Claim file and exposure file headers and left menu navigation

Within a claim, you can access to two different headers: the claim file header and the exposure file header. Regardless of the claim or exposure section you accessed, one of these headers will appear across the top of the screen. The header will remain fixed at the top of the screen as you scroll through the screen. The claim file header provides information about the overall claim, such as the claim number, tags assigned to the claim, and claim status. The exposure file header provides information about the specific exposure, such as the exposure ID and coverage name, tags assigned to the exposure, and exposure status. Each header includes breadcrumbs and tabbed navigation so you can easily access the Claims Home screen or additional screens associated with the claim or exposure.

When inside a claim file, the menu on the left side of the screen provides additional claim details or exposure details. If you’re in the claim file, then Claim Details will display. If you’re in the exposure file, then Exposure Details will display. In addition, the left menu provides access to the policy that the claim is linked to and all exposures included in the claim.

Claim file header

The claim file header includes breadcrumbs, claim ID, claim tags, claim status, and tabbed navigation.

Figure 1: View of the claim file header.

Breadcrumbs

The number 1 in Figure 1 indicates the breadcrumb trail that appears at the top of the header. Breadcrumbs indicate where you’re at in the claim, such as the claim file or the exposure file. In Figure 1, the breadcrumb path is Claims Home > C-02-2020. This shows that from the Claims Home screen, you accessed claim C-02-2020. Claims Home is bold, indicating it’s a link. Claims Home will redirect you to the Claims Home screen.

Claim ID

The claim ID appears directly below the breadcrumbs in the header. Number 2 in Figure 1 displays the claim ID, which is C-02-2020.

Tags

In the top-right area of the header, you will see tags assigned to the claim. Number 3 in Figure 1 displays the claim tags. If tags are applied to the claim, next to the tag icon you will see the tags applied. In Figure 1, Out of State is applied to the claim. To update the tags applied, select the caret next to the tag to open the dropdown list of possible tags. For more information, see Managing claim and exposure tags.

Status

In the top-right area of the header next to tags, you will see the status of the claim. The current status of the claim is indicated by both the color of the dot and the selected status. Number 4 in Figure 1, displays the claim status as Open accompanied by a green dot. To update the status, select the caret next to the current status. For more information, see Managing claim and exposure status.

Tabbed navigation

Number 5 in Figure 2 depicts tabbed navigation in the claim header. When you select a tab, the system will open the screen of that tab. For personal auto, the tabs that will appear are Details, Exposures, Accounting, Parties, Attachments, Injuries, Vehicles, and Damaged Properties.

See Details overview, Exposures overview, Accounting overview, Parties overview, Attachments overview, Injuries overview, Vehicles overview, and Damaged Properties overview for more information.

Exposure file header

As mentioned above, the exposure file header includes breadcrumbs, exposure ID, exposure tags, exposure status, and tabbed navigation.

Figure 2: View of the exposure file header.

Breadcrumbs

The number 1 in Figure 2 indicates the breadcrumbs, which live at the top of the header. Breadcrumbs indicate where you’re in the claim and provide a general path to this location. In Figure 2, the breadcrumb path is Claims Home > C-02-2020 > P01 – Joe Insured > E001 – Medical Expense. This indicates that from the Claims Home screen, you accessed claim C-02-2020. When you see P01 – Joe Insured > E001 – Medical Expense, it means you have accessed the exposure associated with a specific party.

If the hand icon appears when you hover over a breadcrumb component, this indicates that the breadcrumb component is a link. In Figure 2, C-02-2020 also has a dropdown arrow, indicating a dropdown list will open. Claims Home will redirect you to the Claims Home screen, and C-02-2020 will direct you to the claim file’s Details screen unless you select one of the dropdown options that appear when you hover over C-02-2020.

Note: The dropdown arrow only appears in an exposure file’s breadcrumb.

Exposure ID and coverage name

The exposure ID and coverage type appear directly beneath the breadcrumb in the header. Number 2 in Figure 2 displays the exposure ID and coverage name. The exposure ID is E001, and the coverage name is Medical Expense.

Note: The information icon will appear next to some coverage names, such as the coverage name Collision. When you hover over the icon, a tooltip will open with a list of Endorsements contained within the coverage. The coverage name comes directly from the product in BriteLines, if you’re connected to BriteLines. Endorsements come from the policy that the claim is linked to. The endorsements modify the coverage.

Tags

In the top-right area of the header, you will find tags assigned to the specific exposure. Number 3 in Figure 2 displays the exposure tags. If tags are applied to the exposure, next to the tag icon you will see the tags applied. In Figure 2Medicare is applied to that specific exposure. To update the tags applied, select the caret next to the tag to open the dropdown list of possible tags. For more information, see Managing claim and exposure tags.

Status

In the top-right area of the header next to Tags, you will find the status of the specific exposure. The current status of an exposure is indicated by both the color of the dot and the selected status. Number 4 in Figure 2 displays the exposure status as Open accompanied by a green dot. To update the status, select the caret next to the current status. For more information, see Managing claim and exposure status.

