Claims

To navigate to the claims tab, click HOME > CLAIMS. The claims tab serves as a way to keep track of all policies with an open claim. Closed claims may be displayed as desired by using the filters at the top of the page. Open claims will display by default until the claim is closed. For information on generating a new claim, see Servicing > Claims.

Note: A maximum of 2000 records can be returned in a search.

Policies that are restricted are displayed only if the person logged on is assigned to them. All other non-restricted policies are displayed and can be searched for by all staff members. There are several options when working with policies on the claims tab. Notice the options at the top of the claims tab and the active icons within the tab.

The following options are available when working on the claims tab: 

• Branch: The Branch  list box in the upper left can be used to select a branch, this will narrow the search results. Once a branch is selected, claims tied to the selected branch are displayed.
• Showing Page: The Arrow   icons can be used to navigate through pages of search results.
• First Page  icon.
• Previous Page icon.
• Next Page icon.
• Last Page icon.
• Page List: Click the Page List  arrow to open a list of all search results pages. Select the desired page number to open that page of search results.
• Export: Click [Export] to generate a Microsoft® Excel® spreadsheet from the claims displayed on the screen. Exporting to Excel can help to manage large amounts of records that can be returned by using Excel's search, sort, and print capabilities. A maximum of 5000 records can be exported.
• Search Filters: Click [Show] or [Hide] to toggle the Search Filters screen.

The options available on the Search Filters screen are: 

• Save Filter Settings: Selecting the Save Filter Settings check box on the Search Filters screen and clicking Search will change the default Search Filter setting. The next time the claims tab is opened, the policies returned will be filtered by the saved setting. Exercise caution when using the Save Filter Settings check box with a date range as returned policies will be restricted to that date range. As a general rule, check the filter settings each time this tab is accessed.
• Client Name: Enter the name of a client to return results that include all policies with claims for a particular client. Enter at least two characters to narrow the search results. Entering some of the Client Name returns a broader result, enter most of the name for more specific results.
• Client Type: There are two client types in Nexsure: Commercial and Personal. The search can be narrowed to make the results returned specific to a commercial or personal client.
• Claim Status: Select either Open or Closed.
• Bill Method: Select the Bill Method that is used for the policy. The available selections are:
• All
• Agency Bill
• Direct Bill
• Adjustor: Enter all or part of the name of the adjustor. Enter at least two characters to narrow the search results. Entering some of the Adjustor Name returns a broader result, enter most of the Adjustor Name for more specific results.
• Claimant: Enter the name of the claimant to return results that include all policies for that claimant. Enter at least two characters to narrow the search results. Entering some of the Claimant name returns a broader result, enter most of the name for more specific results.
• Eff. Date (Fr): Click the Calendar icon to select the beginning date in a date range. A date range can be selected to return policies with term effective dates in the date range. Click the Variable icon and enter a variable number of days to set a continuous date range to be used with Save Filter Settings. Enter + or - and the number of days up to three digits. The date will then be + (after) or - (before) the current date. Policy term effective dates can be created three ways:
• If an opportunity was created and sent to marketing, the policy term effective date will default to the X/BOR Date of the opportunity.
• If a marketing submission was created clicking SERVICING on the Client menu, the policy term effective date will default to the Eff. Date entered on the servicing tab.
• If a marketing submission was created by clicking MARKETING on the Client menu, the policy effective date will default to the current date.
• Exp. Date (Fr): Click the Calendar icon to select the beginning date in a date range. A date range can be selected to return all policies with term expiration dates in the date range. Click the Variable icon and enter a variable number of days to set a continuous date range to be used with Save Filter Settings. Enter + or - and the number of days up to three digits. The date will then be + (after) or - (before) the current date.
• Issuing Carrier: An Issuing Carrier is the company that issues the policy. Enter at least two characters to narrow the search results. Entering some of the Issuing Carrier name returns a broader result, enter most of the Issuing Carrier name for more specific results.
• Date of Loss (Fr): Enter the Date of Loss. Click the Calendar icon to select the beginning date in a date range. A date range can be selected to return all policies with term expiration dates in the date range. The Date of Loss was first entered on the servicing tab when the claim was opened. The Date of Loss can also be found on the POLICIES > claims tab. Click the Variable icon and enter a variable number of days to set a continuous date range to be used with Save Filter Settings. Enter + or - and the number of days up to three digits. The date will then be + (after) or - (before) the current date.
• Claim Stage: Select the stage of the claim. The stages are set up by each organization in Lookup Management > Policy > Claim Stages.
• Clmnt Contact First Name: Enter the first name of the claimant contact to search. Enter at least two characters to narrow the search results. Entering some of the first name returns broader results, enter most of the first name for more specific results.
• Eff. Date (To): Click the Calendar icon to select the ending date in a date range. A date range can be selected to return all policies with term effective dates in the date range. Click the Variable icon and enter a variable number of days to set a continuous date range to be used with Save Filter Settings. Enter + or - and the number of days up to three digits. The date will then be + (after) or - (before) the current date.
• Exp. Date (To): Click the Calendar icon to select the ending date in a date range. A date range can be selected to return all policies with term expiration dates in the date range. Click the Variable icon and enter a variable number of days to set a continuous date range to be used with Save Filter Settings. Enter + or - and the number of days up to three digits. The date will then be + (after) or - (before) the current date.
• LOB: Enter the line of business for the policy. Enter at least two characters to narrow the search results. Entering some of the line of business title returns broader results, enter most of the line of business for more specific results.
• Date of Loss (To): Enter the Date of Loss. Click the Calendar icon to select the ending date in a date range. A date range can be selected to return all policies with term effective dates in the date range. The Date of Loss was first entered on the servicing tab when the claim was opened. The Date of Loss can also be found on the POLICIES > claims tab. Click the Variable icon and enter a variable number of days to set a continuous date range to be used with Save Filter Settings. Enter + or - and the number of days up to three digits. The date will then be + (after) or - (before) the current date.
• Claim Number: Enter some or all of the claim number. Enter at least two characters to narrow the search results. Entering some of the Claim Number returns a broader result, enter most of the Claim Number for more specific results.

