Claims

Claims

Accounting overview

In the Accounting screen, you can set and manage reserves, view losses incurred, view the recovery history, and add transactions. If you are using tabbed navigation, you will find Accounting on the third tab. If you are using the claim menu, Accounting will appear as the third option. To access the Accounting screen, access a claim, and select Accounting from the claim menu.

 

Figure 1: The Accounting screen with a view of the collapsible boxes.

Overview section

 

Figure 2: View of the Overview section.
  1. Transaction Date – The Transaction Date boxes display the current date by default. If you change the Transaction Date boxes and update the reserves in the Overview box, the reserve changes will post with the updated transaction date.
  2. Summary – The Summary displays a high-level overview of the accounting screen, including total loss incurred, remaining reserves, and losses paid. The Summary automatically updates as reserves are set and transactions are entered.
    1. Total Incurred – This figure includes Reserve and Paid to Date for Loss, Adjusting, and Legal. This doesn’t include the Recovery Reserve or Received to Date for Subrogation, Salvage, or Reinsurance.
    2. Loss – This is the abbreviation of Loss Incurred and is simply a total of Reserve and Paid to Date for Loss. This figure is used to calculate User Financial Authority Limits.
    3. Expense – This is a combination of Legal and Adjusting Reserve and Paid to Date. This figure is also used to calculate User Financial Authority Limits.
    4. Remaining Reserve – This is the total amount of reserve available across Loss, Adjusting, and Legal.
    5. Losses Paid – This is a total of all payments, including Loss, Adjusting, and Legal.
  3. Coverage table – The Coverage table will appear for each coverage added to a claim. For each coverage, the table provides a snapshot of the reserves set as well as the amount paid to date toward the claim. When you set reserves for coverages, take into account the expected amount of unpaid losses as well as loss adjustment expenses, as outlined in the Statutory Issue Paper, No. 55: Upaid Claims, Losses, and Loss Adjustment Expenses.
    1. Override Deductible – The Override Deductible checkbox allows you to override the amount of deductible paid toward the claim.
    2. Loss – The Loss box in the Reserves column provides a space to set the reserve limit for the loss incurred for the specific coverage. The number entered for the reserve immediately updates the reserve. If Financial Authority Limit rules are configured, they will be triggered as soon as the user removes their focus from this box.
    3. Adjusting – The Adjusting box in the Reserves column provides a space to set the reserve limit for the cost of managing the claim for the specific coverage. The number entered for the reserve immediately updates the reserve. If Financial Authority Limit rules are configured, they will be triggered as soon as the user removes their focus from this box.
    4. Legal – The Legal box in the Reserves column provides a space to set the reserve limit for legal costs in the event of a lawsuit for the specific coverage. The number entered for the reserve immediately updates the reserve. If Financial Authority Limit rules are configured, they will be triggered as soon as the user removes their focus from this cell.
  4. Recovery table – The Recovery table provides a snapshot of the recovery reserve set for the expected recovery amount as well as the amount recovered to date for the claim.
    1. Reinsurance – The Reinsurance box in the Reserves column shows the value expected to be recouped from the loss due to reinsurance. Although Reinsurance Recovery Reserves and Received to Date aren’t included in the Summary total, they will be included in the figures for statutory reporting.
    2. Subrogation – The Subrogation box in the Reserves column shows the value expected to be recouped from the loss due to a third party’s fiduciary responsibility. Although Subrogation Recovery Reserves and Received to Date aren’t included in the Summary total, they will be included in the figures for statutory reporting.
    3. Salvage – The Salvage box in the Reserves column shows the value expected to be recouped from the loss due to undamaged materials being sold. Although Salvage Recovery Reserves and Received to Date aren’t included in the Summary total, they will be included in the figures for statutory reporting.

Losses Incurred section

 

Figure 3: View of the Losses Incurred section.
  1. Losses Incurred table – The Losses Incurred table displays an itemized list of the reserves and transactions entered that impact the total amount of losses incurred.
  2. Gray arrow – The gray arrow next to each line item opens a detailed report of the transaction that occurred.

Recovery History section

 

Figure 4: View of the Recovery History fields.
  1. Recovery History table – The Recovery History table displays an itemized list of the set recovery reserves and recouped recovery amounts that impact the Total Reserves.
  2. Gray arrow – The gray arrow next to each line item opens a detailed report of the reserve amount, the amount received, the change in reserve, and the change in amount received.

Transactions fields

 

Figure 5: View of the Transactions fields.
  1. Payments table – The Payments table is an itemized list of claim payments made.
  2. Gray arrow – The gray arrow opens a detailed report of the payment entered into the system.
  3. Red X – The red X gives you the option to void a payment in the Payments table. In the Recoveries table, it gives you the option to delete a recovery transaction.
  4. + Add an Entry – The + Add an Entry button opens the Payment dialog box, where you can add a payment.
  5. Recoveries table – The Recoveries table is an itemized list of recovery transactions made on behalf of the claim.
  6. + Add an Entry – The + Add an Entry button opens the Recovery dialog box where you can add a recovery transaction.

Accounting actions

Within the Accounting screen, you can view itemized transactions, set reserves, and manage reserves and payments. See Set reserves – step 6, Make a payment – step 7, Review the accounting summary – step 8, Set recovery reserves – step 9, and Create recovery receipts – step 10.

In the Accounting screen, you can complete the following actions:

  • Override the deductible
  • View Losses Incurred transaction
  • View recovery transaction
  • Void a payment
  • Delete a recovery entry