Speed up claim payment approvals with built-in financial authority controls, protect claim budgets with automated reserve checks, and improve payouts by enforcing the policy terms defined for each insured asset or person.
Where: This change applies to Lightning Experience in Enterprise, Unlimited, and Developer editions with Digital Insurance.
- Protect Claim Budgets with Automated Reserve Checks at Payment Time
Set loss and expense reserves directly on each claim to establish a financial plan for the overall claim, alongside the reserves your adjusters already maintain on each claim coverage. At payment time, standard payments stay within the loss and expense limits you set at both the claim and coverage levels, and ex-gratia payments complete with a warning so your adjusters can handle exceptional cases. Supervisors can look up every reserve change with the amount and reason for each adjustment. After each payment, your adjusters see the remaining reserve at both the claim and coverage levels. - Streamline Claim Payment Approvals with Built-In Financial Authority Controls
Keep your claims team focused on adjudicating claims while high-value payments reach the right manager for approval automatically. Adjusters submit payments with instant visibility into whether each one falls within their authority and managers receive high-value approval requests directly in their queue. Your team no longer needs to track down approvers manually or wait on email chains for a high-value payment to clear. Claims get paid faster, compliance is maintained without extra effort, and every decision is on record. - Improve Claim Payouts by Enforcing Policy Terms for an Insured Asset or Person
When your adjusters determine claim payouts, automatically apply the policy terms defined for the insured asset or person involved in the claim incident. For example, if vehicles on a fleet policy each carry a different deductible, the payout for a claim on a vehicle reflects its deductible. If members on a medical policy each carry a different copay, the payout for a member accounts for their copay. Your adjusters can track exactly how each payout affects the limits for each asset or person. - New Connect REST APIs in Insurance Claims Management
Check whether the current user has sufficient financial authority to approve a claim coverage payment detail, and create or update a claim reserve limit. When the user’s limit is exceeded and a manager is available, the payment detail is submitted for approval. - Changed Connect REST API Request Bodies in Insurance Claims Management
Set loss and expense reserves when you create or update a claim, and control which pre-payment checks run when you pay or make an ex gratia payment for a claim coverage payment detail. - Changed Connect REST API Response Bodies in Insurance Claims Management
Retrieve the current loss and expense reserve amounts when you get claim details, get warnings when a claim coverage reserve exceeds the claim-level reserve, and retrieve financial authority details, remaining reserve amounts, and warnings after payment or an ex gratia payment. - New Connect in Apex Methods in Insurance Claims Management
Check whether the current user has sufficient financial authority to approve a claim coverage payment detail, and create or update a claim reserve limit, by using Connect in Apex methods. - Changed Connect in Apex Input Classes in Insurance Claims Management
Set loss and expense reserves when you create or update a claim, and control which pre-payment checks run when you pay or make an ex gratia payment for a claim coverage payment detail. - Changed Connect in Apex Output Classes in Insurance Claims Management
Retrieve the current loss and expense reserve amounts when you get a claim, get warnings when a claim coverage reserve exceeds the claim-level reserve, and retrieve financial authority details, remaining reserve amounts, and warnings after payment or an ex gratia payment. - New and Changed Invocable Actions in Insurance Claims Management
Check whether the user has sufficient financial authority to pay a payment detail record. Set loss and expense reserves when you create or update a claim, retrieve the current reserve amounts when you get a claim, and control pre-payment checks and retrieve remaining reserve amounts when you pay or make an ex gratia payment for a claim coverage payment detail, by using the updated standard invocable actions.