• Clmnt Contact Last Name: Enter the last name of the claimant contact to search. Enter at least two characters to narrow the search results. Entering some of the last name returns broader results, enter most of the last name for more specific results.

• Assignment: Enter the name of the person to whom the policy has been assigned. Enter at least two characters to narrow the search results. Entering some of the Assignment name returns a broader result, enter most or full first and last names for more specific results.
• Responsibility: Enter the name of the person with primary responsibility for the policy. Enter at least one character to narrow the search results. Entering some of the Responsibility name returns a broader result, enter most or full first and last names for more specific results.
• Updated By: Enter the name of the person that last updated the policy. Enter at least two characters to narrow the search results. Entering some of the Updated By name returns a broader result, enter most or full first and last names for more specific results. 
• Retail Agent: Retail agents are outside producers that broker business through another agency because they do not have a market. Enter at least one character to narrow the search results. Entering some of the Retail Agent name returns a broader result, enter most of the Retail Agent name for more specific results.
• Sort Filters: Use the Sort Filters to sort the results of the claims search. 

The options available on the Sort Filters screen are:

• Sort Field 1: Select a column heading from the Sort Field 1 list. The search results will be sorted by the column selected in the Sort Field 1 list. The available selections are:

• Sort Order 1: Select either Ascending or Descending to set the order of the policies returned. Ascending will set the order from A-Z. Descending will set the order from Z-A. The Sort Field 1 will be the first sort and Sort Field 2 will be the sub sort. 
• Sort Field 2: Select a column heading from the Sort Field 2 list. The search results will be sorted by the column selected in the Sort Field 2 list. The available selections are:

• Sort Order 2: Select either Ascending or Descending to set the order of the policies returned. Ascending will set the order from A-Z. Descending will set the order from Z-A. The Sort Field 1 will be the first sort and Sort Field 2 will be the sub sort. 
• Clear: Click Clear to remove all entries in the Search Filter and Sort Filters fields.

