> ## Documentation Index
> Fetch the complete documentation index at: https://docs.bizaxl.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Claims
> Registering a claim against a policy and moving it through submission, review, approval, and settlement, including the claim type, amounts, documents, and who alerts whom.
A claim is a client's request to be paid the benefit their policy promises: on a death,
a maturity, a hospitalization, a surrender, or an accident. Insurance Advisor tracks each
claim against the policy it belongs to and carries it through a clear set of stages, from
the moment it is registered to the day it is settled. This page explains the claim
lifecycle, the fields you capture, and who does what.
## The claim lifecycle
A claim moves through a set of stages over its life. An advisor registers it and files
it; an admin reviews, approves, and settles it.
The claim has been logged against the policy. This is the starting point.
The claim and its documents have been submitted for the agency to act on.
The agency is assessing the claim and the supporting documents.
The claim has been accepted and is cleared for settlement.
The benefit has been paid out, with the settlement amount and date recorded.
The claim was declined. The reason is captured in the remarks.
When a claim is filed, the owning advisor and the agency admins get an in-app alert that
a claim has come in, and the client gets a confirmation that theirs was received. Nobody
has to remember to pass the message on.
## Field guide: the claim record
| Field | What to enter | Required? |
| ----------------- | ------------------------------------------------------------------------------------------- | --------- |
| Policy | The policy the claim is made against. | Yes |
| Customer | The policyholder making the claim. Filled from the policy. | No |
| Agent | The advisor who owns the policy and the claim. | No |
| Claim Type | Death, Maturity, Health, Surrender, or Accident. | Yes |
| Claim Amount | The amount being claimed. | Yes |
| Claim Date | When the claim is being made. | No |
| Incident Date | When the event behind the claim happened (the date of death, accident, or hospitalization). | No |
| Workflow State | Registered, Submitted, Under Review, Approved, Settled, or Rejected. | No |
| Settlement Amount | The amount actually paid out on settlement. | No |
| Settlement Date | When the claim was settled. | No |
| Claim Documents | The supporting files: death certificate, hospital bills, discharge summary, and the like. | No |
| Remarks | Notes on the claim, including the reason for a rejection. | No |
## Filing and settling a claim
Open the claim area, choose the policy, pick the claim type, and enter the amount and
the incident date. This creates the claim in the Registered stage.
Add the supporting documents the claim type calls for, then submit the claim. The
advisor and admins are alerted, and the client is told theirs was received.
An admin moves the claim to Under Review and assesses it against the policy and the
documents.
The admin approves a valid claim, or rejects it and records the reason in the remarks.
On an approved claim, the admin records the settlement amount and date and marks it
Settled. The benefit has been paid.
Register a claim against the correct policy and with the right claim type from the
start. The claim type (for example Death versus Maturity) shapes how it is assessed and
which documents are expected, so a mis-typed claim slows the whole review.
## Who does what
| Action | Responsible |
| ----------------------------------------- | ------------------------------ |
| Register a claim and attach documents | Advisor (for their own client) |
| Submit the claim for review | Advisor |
| Move the claim Under Review | Admin |
| Approve or reject the claim | Admin |
| Record the settlement and mark it Settled | Admin |
| See every advisor's claims | Admin |
## Dependencies
* **Before you can register a claim:** an issued policy must exist for the client. See
[Managing policies](./managing-policies).
* **What a claim needs:** the claim type, the amount, and the supporting documents for
the review to proceed.
* **What a claim feeds:** a settled claim records the amount paid against the policy, and
the alerts keep the advisor, the admins, and the client in step throughout.
## Best practices
* **Log the incident date, not just the claim date.** The date of the event behind the
claim matters for the assessment, so capture it alongside the date you are filing.
* **Attach documents up front.** A claim with its paperwork already attached moves through
review faster than one that has to be chased for documents.
* **Record the settlement in full.** Enter the settlement amount and date when you settle,
so the claim history is complete and reconcilable later.
* **Use the remarks on a rejection.** A rejected claim should always carry the reason, so
the client and the advisor understand the outcome.