Overview
This feature enhances claims accounting controls by restricting the ability to set reserves beyond a policy's coverage limit. Only users or user groups explicitly granted the new permission can reserve amounts that exceed policy limits, supporting compliance and risk management for extracontractual exposures.
Key Functionality
1. Permission Control
- Authority Limit Configuration: Authority limits are defined using multiple dimensions, including Effective Date, Owner Type and Owner Name (user, permission, or group), Business Location, Policy Type, Coverage Type, and Limit Type. These dimensions determine when the rule applies and which users it governs.
- Limit Types: Limits can be applied at different scopes:
- Individual: Applies separately to each exposure.
- Coverage Aggregate: Applies to the total across all exposures for a specific coverage within a claim.
- Claim Aggregate: Applies to the total across the entire claim, regardless of coverage or exposure.
- Financial Limits: Authority limits can be set for reserves and payments across categories such as Loss, Adjusting, Legal, and Expense, controlling how much a user can transact within the defined scope.
- Allow to Exceed Policy Limits: A checkbox labeled Allow to Exceed Policy Limits is available in the Authority Limits configuration. When enabled, it allows users within that authority limit configuration to exceed policy limits for claim transactions (reserves and payments) without being blocked by authority limit validations, even if no specific transaction type or amount is defined. If not enabled, users exceeding limits will receive an “Authority Limits Exceeded” message and the transaction will not be saved.
2. Default Behavior
- Restrictive by Default: Users without the permission cannot reserve amounts exceeding the policy limit.
- Error on Exceeding Limit: If an unauthorized user attempts to reserve above the limit, an error or warning message is displayed, and the action is blocked.
- Current Behavior Change: Previously, any user could reserve above the limit. After this update, only authorized users can do so.
3. Auditability
- Automatic System Notes: When a user with permission sets a reserve above the policy limit, an audit log entry or note is automatically created.
- Log Details Include:
- User performing the action
- Amount reserved
- Policy limit
- Date and time
- Reason (if provided)
4. How to Use
- Configure Authority Limits
- Create or update an authority limit by completing each column in order:
- Set the Effective Date.
- Select the Owner Type (Contact, Permission, or User Group) and corresponding Owner Name.
- Define the Business Location, Policy Type, and Coverage Type.
- Choose the Limit Type (Individual, Coverage Aggregate, or Claim Aggregate).
- Enable Allow to Exceed Policy Limits if users under this configuration should be permitted to exceed policy limits.
- Enter the applicable financial limits for reserves and payments (Loss, Adjusting, Legal, Expense).
- Create or update an authority limit by completing each column in order:
- Apply the Configuration
- Once saved, the authority limit applies to the selected user, permission, or group based on the defined criteria.
- Reserve or Pay on a Claim
- When creating a transaction, the system evaluates the authority limit using the configured dimensions and limit type.
- If the transaction exceeds defined limits or policy limits, only users with the appropriate configuration (including the exceed permission, if enabled) can proceed.
- System Enforcement and Feedback
- If a user exceeds their authority limits without the appropriate permission, an “Authority Limits Exceeded” message is displayed and the transaction is not saved.