Important: Clicking Clear does not remove the Save Filter Settings selection. 

• Search: Click Search. The results of the Search Filter criteria and Sort Filter settings are displayed. A maximum of 2000 records can be returned in the search results.

The following columns are displayed in the claims search results: 

• Details: There are two types of Details icons that will each give access to different information:
• The blue Client Details icon beside the entity name will display the client profile tab. Right-clicking the Client Details  icon will display the following navigation options:
• Open: Opens the client card file tab. Opens the Add New Opportunity dialog box to choose a line of business.
• Add New Opportunity: Opens the Add New Opportunity dialog box to choose one or more line of business.
• Market New Line of Business: Adds a marketing record with the expiration date of the existing policy as the effective date of the marketing submission and brings up the Add Line of Business screen.
• The Policy Details icon will display the underwriting tab for that policy. Right-clicking the Policy Details icon will display the following navigation options: 
• Open: Opens the claim details tab.
• Market Existing: Copies the forms and adds to marketing with the expiration date of the submission as the effective date to create a new marketing submission.
• Print: Click this link to print the forms associated with the policy.
• Service: Opens the servicing tab allowing a service option to be selected while maintaining this policy as the policy being serviced.
• Assign: Click the Assign icon to display the Assignment List dialog box with the list of people in the agency assigned to this policy. The Assignment List is populated from the assignment tab. 

• Retail Agent: If a Retail Agent is associated with the client, the Retail Agent icon will be displayed. Click the Retail Agent icon to open the Retail Agent > card file tab.
• Action Description: The Action Description is displayed.

• Action Items: Click the Action Items  icon to display the Action Items dialog box. The action can then be modified or updated. 

• Client Name: The client's name will be displayed as the primary named insured. The client's name displays once regardless of the number of expiring policies.
• Line of Business: The claim Line of Business will be displayed. The LOB selected on SERVICING will be the claim LOB displayed. The line of business is identified on the underwriting tab. Holding the cursor over the Line of Business will display the information in a larger font for ease of reading. Clicking the item in the summary view will open a display box containing the selected information.
• Claim Number: The Claim Number is displayed. Holding the cursor over the Claim Number will display the information in a larger font for ease of reading. Clicking the item in the summary view will open a display box containing the selected information.
• Date of Loss:  Identifies the day the loss occurred.
• Claim Status: Reflected as either Open or Closed. The Claim Status is assigned on the policy claims > details tab.
• Mode: The policy Mode is displayed. All possible mode types are:
• New
• Renew
• Re-New-Co
• Claim Stage: Displays the claim stage selection from the claims > details tab.
• Taken By:  Displays the employee who entered the claim information. The employee is identified at logon.
• Updated By: Enter the name of the person that last updated the policy. Enter at least one character to narrow the search results. Entering some of the Updated By name returns a broader result, enter most or full first and last names for more specific results.
• Claimant: The Claimant icon is displayed if there is any claimant information. Click the Claimant icon to open a schedule of the claimant names and phone numbers.

• Paid Amount:  Amount paid out for the claim.  This amount is entered on the policy claims > details tab.
• Reserve Amount:  Reserve amount for the claim.  This amount is entered on the policy claims > details tab.
• Policy Term: Populated from the effective and expiration date fields on the underwriting tab.
• Issuing Carrier: An Issuing Carrier is the company that issues the policy. The Issuing Carrier is identified on the underwriting tab in the policy header.
• Adjustor: The Adjustor name displays only if entered on the policy claims > details tab.

Related Topics

Claims Details