Insurance Policy

Central record of the insurance lifecycle. The Insurance Policy is the official contract between the insurance company and the policyholder. All premium payments and claims are linked to it.

Comes after: Policy Proposal (approved) Leads to: Once approved and confirmed, the system automatically creates the Insurance Premium Schedule.

Overview

An Insurance Policy is the formal, active insurance contract. It records who is covered, what they are covered for, how much it costs, and for how long. Before a policy can become active, it goes through a verification process - called KYC (Know Your Customer) - where the team checks the applicant’s identity and documents. This involves three different teams, each handling one step of the review. Once the policy is fully approved and confirmed, the system automatically sets up the payment schedule so premiums can be collected.

Who Uses This Feature

Role	What They Do
Customer Service Team	Creates the policy, starts the KYC process, and moves it to the document review stage
Insurance Billing Specialist	Reviews and completes the KYC verification - checks documents, confirms identity details
Insurance Manager	Gives final approval for the policy to become active; can also reject at any stage
HR Team / HR Manager	Can view policies linked to employees (read only)
Employees	Can view their own policy (read only)

Before You Start

Before you create an Insurance Policy, make sure the following already exist:

An approved Policy Proposal - the policy is normally created by converting an approved proposal. You can also create one directly, but the proposal must have been reviewed first.
An Insurance Product - the product defining coverage rules, premium rates, and terms
The policyholder - either a Customer or an Employee record must already exist
Supporting documents - identity proof, address proof, and any medical documents required by the insurer

How to Create an Insurance Policy

Convert from an approved proposal (recommended)

The easiest way to create a policy is directly from an approved Policy Proposal.Open the approved proposal, tick the Create Insurance Policy checkbox, and save. The system creates a new Insurance Policy pre-filled with all the applicant’s details from the proposal.Alternatively, you can create a policy from scratch by going to the Insurance Management workspace → Insurance Policy → New.

New Insurance Policy form pre-filled from a Policy Proposal, showing the linked proposal number

Confirm the policyholder details

Verify that the following details are correct - especially if you did not convert from a proposal:

Policyholder Type - Customer or Employee
Policyholder - the specific person being insured
First Name, Last Name
Date of Birth and Age
Email Address and Phone Number

Insurance Policy form showing policyholder type, name, date of birth, age, and contact details

Confirm the insurance details

Review or fill in:

Insurance Company - the provider
Proposal Date - date of the original application
Insurance Product - the plan being issued
Coverage Amount - the sum insured
Policy Duration - how long the policy runs
Premium Calculation Mode - Monthly, Quarterly, or Yearly
Premium Amount, Total Premium, and Total Premium for Policy Term - calculated automatically

Insurance details section showing product, coverage amount, premium mode, and calculated totals

Fill in the address

Confirm or enter the policyholder’s full residential address. This is used for official correspondence and records.

Add insured members (for group or family policies)

If the policy covers more than one person, go to the Members tab and add each covered member:

Member Type - Employee or Family
Name - select from the employee list or enter the name
Relationship - Self, Spouse, Child, or Parent
Date of Birth and Age
Status - Active or Closed

Members tab showing a table of insured members with relationship, date of birth, and status columns

Add nominees

In the Nominee section, record who should receive the benefit if the policyholder passes away:

Nominee Name
Phone Number
Age
Nominee Applicant (if they are already in the system)

Nominee section showing fields for nominee name, phone number, age, and applicant link

Upload all required documents

Go to the Documents tab and attach the required files - ID proof, address proof, photographs, and any medical records needed for underwriting.

Documents tab showing rows for document type, file upload, and image attachment

Save the policy

Click Save. The policy is now in Draft status. It is not yet active and cannot collect premiums until it completes the approval process.

