Claim and exposure status

Throughout the claim lifecycle, the status of a claim and its associated exposures will change. Claim status, exposure status, and role-based permissions can dictate what users can see and do within the claim and exposure.

Claim statuses are limited to New, Open, Closed, and Reopened. Exposure statuses are limited to Open, Closed, and Reopened. To the left of the status, you will see a colored dot. The color of the dot is associated with the claim or exposure status:

  • The blue dot is associated with New status.
  • The green dot is associated with Open status.
  • The peach dot is associated with Reopened status.
  • The red dot is associated with Closed status.

When you change the status of a claim or exposure, an entry is made in the Claim Activity log. The entry includes the user who changed the status and the date and time the status was changed. Before you can close a claim, all associated exposures must also be closed.

Claim status workflows

Change claim status from New to Open or New to Closed

When you first submit a claim or first notice of loss (FNOL), the status of the claim is New. The New status suggests that you’re in the investigation phase and can change information in the Parties, Vehicles, Damaged Properties, and claim file’s Details screens. When the status of a claim is New, you can change its status to Open or Closed.

Note: You can’t add exposures to a claim if the claim’s status is New.

To change the status of a claim from New to Open:

  1. Select the dropdown list next to New in the claim file header at the top-right corner of the screen.
  2. Select Open Claim. The system changes the status to Open.

To change the status of a claim from New to Closed:

  1. Select the dropdown list next to New in the claim file header at the top-right corner of the screen.
  2. Select Close Claim. The Close Claim dialog box will open.
  3. From the Reason dropdown list, select a reason. The reasons that display are configured at implementation to meet your needs. For example, you may choose to display the following reasons: Denied, Record Only, and Withdrawn.
  4. Select Save. The system will change the status to Closed.

Change claim status from Open to Closed

When a claim’s status is Open, the only status you can change it to is Closed.

To change the status from Open to Closed:

  1. Select the dropdown list next to Open in the claim file header at the top-right corner of the screen.
  2. Select Close Claim.
    1. If there are open exposures on the claim, the system will display the following message:

      Please close all exposures before closing the claim file.

      Select OK and proceed to close the exposures.

  3. The Close claim dialog box will open and prompt you to select a reason for closing the claim.
  4. Select a reason from the Reason dropdown list. The reasons that display in the Reason dropdown list can be configured at implementation to meet the your needs. For example, you may choose to display the following reasons: With Pay, Without Pay, Record Only, Denied, and Withdrawn.
  5. Select Save. The system will change the status to Closed.

Change claim status from Closed to Reopened

When a claim is closed, the only status you can change it to is Reopened.

To change the status from Closed to Reopened:

  1. Select the dropdown list next to Closed in the claim file header at the top-right corner of the screen.
  2. Select Reopen claim. The Reopen claim dialog box will open.
  3. From the Reason dropdown list, select one of the following: Additional payments, Closed by mistake, or Litigation. When you select the reason, the system will change the status to Reopened.

Change claim status from Reopened to Closed

When a claim is reopened, the only status you can change it to is Closed.

To change the status from Reopened to Closed:

  1. Select the dropdown list next to Reopened in the claim file header at the top-right corner of the screen.
  2. Select Close claim.
    1. If there are open exposures, the system will display the following message:

      Please close all exposures before closing the claim.

      Select OK and proceed to close the exposures.

    2. If payments have or haven’t been made on the claim, the Close claim dialog box will open and prompt you to select a reason for closing the claim.
  3.  Select a reason from the Reason dropdown list. The reasons that display in the Reason dropdown list can be configured at implementation to meet your needs. For example, With Pay, Without Pay, Record Only, Denied, and Withdrawn may be reasons you choose to display in the Reasons dropdown list.
  4. Select Save. The system will change the status to Closed.

Exposure status workflows

You can change the exposure status in either the exposure file header on the exposure file’s Details screen or on the Exposures screen.

 Change exposure status from Open to Closed

When an exposure is open, the only status you can change it to is Closed.

To change the status from Open to Closed:

  1. Select the dropdown list next to Open at the top-right corner of the exposure file’s Details screen, or select the ellipsis in the Actions column of the exposure on the Exposures screen.
  2. Select Close Exposure.
    1. If there are payments in Draft status, the system will display the following message:

      This exposure has at least one payment in Draft status. Please submit or delete these payments before trying to close the exposure.

      Select OK and proceed to submit or delete the payments in Draft status.

    2. If there are open reserves, the system will display the following message:

      There are Open Reserves on this Exposure. Closing this Exposure will Close the Reserves too.

      1. If you select Cancel, the exposure won’t close, and the system will display the following message:

        Reserves have not been set to Zero and the exposure has not been closed.

      2. If you select Yes, Close the Exposure, the system will create a reserve transaction to zero the reserves. The Close Exposure dialog box will open and prompt you to select a reason for closing the exposure. The reasons that display are configured at implementation to meet your needs. For example, you may choose to display the following reasons: With Pay, Without Pay, and Void/Opened in Error.
        1. Select a reason from the Reason dropdown list.
        2. Select Save. The system will change the status to Closed and the system will display the following message:

          Exposure has been closed.

    3. If there aren’t open reserves, the Close Exposure dialog box will open and prompt you to select a reason for closing the exposure. The reasons that display are configured at implementation to meet your needs. For example, you may choose to display the following reasons: Without Pay and Void/Opened in Error.
      1. Select a reason from the Reason dropdown list.
      2. Select Save. The system will change the status to Closed and the system will display the following message:

        Exposure has been closed.

Change exposure status from Closed to Reopened

When an exposure is closed, the only status you can change it to is Reopened.

To change the status from Closed to Reopened:

  1. Select the dropdown list next to Closed on the exposure file’s Details screen, or select the ellipsis in the exposure’s Action column on the Exposures screen.
  2. Select Reopen. The system will change the status to Reopened.

Change exposure status from Reopened to Closed

When an exposure status is reopened, the only status you can change it to is Closed.

To change the status from Reopened to Closed:

  1. Select the dropdown list next to Reopened at the top-right corner of the exposure file’s Details screen, or select the ellipsis in the reopened exposure’s Actions column on the Exposures screen.
  2. Select Close Exposure.
    1. If there are currently payments in Draft status, the system will display the following message:

      The exposure has at least one payment in Draft status. Please submit or delete these payments before trying to close the exposure.

      Select OK and proceed to submit or delete the payments.

    2. If there are open reserves, the system will display the following message:

      There are Open Reserves on this Exposure. Closing this Exposure will Close the Reserves too.

      1. If you select Cancel, the system won’t close the exposure, and the following message will display:

        Reserves have not been set to Zero and the exposure has not been closed.

      2. If you select Yes, Close the Exposure, the system will create a reserve transaction to zero the reserves. The Close Exposure dialog box will open and prompt you to select a reason for closing the exposure. The reasons that display are configured at implementation to meet your needs. For example, you may choose to display the following reasons: With Pay, Without Pay, and Void/Opened in Error.
        1. Select a reason from the Reason dropdown list.
        2. Select Save. The system will change the status to Closed and the system will display the following message:

          Exposure has been closed.

    3. If there aren’t open reserves, the Close Exposure dialog box will open and prompt you to select a reason for closing the exposure. The reasons that display are configured at implementation to meet your needs. For example, you may choose to display the following reasons: Without Pay and Void/Opened in Error.
      1. Select a reason from the Reason dropdown list.
      2. Select Save. The system will change the status to Closed and the system will display the following message:

        Exposure has been closed.