Claims

Use this feature to create a Claim record by entering information about the loss. You can then use this information to generate an ACORD loss notice in eForms Manager or track claim status, payments, reserves, recoveries, and expenses. You can also track individuals associated with the claim such as injured parties, witnesses, or adjusters.

Claims information you enter appears on the Claims Management report.

Claim Data Entry Form Sections

Basic Claim Information

Field/Group Name

What is this?

Claim #

The claim number can be up to 36 characters.

Kind of Loss

Select the kind of loss from the list. For information on adding to the Kind of Loss list see List Setup.

The Kind of Loss is a selection criteria for Claims Management reporting.

Policy Information

Field

What is this?

Policy #

Select the policy from the list.

Basic policy information must be entered before you can enter a Claim.

Eff Date

The effective and expiration dates of the policy to which this claim applies.

Exp Date

Transaction Date

The Transaction Date of the policy to which this claim applies.

Line of Business

Select the Line of Business to which this claim applies.

Date Information

Field	What is this?
Loss Date	Enter the date and time the insured claims the loss occurred.
Time
Occurrence Date	Enter the date when the insurance company proves the accident and/or injury occurred. Default is the Loss date and time entered.
Time

Date Reported

Field	What is this?
Date Reported	The date the loss was reported to your agency or the company.
Report #	Enter the police report number, if available.
Report To	Enter the name of the agency or company person who took the report.
Reported By	Enter the name of the person who reported the loss to your agency or the company.
Authority Contacted	Enter the name of the police, fire, or emergency agency contacted, if applicable.

Description of Loss

Field	What is this?
Prevent Update by Download	Select the box to retain your description and prevent a description sent by the company to download and overwrite your description.
(Description box)	Use for description of the claim.

Location of Loss or Accident

Field

What is this?

Select Address from Existing Location

Select from list if location of loss or accident matches a location on the policy or line of business.

List includes the Policy Commercial Locations addresses, as well as locations entered on the Line of Business.

Refresh

If you selected an address from the list, click the Refresh icon to automatically enter data in the other fields.

Address

City

State

Zip

Enter the address information for the location of loss or accident.

Type address information directly in these field, or auto-fill from a list selection by clicking the Refresh icon.

Use the following table to determine whether the Selected Risk or Location of Loss or Accident will appear on the integrated ACORD Loss Notice form.

ACORD Loss Notice

Which field appears?

Automobile Loss Notice

The Location of Loss or Accident address will print in the "Location of Accident" field on the form.

Property Loss Notice

The Selected Risks location, as entered in the Insured Risk Information section, will print on the "Location of Loss" field on the form.

If multiple location risks are selected, the system will produce a Loss Notice for each risk

If no risks have been selected, the Location of Loss or Accident address will print in the "Location of Loss" field on the form. In this case, only one form will be created.

General Liability Notice

The Selected Risks, as entered in the Insured Risk Information section, will print in the "Location of Occurrence" field on the form.

If multiple location risks are selected, the system will produce a Loss Notice for each.

If no risks have been selected, the Location of Loss or Accident address will print in the "Location of Occurrence" field on the form. In this case, only one form will be created.

Workers Compensation - First Report of Injury

The Location of Loss or Accident will print in the "Department or Location where Accident or Illness Exposure Occurred" field on the form.

Claim Status

Field

What is this?

Status of Claim

Select the status of the claim. The options are:

All closed types
All open types
Closed
Closed and hold
Closed without payment
Closed, in subrogation
Closed, no claim
Open
Open, hold for submission
Open, in litigation
Re-opened

Date Closed

Enter the date when the claim is closed.

If a Final Payment is entered, the final payment date fills to this field.

CAT #

If a catastrophe number has been assigned by the Property Claim Service or other industry organization, enter the CAT number. Typically this is a three-digit (ACORD level 3 standard) number.

Insured Risk Information

You can enter multiple insured risk information using this section.

Field/Button

What is this?

Add Selected Risks

Click to add the risks you have selected from the Available Risks grid to the Selected Risks grid.