Field Guide

Field	Purpose
Policyholder Type	Whether the insured person is a Customer (external) or an Employee (staff member)
Policyholder	The specific person the policy is issued to
First Name / Last Name	Legal name of the insured person
Date of Birth	Used for age verification and premium eligibility
Age	Current age - must match the date of birth
Email Address	Where policy documents and notifications are sent
Phone Number	Contact number for the policyholder
Insurance Company	The provider issuing this policy
Proposal Date	The date the original application was made
Policy Proposal	Link to the proposal this policy was created from
Insurance Product	The plan type - determines what is covered and at what rate
Coverage Amount	The maximum amount the policy will pay out
Policy Status	Whether the policy is Active, Lapsed, or Closed
Premium Calculation Mode	How often premiums are due: Monthly, Quarterly, or Yearly
Premium Amount	The amount due each payment cycle - auto-calculated
Total Premium	Total annual premium - auto-calculated
Total Premium (Policy Term)	Grand total payable over the full policy life - auto-calculated
Policy Duration	How long the policy runs from start to end
Members	List of all people covered under this policy
Nominees	Who receives the benefit in the event of the policyholder’s death
Documents	Identity, address, medical, and other supporting documents

Workflow Journey

This policy goes through a four-stage verification process before it becomes active.

Stage	What It Means	Who Acts
Draft	The policy has been saved but not yet reviewed	Customer Service Team
Initiated	The Customer Service team has opened the review process	Customer Service Team clicks Initiate
KYC Pending	Documents have been sent to the Billing Specialist for identity verification	Customer Service Team clicks Review
KYC Complete	The Billing Specialist has verified all documents and confirmed the applicant’s identity	Insurance Billing Specialist clicks Complete KYC
Approved	The Insurance Manager has given final sign-off. The policy is now active.	Insurance Manager clicks Approve
Rejected	The policy has been declined at one of the review stages	Customer Service, Billing Specialist, or Insurance Manager clicks Reject

Insurance Policy status bar showing the stages: Draft, Initiated, KYC Pending, KYC Complete, Approved

What Happens Next

Once the Insurance Manager approves the policy and you confirm it by clicking Submit:

The Policy Status changes to Active
The system automatically creates an Insurance Premium Schedule - a complete table of all monthly payment instalments for the entire policy duration
A notification is sent to the policyholder confirming that their policy has been issued
The policy is now ready to collect premiums and accept claims

If the policy is Rejected, the process ends. The applicant can submit a new proposal with corrected information if they wish to reapply.

Automatic Actions

Premium Schedule is created automatically on approval

As soon as the policy is approved and submitted, the system automatically creates a full Insurance Premium Schedule. This schedule lists every instalment due from the start date to the end of the policy - you do not need to create it manually.The system also checks whether a schedule already exists for this policy, so you will never get duplicate schedules by accident.

Notification sent to policyholder on submission

When the policy is submitted, the system automatically sends a notification to the policyholder confirming that their policy has been created. This happens without any manual action from the team.

Premium amounts are calculated automatically

When you select the Insurance Product, Coverage Amount, and Policy Duration, the system calculates all premium figures (amount per period, annual total, full-term total) based on the product’s rate tables. You do not need to calculate these yourself.

Best Practices

Do

Always start from an approved Policy Proposal - this pre-fills the form and avoids data entry errors
Complete all document uploads before initiating KYC - the Billing Specialist cannot verify identity without them
Verify the date of birth carefully - an incorrect date of birth affects the premium calculation and could invalidate the policy
Add all members before submitting - members cannot be added easily after the policy is approved
Check the nominee details - nominees protect the policyholder’s family; missing or incorrect details can delay claims later

Don’t

Don’t initiate KYC before documents are uploaded - this creates unnecessary back-and-forth between teams
Don’t approve a policy with incomplete or mismatched details - corrections after approval are difficult and may require cancellation
Don’t create a policy directly without a proposal unless instructed by your manager - the proposal approval is an important control step
Don’t confuse Policy Status (Active/Lapsed/Closed) with the workflow stage - Status reflects whether the policy is currently in force; the workflow tracks the approval process

Common Mistakes & Troubleshooting

If the Initiate button does not appear, the policy may still be in Draft. Make sure the policy has been saved before trying to start the workflow. If you still cannot see the button, check with your administrator that your account has the Customer Service role.

If you cannot complete the KYC step, your account needs the Insurance Billing Specialist role. The Customer Service team hands the policy off at this stage - they cannot complete KYC themselves.

If the Insurance Product you need is not in the list, it has not been configured yet. Ask your Insurance Manager to set it up under Insurance Management → Masters → Insurance Product before proceeding.

