Claims

This feature, or some fields and options described, might not be available depending on your settings, security rights, or platform package.

Claims

Use this feature to create a Claimrecord 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.

Accessing the Claim Data Entry Form

You can access the Claim data entry form from several locations by doing one of the following:

From the Customer Center menu, click Actions>New Claim.
From the PolicyorLine of Business data entry forms menu, click Operation>Claim.
Click the Claims icon from the toolbar, when available.

The Claim Menu and Toolbar

The Claim Menu

File

Menu Option	Icon	Function
Save		Saves the information you have entered on the data entry form without closing the form.
Save & Close		Saves the information you have entered on the data entry form and closes the form.
Sign Off & Close		When accessed from the File menu of a form, Sign Off & Close completely closes AMS360 (all centers and forms) and stops AMS360 Client.
Close		Closes the data entry form without saving the information you have entered.
Delete		Use to delete a claim.

Section

Menu Option	Function
List of Sections	The first portion of the list is the sections of the Claims data entry form such as: Basic Claim Information, Property Damage to Others, Injured Parties, etc. Click the name to go to that section.
Next Section	Use to move to the section following the one you are in.
Previous Section	Use to move to the section before the one you are in.
Top of Form	Use to move to the first section, first field in the form.
Bottom of Form	Use to move to the last section, last field in the form.
Expand All	Use to open all sections of the data entry form at once.
Collapse All	Use to close all sections of the data entry form at once.
Explorer	Use to open the Section Explorer in a frame on the data entry form. Exploreris a similar format to Windows Explorer, and can be used to quickly move between sections.
Switch Explorer/Winform	Once the Explorer is open, Switch Explorer/Winform changes the focus of your cursor from the explorer to the form and vise/versa. Keyboarding: This feature enhances keyboarding. If your current focus is in the form and you want to switch sections, you can Alt +S and X to open the Explorer, arrow to the section you want to open and Alt +S and S which returns focus to the form and opens the desired section.

Operation

Menu Option	Icon	Submenu Options	Uses
Activity		New	Opens the Activity data entry form so you can enter a new activity.
Activity		View	Opens View Activity and lists activities for the open customer and policy for the past 30 days.
Contacts			Opens the Contacts feature.
DocManagement		Check Out Status	Launches the Doc360 Check Out Status form. Use Doc360 Check Out Status to keep track of the documents that are checked out under your name, or under anyone else's name for whom you are authorized. This form provides you with the option to cancel editing (Undo check-out) for one or multiple documents by checking the document(s) back in without changes.
		Distribute Documents	Launches the Document Distribution form. Use the Document Distribution form to distribute electronic files to other employees in your agency. You can enter additional information about the document file before you send it, including comments, system center assignment, and searchable index keywords. You can also select the document's security classification.
		Find Documents	Launches the Doc360 Search form. You can search for a specific Doc360 document in AMS360 using the Doc360 Search form. This form provides many selection criteria to help you narrow your search.
		Get Documents	Launches the Get Documents form. In the front-end scanning workflow, the Get Documents feature is a means by which agency employees import electronic files into AMS360.
		Match Pending Attachments	Launches the Doc360 Match Pending Attachments form. If your agency utilizes the back-end Scanning workflow, then the Doc360 Match Pending Attachments form plays the essential role of attaching scanned files to their proper placeholders in the system.
Form Letters			Initiates the Form Letters data entry form.
Notes		New	Opens the Notes data entry form so you can enter a new note.
Notes		View	Opens View Notes for the open customer.
Suspense		New	Opens the Suspense data entry form so you can enter a new suspense.
Suspense		View	Opens View Suspense and lists suspense items for the customer and policy that are not complete and due within 30 days.
Reports			Launches the Reports - All selection form where you can select to create reports.
eForms Manager			Launches the eForms Manager where you can create, edit, view, print, or delete applications, electronic laser forms, loss notices, and supporting forms.

Toolbox

Help

Menu Option	Function
Context	Displays help for the active data entry form or center.
Search	Search for the Helpyou need by typing in a keyword and pressingOK.
Help Center	Displays the AMS360Help Center that contains system news and links to other resources.
Keyboard Shortcuts	Displays the Keyboard Shortcuts for AMS360 Help topic to learn more about how to use keyboard shortcuts in AMS360.
Email Event Logs	Opens the Email Event Logs form. Enter the Email Address where you want to send the event log, select the Event Log(s) you want to send, and click OK.
About	Shows you the current version information for AMS360.

The Claim Toolbar

Icon

Feature

Uses

Save

Saves the currently entered data.

Save & Close

Saves the currently entered data and closes the Claims data entry form.

Form Letters

Initiates the Form Letters data entry form.

Contacts

Opens the Contacts feature.

Activity

Opens the Activity data entry form so you can enter a new activity.

Suspense

Opens the Suspense data entry form so you can enter a new suspense.

Notes

Opens the Notes data entry form so you can enter a new note.

Doc
Management

Doc 360 Selection	What is this?
Check Out Status	Launches the Doc360 Check Out Status form. Use Doc360 Check Out Status to keep track of the documents that are checked out under your name, or under anyone else's name for whom you are authorized. This form provides you with the option to cancel editing (Undo check-out) for one or multiple documents by checking the document(s) back in without changes.
Distribute Documents	Launches the Document Distribution form. Use the Document Distribution form to distribute electronic files to other employees in your agency. You can enter additional information about the document file before you send it, including comments, system center assignment, and searchable index keywords. You can also select the document's security classification.
Find Documents	Launches the Doc360 Search form. You can search for a specific Doc360 document in AMS360 using the Doc360 Search form. This form provides many selection criteria to help you narrow your search.
Get Documents	Launches the Get Documents form. In the front-end scanning workflow, the Get Documents feature is a means by which agency employees import electronic files into AMS360.
Match Pending Attachments	Launches the Doc360 Match Pending Attachments form. If your agency utilizes the back-end Scanning workflow, then the Doc360 Match Pending Attachments form plays the essential role of attaching scanned files to their proper placeholders in the system.

eForms Manager

Launches the eForms Manager where you can create, edit, view, print, or delete applications, electronic laser forms, loss notices, and supporting forms.

Launch Customer Center

Opens Customer Search so you can search for and open another customer.

Reports

Launches the Reports - All selection form where you can select to print reports.

Claim Data Entry Form Sections

Basic Claim Information

Field/Group Name

What is this?

Claim #

Enter the claim number here, if known.

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

Describe the details of the loss.

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 Refresh 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 Refresh.

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 it here. 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.

Additional Risk Information

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 AgeandSexof 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 Summaryinformation 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 Paymentis selected the status of the claim is changed toClosed.
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

What's Next?

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