/Province, and County (if applicable) in the highlighted fields that display.
       4. Enter the ZIP/Postal code, or click the lookup button to look up the code.
          1. Make a selection from the Search where dropdown to indicate your preferred search method.
          • If you selected ZIP Code/Postal Code or City:
          1. From the second dropdown, select Begins with or Contains.
          2. Enter at least one character of the desired zip code or city and click Locate or press [Enter]. If more than 500 results are found, you must enter more than one character.
          • If you selected State Code or Province Code, the second dropdown defaults to Equals and cannot be changed. Enter the two-character abbreviation for the state/province and click Find or press [Enter].
          2. Click to highlight the appropriate zip code in the list and click OK or press [Enter].
       5. Enter the Site ID if applicable.
       6. Enter or update the Residence, Mobile, Business, and Fax numbers as necessary.
       7. Enter or update the Primary email and/or Secondary email address.
       8. Enter the preferred contact time in the When field.
       9. Choose the Relationship to insured.
       10. Enter Comments as necessary.
     • Spouse
       1. If the spouse's Name is incorrect, click the lookup button to the right of the field. Click on the appropriate contact in the window that displays and click Finish.
       2. To change the address, click in the large field in the Address/Phone Number section. Enter the Street, City, State/Province, and County (if applicable) in the highlighted fields that display.
       3. Enter the ZIP/Postal code, or click the lookup button to look up the code.
       4. Enter or update the Residence, Mobile, Business, and Fax numbers as necessary.
       5. Enter or update the Primary email and/or Secondary email address.
       6. Enter the Date of birth.
       7. Select the Marital status.
       8. Enter the FEIN if applicable.
     • Authority Contacted
       1. Enter the Authority.
       2. Enter the Report #.
       3. List any Violations/Citations.
       4. Enter the Municipality and Division #.
       5. Enter the Office name, Badge # and Phone/email.

   • Adjustor

     Adjustors are added to the system through Adjustor Configuration.

     1. To add an adjustor to the claim, click the Add button to the left of the Adjustors list.
     2. Click the lookup button to the right of the Name field.
     3. In the Adjustor Lookup window, enter at least one character in the Adjustor field and click Locate.
     4. Click the appropriate adjustor and click Finish.
     5. Information for the selected adjustor defaults in the fields but can be changed if necessary.
     6. Enter an Assigned date or select the date from the dropdown calendar.
     7. Enter Comments as needed.

   • Litigation

     1. Enter the Case #, Court and Venue.
     2. Enter a Served date or choose the date from the dropdown calendar.
     3. Enter an Answered date or choose the date from the dropdown calendar.
     4. Enter the Defense Name, Address, and Phone #, and enter Remarks if needed.
     5. Enter the Plaintiff Name, Address, and Phone #, and enter Remarks if needed.

   • Additional Parties

     1. To add an additional party, click the Add button to the left of the list.
     2. The fields below the list are enabled. Enter the Name of the additional party, or click the lookup button to the right of the field to choose a contact associated with the account. Click on the correct contact in the pop-up window that displays and click Finish or press [Enter]. The Name field is required.
     3. Enter the Business name if applicable.
     4. Click in the Address field. Enter the Street, City, State/Province, and County (if applicable) in the highlighted fields that display.
        
        Note: If you click the lookup to choose a contact in the Name field, the address defaults into the field.
     5. Enter the ZIP/Postal code, or click the lookup button to look up the code.
        1. Make a selection from the Search where dropdown to indicate your preferred search method.
        • If you selected ZIP Code/Postal Code or City:
        1. From the second dropdown, select Begins with or Contains.
        2. Enter at least one character of the desired zip/postal code or city and click Locate or press [Enter]. If more than 500 results are found, you must enter more than one character.
        • If you selected State Code or Province Code, the second dropdown defaults to Equals and cannot be changed. Enter the two-character abbreviation for the state/province and click Find or press [Enter].
        2. Click to highlight the appropriate ZIP/postal code in the list and click OK or press [Enter].
     6. Enter the Site ID if applicable.
     7. Enter the Residence and Mobile phone numbers.
     8. Enter the Business number and Ext.
     9. Enter the Fax number and Ext if applicable.
     10. Enter the additional party's Email address if known.
     11. In the Where to contact field, specify the party's preferred contact location.
     12. In the When to contact field, specify the party's preferred contact time.
     13. Select the party's claim Involvement.
     14. Enter any relevant Comments.
     15. To add another party, repeat the steps above.
         
         To remove a party, click on the additional party in the list and do one of the following:
     • Click the Delete button .
     • Press [Delete].

     You are prompted, "Do you wish to delete this record?" Click Yes.

   • Payments/Expenses

     1. To add a claim payment, click the Add button to the left of the list.
        
        Note: If you are only entering a reserve amount, do not click the Add button. Instead, enter the Reserved value(s) in the Totals section.
     2. The fields below the list are enabled. Enter a Date, or click the down arrow to the right of the field to select a date from the dropdown calendar.
     3. Enter a Check #.
     4. Enter the Amount of the claim payment. This field is required.
     5. Select a Payment type.
     6. Enter a Description of the payment.
     7. Choose a Loss type.
     8. Select the Payee type.
     9. Enter the payee Name. To locate the payee, click the lookup button to the right of the field to choose a contact associated with the account, click on the correct contact in the pop-up window that displays, and click Finish or press [Enter]. The Name field is required.
     10. Click in the large Address field. Click in the large field in the Main or Mailing section of the Address frame. Enter the Street, City, State/Province, and County (if applicable) in the highlighted fields that display.
         
         Enter the ZIP/Postal code, or click the lookup button to  look up the code.
         
         Note: If you click the lookup button to choose a contact in the Name field, the address defaults into the field.
         1. Make a selection from the Search where dropdown to indicate your preferred search method.
         • If you selected ZIP Code/Postal Code or City:
         1. From the second dropdown, select Begins with or Contains.
         2. Enter at least one character of the desired zip/postal code or city and click Locate or press [Enter]. If more than 500 results are found, you must enter more than one character.
         • If you selected State Code or Province Code, the second dropdown defaults to Equals and cannot be changed. Enter the two-character abbreviation for the state/province and click Find or press [Enter].
         2. Click to highlight the appropriate ZIP/postal code in the list and click OK or press [Enter].
     11. Enter the Site ID if applicable.
     12. In the Totals section, click the Calculate link label to enter the payment amount in the correct field automatically. You can also enter the amounts manually if desired.
     13. In the Subrogation section, enter the Sent Amount and Date.
     14. Enter the Received Amount and Date.
     15. To add another payment, repeat the steps above.

     To delete a payment, click on the payment and click the Delete button . You are prompted, "Do you wish to delete this record?" Click Yes.

8. View, add to, or edit the fields on the remaining screens as necessary.

9. Many of the forms have a list at the top. To expand the list, click the splitter at the bottom of the frame and drag it down the screen.
10. Various tabs display below the list. Each tab contains different fields. To view or revise information in these fields, select the correct line in the list. If there are no items in the list and the fields are grayed out, click the Add button . The fields on the form are activated, allowing you to fill in the information.
11. When you are finished, click the X in the upper right corner of the screen or click the X on the navigation panel below the Claims button.