> ## 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.
# Insurance Policy
> Issue a formal insurance policy after a proposal is approved, complete the KYC verification process, and activate coverage for the policyholder.
**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](./policy-proposal) (approved)
**Leads to:** Once approved and confirmed, the system automatically creates the [Insurance Premium Schedule](./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
The easiest way to create a policy is directly from an approved [Policy Proposal](./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**.
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**
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
Confirm or enter the policyholder's full residential address. This is used for official correspondence and records.
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
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)
Go to the **Documents** tab and attach the required files - ID proof, address proof, photographs, and any medical records needed for underwriting.
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.
```mermaid theme={null}
%%{init: {'theme':'base','themeVariables':{'fontFamily':'DM Sans','primaryColor':'#e7fdf6','primaryBorderColor':'#14f1b1','primaryTextColor':'#0f172a','lineColor':'#14f1b1'}}}%%
flowchart TD
A[Draft] -->|Initiate| B[Initiated]
B -->|Review| C[KYC Pending]
C -->|Complete KYC| D[KYC Complete]
D -->|Approve| E[Approved
Policy Active]
B -->|Reject| F[Rejected]
C -->|Reject| F
D -->|Reject| F
```
| 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** |
***
## 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](./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
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.
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.
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**
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.
***
## Related Features
* [Policy Proposal](./policy-proposal) - the application that must be approved before a policy is created
* [Insurance Premium Schedule](./insurance-premium-schedule) - the payment schedule created automatically when this policy is approved
* [Insurance Claim](./insurance-claim) - how policyholders make a claim against this active policy