Tabbed navigation

Number 5 in Figure 2 depicts tabbed navigation in the exposure header. When you select a tab, the system will open the screen of that tab. The following tabs will exist on all claims regardless of the product line of business (LOB) associated with the policy that the claim is linked to:

  • Claim Details
  • Exposures
  • Accounting
  • Parties
  • Attachments

Product-specific tabs will appear to the right of Attachments. In the case of Personal Auto, Injuries, Vehicles, and Damaged Properties are product-specific tabs.

The following tabs will always exist at the exposure file level:

  • Exposure Details
  • Exposure Accounting
  • Attachments

Product-specific tabs will appear to the right of Attachments. The product-specific tabs are risk detail tabs for the risk associated with the exposure. In the case of Personal Auto, risk detail tabs can include: Vehicle Detail, Damaged Property Detail, and Injury Detail tabs. Notice, in Figure 2, the exposure is Medical Expense, so the tabs that will appear are Details, Accounting, Attachments, and Injury. Vehicle and Damaged Property tabs won’t appear because they aren’t relevant to the type of risk you’re viewing.

See Exposure Accounting screen overview, Attachments screen overview, Vehicles overview, Injuries overview, and Damaged Properties overview for more information.

Left menu

The left menu is divided into three sections:

  • Claims (global navigation)
  • Claim Details or Exposure Details
  • Exposures
Figure 3: View of the left menu at the claim file level.
Figure 4: View of the left menu at the exposure file level.

Claims (global navigation)

Within the Claims section, you will find global links to main sections of the Claims platform that exist outside of the context of a single claim file: Claims Home, FNOL Drafts, Assign Adjuster, and System Admin.

  • Claims Home: The Claims Home link will direct you to the Claims Home screen, where you can search for and access claims or create new claims.
  • FNOL Drafts: The FNOL Drafts link will direct you to the FNOL Drafts screen, where you can view and access incomplete FNOLs or create a new FNOL.
  • Assign Adjuster: The Assign Adjuster link will direct you to the Assign Adjuster screen, where you can view or access claims that are currently unassigned and assign these claims in bulk to an adjuster.
  • System Admin: The System Admin link will direct you to the System Admin section of claims, where you can manage various components used throughout the Claims platform. See Figures 3 and 4.

Claim Details or Exposure Details

The Claim Details/Exposure Details section holds information that is configured based on the level you’re in. For example, if you’re in the claim file, the second section will hold information about the claim and the section title will be Claim Details. If you’re in the exposure file, the second section will hold information specific to the exposure and the section title will be Exposure Details.

The Claim Details and Exposure Details sections provide the same information and behave the same at both the claim file level and at the exposure file level, except for the following:

  • Primary Adjuster / Exposure Adjuster: At the claim file level, the Primary Adjuster is displayed. The Primary Adjuster is the adjuster for the overall claim. At the exposure file level, the Exposure Adjuster is displayed. The Exposure Adjuster is the adjuster for the specific exposure. The Primary Adjuster and Exposure Adjuster are two different roles, and they can be assigned to the same person or to separate people.
  • Loss Cause(s): At the claim file level, the loss cause(s)/peril(s) that impact the entire claim is/are displayed. At the exposure file level, the loss cause(s)/peril(s) specific to the exposure is/are displayed.

Claim Details

The Claim Details section is shown in Figure 3. Within the Claim Details section, you can view a high-level snapshot of the claim, which helps inform you about the claim file you’re working in. The high-level snapshot displays:

  • Policy: This includes policy number, product name, and a link to the Policy Detail pop-up window.
  • Loss Date: This includes the loss date, loss time, and timezone where the loss occurred.
  • Loss Cause(s): This includes the loss cause(s) or peril(s) for the entire claim.
  • Insured: This includes the claimant ID(s) and named insureds on the policy that the claim is filed on.
  • Primary Adjuster: This includes the name of the Primary Adjuster assigned to the overall claim.

You can expand or collapse this section by selecting the arrow next to Claim Details. This section is read-only, with the exception of the policy. When you select the policy link, the Policy pop-up window appears.

Exposure Details

The Exposure Details section is shown in Figure 4. Within the Exposure Details section, you can view a high-level snapshot of the exposure which helps inform you about the exposure file you’re working in. The high-level snapshot displays:

  • Policy: This includes policy number, product name, and a link to the Policy Detail pop-up window.
  • Loss Date: This includes the loss date, loss time, and timezone where the loss occurred.
  • Loss Cause(s): This includes the exposure loss cause(s) or peril(s).
  • Claimant: This includes the claimant ID and claimant name associated with the exposure.
  • Exposure Adjuster: This includes the Exposure Adjuster assigned to the exposure file.

You can expand or collapse this section by selecting the arrow next to Exposure Details. This section is read-only, with the exception of the policy. When you select the policy link, the Policy pop-up window appears.

Exposures

The Exposures section provides you with quick access to all exposures within a claim. Exposures are grouped by claimant. Each claimant listed under Exposures will have one or more exposure linked to them. Select the party to open a dropdown list of exposures linked to that party. Select the exposure ID to be directed to the Details screen of that exposure file. You can expand or collapse this section by selecting the arrow next to Exposures. See Figures 3 and 4.