Once a policy is Approved and Submitted, it is locked. The premium schedule will be created automatically. If you notice an error after this point, contact your Insurance Manager immediately - corrections at this stage require cancellation and re-issuance.

If the premium schedule does not appear after approval, wait a moment and refresh the page. The system creates it automatically in the background. If it still does not appear after a few minutes, contact your administrator.

Workspace Access

You reach Insurance Policy through the Insurance Management workspace. Path: Insurance Management workspace → Insurance Management card group → Insurance Policy

Insurance Management workspace with the Insurance Management card group highlighted, showing the Insurance Policy link

The visual workflow pipeline on the workspace shows Insurance Policy as the third step in the Insurance Process lane (after Insurance Product and Policy Proposal), and as the first step in the Employee Insurance lane - a reminder that both external and employee insurance journeys go through this record.

Number Cards - What to Watch

Three number cards on the workspace relate directly to Insurance Policies:

Approved Policies

What it shows: Total policies that have completed all approvals and are fully active. Who should act: Insurance Manager (oversight); Billing Specialist (confirm premium schedule exists). What to do: After a new policy is approved, confirm within a day that its Premium Schedule has been created automatically. If the count here grows but no schedules appear, something went wrong with the automatic creation - alert your administrator.

Policies in KYC Pending

What it shows: How many policies are waiting for the Billing Specialist to verify the applicant’s identity and documents. Who should act: Insurance Billing Specialist - immediately. What to do: Open each pending policy, review the documents, and click Complete KYC. A high number here means applicants are waiting. This is the most action-sensitive card on the workspace.

Click the Policies in KYC Pending card to jump directly to the list of policies waiting for your attention.

Rejected Policies

What it shows: Total policies that were declined at any stage of the KYC review. Who should act: Insurance Manager (for patterns); Customer Service Team (to inform applicants). What to do: Review rejected policies periodically. If the same reason appears repeatedly (consistently missing documents, ineligible age, wrong product), update the intake guidance to prevent the same issue recurring.

Monitoring Without Reports

There are no dedicated reports for Insurance Policies. Use the list view with filters to track your work queue:

What You Want to See	Filter To Apply
Policies waiting to be initiated	Workflow State = Draft
Policies in the KYC review stage	Workflow State = KYC Pending
All fully approved policies	Workflow State = Approved
Policies for a specific insurance company	Insurance Company = [company name]
Policies issued this month	Proposal Date = This Month
Lapsed policies	Policy Status = Lapsed

Notifications & Alerts

Policy Confirmation Email - Sent to Policyholder Automatically

When it fires: The moment the Insurance Policy is approved and submitted. Who receives it: The policyholder - sent to the email address recorded on the policy. What the email contains:

Applicant name, contact details, and date of birth
Insurance company and product
Proposal date, policy start date, and policy status
Coverage amount (sum assured)
Premium payment mode, premium amount, total premium, and policy duration
Registered address

What you need to do: Nothing - the email goes out automatically. If a policyholder reports not receiving it, check that their email address on the policy is correctly filled in.

The confirmation email uses the policyholder’s email address from the policy form. If the email address field is empty, no email will be sent. Always ensure the email is entered before submitting the policy.

Print Formats - Printing Policy Documents

Two print templates are available for Insurance Policies, accessible from the policy record’s Print button:

Insurance Policy (Card Format)

A compact, professional summary of the policy - suitable for handing to the policyholder as their policy card. Includes key details: policy number, insured name, product, coverage amount, premium, and validity period. When to use: When the policyholder needs a physical or digital copy of their policy details for their records.

Policy Terms

A full-format document showing the complete policy terms and conditions. Suitable for formal correspondence, legal record-keeping, or when the insurer requires a signed copy. When to use: When the policyholder needs the full terms for review, when a signed copy is required, or when creating formal policy documentation.

To print either format, open the policy record, click the Print button (top right), and select the format from the dropdown. You can preview before printing or download as a PDF.

Insurance Policy record showing the Print button and dropdown with Insurance Policy and policy terms format options

Policy Proposal - the application that must be approved before a policy is created
Insurance Premium Schedule - the payment schedule created automatically when this policy is approved
Insurance Claim - how policyholders make a claim against this active policy

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