Claim file Accounting overview

In some claims, the law may dictate that a barrier be created between adjusters who manage different coverages on the same claim for the same party. To address this need, depending on roles and permissions, the system is designed to allow an adjuster to manage a claim either at the claim file or at the exposure file level. For example, an exposure-level adjuster can manage an exposure file on a claim without the need to navigate to the parent claim file or access other exposures.

With this design, some information available on the claim file level is also available at the exposure file level. For example, the information in the Claim Accounting Summary related to an exposure is also available in the Exposure Accounting Summary. The ability to set reserves and make payments on an exposure is available only at the exposure file level.

The Accounting screen of the claim file displays all accounting information for the claim. Similar to the exposure file’s Accounting screen, the claim file’s Accounting screen displays two tables: Claim Accounting Summary and Transactions.

Figure 1: The Accounting screen of the claim file.

Claim Accounting Summary

The Claim Accounting Summary table is read-only. The accounting summary for personal auto is grouped by claimant. By default, the Claim Accounting Summary view displays, for each exposure, the high-level summary of:

  • Reserves and payments for Level 1 reserve categories.

    Note: The example in Figure 1 shows the configured Level 1 reserve categories of Loss and Expense.

  • The total of all standard payments and reserves.
  • The total of all recovery reserves and recovery receipts.
  • The total net incurred.

Selecting the caret next to a claimant’s name will expand the view and display the accounting summary of each exposure associated with the claimant. Additional columns exist beyond the default view. To view these columns, select inside the table and use your right and left arrow keys to navigate to and from the right-most columns.

Note: Using a larger screen can eliminate the need to scroll horizontally within the Claim Accounting Summary table.

The Claim Accounting Summary contains the following columns:

  • Claimant/Coverage: This column includes all claimants involved with the claim who have exposures associated with them. Claimants are first or third-party involved parties, and they are assigned a claimant ID when an exposure is associated with them. To view the coverages or exposures associated with the claim, select the caret next to a claimant’s name. The exposure ID(s) and coverage(s) associated with the claimant will appear below. See Figure 1.

    Note: If you select the exposure ID/coverage link, you will be directed to the exposure file’s Accounting screen.

  • Loss (or other configured <Level 1 reserve category>): In Figure 1, the configured Level 1 reserve category that appears first is Loss. This column is further broken down into Reserve and Payment. The configured Level 1 reserve category is the sum of the remaining reserve (Reserve) and approved or posted payments (Payment). In the claimant row, you will see a summary of the Reserve and Payment for all exposures associated with the claimant. To view the Reserve and the Payment specific to an exposure, select the caret next to the claimant’s name. The Reserve and Payment amounts come directly from the Exposure Accounting Summaries.
  • Expense (or other configured <Level 1 reserve category>): In Figure 1, the configured Level 1 reserve category that appears second is Expense. This column is further broken down into Reserve and Payment. The configured Level 1 reserve category column is the sum of the remaining reserve (Reserve) and approved or posted payments (Payment). In the claimant row, you will see a summary of the Reserve and Payment for all exposures associated with the claimant. To view the Reserve and Payment specific to an exposure, select the caret next to the claimant’s name. The Reserve and Payment amounts come directly from the Exposure Accounting Summaries.
  • Total: Total refers to the total reserves and payments for the configured Level 1 reserve categories. Loss and Expense are the configured Level 1 reserve categories in Figure 1, and so the Total is the sum of (Loss Reserve + Loss Payment) + (Expense Reserve + Expense Payment).
  • Total Recovery: This column refers to the total of Recovery Reserves and Recovery Receipts for the configured Level 1 recovery reserve categories. Subrogation and Salvage are examples of configured Level 1 recovery reserve categories. With this example, Total Recovery is (Subrogation Recovery Reserves + Subrogation Recovery Receipts) + (Salvage Recovery Reserve + Salvage Recovery Receipts). Total Recovery is pulled from the Recovery view of the Exposure Accounting Summary.
  • Net Incurred: Net Incurred is the actual cost of the claim after payments are issued and amounts are recovered. Net Incurred can be described with the following equation: TotalTotal Recovery = Net Incurred.
  • Coverage Limits: The Coverage Limits will appear only in the exposure ID rows. Coverage Limits are based on LOB and pulled from BriteLines.
  • Status: The status will appear only in the exposure ID rows. Status refers to the status of an exposure, such as Open, Closed, Reopened.

Transactions

The Transactions table contains information about all transactions on a claim. Additional columns exist beyond the default view, to see these columns, click in the Transactions table near the Type column, you can use the right arrow to view columns from Type to Transaction ID. You can navigate back to the original view by using the left arrow.  Transactions not yet posted will appear at the top of the Transactions table.

You can filter transactions by Transaction Amounts, Transaction Type, Transaction Code, Claimant ID, Exposure ID, and Transaction ID.

Note: If you select Payment from the Transaction Type dropdown list, then additional filters will appear, such as: Payee, Payment Method, Check Number, Check Date range, Check Cleared Status, and Check Cleared Date range.

The Transactions table contains the following columns:

  • Posted Date: The date the transaction is posted, or deemed in a finalized status.
  • Claimant/Exposure ID: The claimant is identified by the claimant ID and exposure is identified by the exposure ID.
  • Amount: Amount of the transaction added. For reserves, this is the new or updated reserve amount. For payments, it is the amount of the payment or check.  Negative amounts represent the amount subtracted from the reserve and are labeled Reserve Change
  • Payee/Payor: In the event of an issued payment or recovery receipt, a name will appear in this column. If a payment is issued to one or more payees on the payment, all payees’ names will appear. If a recovered amount is received, the payor’s name will appear in the column.
  • Reserve Category: The type of standard or recovery reserve category, for example, Legal (Expense), Collision (Loss). Reserve categories are configurable.  
  • Type: The type of transaction. Notes will accompany the type of transaction, such as Reserve Close if the transaction is a change to the reserve to close the reserve. Additional examples of notes include: Reserve (Reserve Open), Reserve (Reserve Change), Recovery Reserve (Reserve Changes), and Recovered (Recovery Receipt).
  • Comments: Comments added to the transaction. For some transactions, comments will automatically populate in this section to help auditors cross-reference one transaction with another transaction. For example, a comment will be added for Reserve Change and it will reference the payment transaction that reduced the reserve. A comment will also be made for Void transactions and the original transaction being voided will be referenced.
  • Status: The status of the transaction will appear in this column. The status options are Draft, Approved, Posted, and Void.
  • Due Date: For payments that must be issued, a due date can accompany the payment and will appear in this column.
  • Check Number: If payments are issued by check, the check number will appear in this column.
  • Check Date: If payments are issued by check, the date the check is written on will appear in this column.
  • Cleared Date: When payments are issued, the Cleared Date of the payment will appear in this column.
  • Transaction ID: All transactions will have a unique ID. This will be used by automated comments to cross-reference transactions. 
  • Actions: The Actions column provides the opportunity to View Detail of the transaction. For issued payments, you also have the opportunity to Void or Clear Check. You can also Unapprove certain transactions.

Actions you can complete from the Accounting screen

  • Access accounting information for an exposure
  • Filter Transactions table
  • View transactions details
  • Void transaction
  • Clear check