Clear all Selected Risks

Click to clear all of the locations, items, subjects of insurance, and/or vehicles from the Selected Risks grid.

Currently you can only clear all selected risks, not an individual risk.

Available Risks

Select the risk(s) from the grid that apply to this claim. You can use the Ctrl and Shift keys to select multiple risks. This grid fills with information based on the line of business from the policy.

Line of Business	Information that appears in Available Risks
Property, Homeowners, Dwelling Fire, Garage & Dealers, Crime, Commercial Inland Marine (Builders Risk, Equip, EDP)	Locations
Property, EDP	Subject of Insurance
Private Passenger Auto, Business Auto, Garage & Dealers Truckers	Vehicles
Homeowners, Watercraft	Units
Homeowners, Scheduled Personal Property, Commercial Inland Marine, (Equipment Floater, EDP)	Items

Selected Risks

To expand these data fields, click Edit in the section header.

Field	What is this?
Risk Type	View-only. Displays the Risk Type from the grid.
Description	View-only. Displays description of risk from the grid.
Describe Damage	Enter a brief description of the claim-related damage.
Estimate Amount	Enter estimated dollar amount of the damage.
Where can Property be seen?	Enter address/ location information regarding where property can be viewed.
When can Property be seen?	Enter time/weekday information regarding when property can be viewed.
Other Insurance on Property	Enter information about additional insurance coverage on property, if applicable.

Use the following table to determine whether the Selected Risk or Location of Loss or Accident will appear on the integrated ACORD Loss Notice form.

ACORD Loss Notice

Which field appear?

Automobile Loss Notice

The Location of Loss or Accident address, as entered in the General Information section, will print in the "Location of Accident" field on the form.

Property Loss Notice

The Selected Risks location will print on the "Location of Loss" field on the form.

If multiple location risks are selected, the system will produce a Loss Notice for each risk.

If no risks have been selected, the Location of Loss or Accident address, as entered in the General Information section, will print in the "Location of Loss" field on the form. In this case, only one form will be created.

General Liability Notice

The Selected Risks will print in the "Location of Occurrence" field on the form.

If multiple location risks are selected, the system will produce a Loss Notice for each

If no risks have been selected, the Location of Loss or Accident address, as entered in the General Information section, will print in the "Location of Occurrence" field on the form. In this case, only one form will be created.

Workers Compensation - First Report of Injury

The Location of Loss or Accident will print in the "Department or Location where Accident or Illness Exposure Occurred" field on the form.

Use this free-form area to add information about the risk that you want to include in the claim.

Property Damage of Others

Field/Group

What is this?

Property Information

Field	What is this?
Describe Property	Enter pertinent information about the property that was damaged.
Describe Damage	Enter information on the damage to the property.
Estimate Amount	Enter the estimate for the damage, if known.
Where can Property be seen?	Enter this information so the adjuster can see the damaged property.
When can Property be seen?

Other Insurance

Field/Option	What is this?
Other Vehicle or Property Insurance	Indicate whether or not other insurance exists to cover the damaged vehicle or property by selecting Yes or No.
Company or Agency Name	Enter the name of the other company or agency that insures the damaged vehicle or property.
Policy #	Enter the policy number that provides other or additional insurance for the damaged vehicle or property.

Owner of Property

Field	What is this?
Name	Enter the name of the property owner.
Address City State Zip Phones Email	Enter contact information for the owner, if available.

Other Driver Information

Field/Option	What is this?
Same as Owner	If the other driver is the same as the owner, check this box. You don't need to complete the other fields.
Name	If the other driver is not the same as the owner, enter the name and contact information of the vehicle driver.
Address City State Zip Phones Email

Injured Parties

You can enter multiple injured parties using this section. Click New, complete the information and then select Add to save the information to the grid. Names in the grid sort in alphabetical order.

Field

What is this?

Name

The name of the person injured.

Address
Phone Numbers
Email

The address and contact information of the person injured.

Personal Information

The Age and Sex of the person injured.

Automobile Loss Information

For auto claims select all that apply to this injured person:
Pedestrian
Insured Vehicle
Other Vehicle

Injury Information

Field/Option	What is this?
Extent of Injury	Briefly describe the injury. Example broken left leg
Fatality	Check if the injury resulted in death.
What was Injured doing?	Describe the actions of the injured person just prior to and at the time of the incident.
Where was Injured taken?	If the injured person was taken for medical attention, list the name of the facility.

Employment Information

Field	What is this?
Occupation	Enter a brief description of the injured person's occupation.
Employer Name Address Phone Numbers Email	Enter the name, address and contact information of the injured person's employer.

Contact Information

Use this section to collect contact information for individuals involved with the claim. Click New, complete the information and then select Add to save the information to the grid. Names in the grid sort in alphabetical order by type.

Field

What is this?

Contact Type

Select the Contact Type from the list. For more information on adding claims contact types, see List Setup.

If you select Driver, an additional field, Vehicle Driven, appears in this section. This is a hidden field for all other selections.

Name

Enter the contact name as you want it to appear on forms, correspondence, and reports, including capitalization and punctuation.

Address
Phone Numbers
Email

Enter the contact's address and contact information as you want it to appear on forms, correspondence, and reports, including capitalization and punctuation.

Where to Contact

Enter where to contact this person, if known.

When to Contact

Enter when to contact this person, if known.

Vehicle Driven

This field is hidden for all Contact Type selections except Driver. From the list, select the vehicle that the driver was driving at the time of the accident.

Witness Information

Indicate where the witness was located at the time of the incident. The options are:

Insured Vehicle
Other Vehicle

Specify Any Other Location - Write in the location.

Employment Information

Field	What is this?
Date Hired	Enter the date the contact was hired at their current job.
State of Hire	Select the two-digit abbreviation for the state where the contact is currently employed.
Employment Status	Indicate the current employment status of the contact.
Occupation	The primary occupation of the contact at the time of the accident or exposure.

Personal Information

Field	What is this?
Date of Birth	Enter the contact's date of birth, if known.
Marital Status	Select the marital status of the contact at the time of the accident or exposure.
SSN	Enter the contact's Social Security Number, if known.
Sex	Is the contact a Male or Female?
# of Dependents	Enter the number of dependents for the contact, if known.

Payments & Reserves

This section gathers and tracks claim payment and reserve information. The first section is Summary information and is display only. The following defines the amounts displayed in these fields.

Field	What is this?
Total Claim	The total of all Claim payments, Final payment, and Supplemental payments, minus Salvage amount, Subrogation amount, and Stop payment amounts entered.
Expenses	The total of all adjustment expenses entered.
Recoveries	The total of Salvage and Subrogation amounts entered.
Paid To Date	The total of all Claim payments, Supplemental payments, and the Final payment, minus all Stop payments entered.
Total Reserves	The total of all Loss reserve amounts entered.
Current Reserves	The Loss reserve amount minus the Total Claim amount.

Payment & Reserve Information

You can add multiple payments or reserve amounts.

Field

What is this?

Name

The Contacts entered for the claim appear in the list. Select the name to whom payment was made.

Phone #
Ext

This number fills if entered in the Contacts area of the claim.

Coverage

Select the coverage to which this payment applies.

Payments

Field

What is this?

Date

The date payment was made.

Payment Type

Select the type of payment made. For more on adding to the Payment Type list, see List Setup.

When Final Payment is selected the status of the claim is changed to Closed..

Paid By

Select who made the payment. For more on adding to the Paid By list, see List Setup.

Amount

The amount of the payment. Format is ###.##

Draft #

The check number used for payment.

Miscellaneous Information

Free form area to type any additional information that is pertinent to the claim payment.

Remarks

Use this area for general claim remarks. This information prints on overflow pages with the loss notice.

Field	What is this?
Remark	Text of the remark.

What's Next?

Do you need to create and print a loss notice? See Loss Notice and eForms Manager Print Options for more information.