You can issue payments on a claim from the exposure file’s Accounting screen. To issue a payment, reserves must first be set. See Set reserves from exposure. The amount of payment can’t exceed the remaining reserve amount.
On the exposure Accounting screen, when you select the Make Payment button, you’re directed to the Make Payment dialog box. The Level 2 sub-reserve category is automatically selected based on your point of entry. You have the following options for the payment transaction you’re entering:
- Cancel: When you cancel the payment transaction, the information you entered won’t be saved.
- Save As Draft: When you save the payment transaction as a draft, you can either submit it at a later date or delete it, which will terminate the workflow. The status of the payment transaction will be Draft.
- Save: When you save the payment transaction, you submit it.
When the payment transaction is submitted, the status Approved is applied. The transaction will automatically update the Exposure Accounting Summary. If you don’t submit the payment, and instead save it as a draft, the status Draft is applied and the Exposure Accounting Summary will remain unchanged.
Once the payment transaction is processed and assigned to a batch field for issuance, the payment transaction status will change from Approved to Posted. After the payment transaction is processed, it can either be voided or exported for issuance.
When a payment transaction is voided, the following happens:
- The payment workflow is terminated.
- Automatic entries are created in the Transactions table. These entries remove the payment, increase the reserve, and reference the Transaction ID of the original payment that was voided.
- The payment transaction status changes to Voided.
See Figure 1 to view the Payment Workflow diagram.
If money needs to be moved from one Level 2 sub-reserve category to another, manual adjustments can be made once the payment transaction is exported for issuance and has been cleared. See Make manual adjustments.
To submit a payment, the payee you select from the Payee dropdown list in the Make a Payment dialog box must be a valid payee. A valid payee is determined by certain criteria, which vary depending on whether:
- The payee is an individual or an organization.
- The payee is a claimant, vendor, or associated party.
- The payee is an injured claimant.
The following fields must be completed in the Make a Payment dialog box for both a payee that is an organization and a payee who is an individual and has the role of Attorney:
- Full Name
- Address boxes
- Tax ID
Note: An organization listed as a payee and an attorney listed as a payee must be an Approved Vendor.
The following fields must be completed in the Make a Payment dialog box for a payee that is an injured individual claimant, claiming against an injury-related coverage:
- Full Name
- Address boxes
- SSN (or the Refused to provide checkbox is selected)
- Date of Birth (or the Refused to provide checkbox is selected)
- Gender (or the Refused to provide checkbox is selected)
Note: The above information for a payee who is an injured individual claimant must be met at the time the payment is created, as this information is recorded as part of the payment data.
The following fields must be completed in the Make a Payment dialog box for both a payee who is an uninjured individual claimant and a payee who is an individual primary payee but isn’t a claimant and doesn’t have the role of Attorney:
- Full Name
- Address boxes
The following field must be completed in the Make a Payment dialog box for a payee that is an individual, but isn’t a claimant, the primary payee, and doesn’t have the role of Attorney:
- Full Name
Complete the Make Payment dialog box
To issue a payment on an exposure, access the desired exposure, go to the exposure file’s Accounting screen, and:
- In the Actions column of the Exposure Accounting Summary table, select Make Payment for the reserve you’re issuing payment on. The Make Payment dialog box will open.
- In the Payee dropdown list, ensure the correct name is displayed. To change the payee name, open the dropdown list and select the correct payee. The dropdown list is separated into Claimants, Associated Parties, Exposure Vendors, and All Vendors.
- To add an additional payee, select + Add Payee. Make a selection from the And/Or dropdown. In the Second Payee dropdown list, select the name of the additional payee. The dropdown list is again separated into Claimants, Associated Parties, Exposure Vendors, and All Vendors and will display all names that appeared in the Payee dropdown list, except for the primary payee’s name. Repeat step 3 to add additional payees.
- In the Display on Check box, ensure the correct information is displayed. To edit the information, type in the Display on Check box. There is a character limit of 70 characters for the Display on Check box. The system will count characters already consumed by the prepopulated information.
- In the Address Information section, complete the address boxes, or if more than one address exists for the payee, select an address from the Select Address dropdown list.
Note: Addresses can be overwritten. The address in the Make Payment dialog box is stored with the payment record and any changes made to the address in the payment record won’t change the address of the party.
- In the Reserve Category dropdown, ensure accurate information for the reserve category is displayed. To change the reserve category, open the dropdown list and select one of the other level two reserve categories listed.
- In the Transaction Codes box, ensure accurate information is displayed. The transaction codes available depend on the reserve category selected. Open the Transaction Codes dropdown list and select the correct code from the list.
- In the Due Date box, use the date picker to select the date of the payment.
- In the Payment Method box, select the type of payment. Payment methods are configurable and separate batch files can be created for each payment method type.
- In the Payment Type box, select the type of payment.
- If you want to apply a deductible, select the Apply Deductible checkbox. Additional fields will appear. If you leave the checkbox unmarked, move to step 13. See Manage Deductibles for more information. Refer to Figure 3 for step 12.
- In the Amount Before Adjustments box, type the amount of the payment before the deductible is applied. In Figure 3, the amount typed is $1,500. The amount in Deductible Amount to Apply is prepopulated and associated with the deductible or overridden deductible associated with the coverage. In Figure 3, the Deductible Amount to Apply is $450. As you type in the Amount Before Adjustments box, the system will automatically subtract the Deductible Amount to Apply box from the Amounts Before Adjustments box and the remaining balance will populate in the Payment Amount box. Using Figure 3 as an example, $450 is subtracted from the $1,500, leaving the Payment Amount at $1,050.
- In the Payment Amount box, type the amount of payment.
Note:The payment amount can’t exceed the reserve balance or be negative, unless the payment method is a manual adjustment.
- In the In Payment Of (Memo) box, type what you want to appear on the memo line.
- In the Comments box, type any comments you have about the payment. This information will display in the Transaction Details section.
- Depending on your role, if manually clearing a check, you can add additional check information. Select the Check Information checkbox and:
- In the Check Number box, type the check number.
- In the Check Date box, use the date picker to select the check date.
- In the Cleared Date box, use the date picker to select the cleared date of the check.
- Select Save. When you select Save, rules are triggered and the payment is submitted. The triggered rules are tied to:
- 1099 information being filled out for payees.
- Data requirements for injured related parties that are a payee.
- Financial authority limits of the user.
After a payment is created for a claimant, the system restricts the ability to change specific claimant information in the claimant’s Party Detail dialog box. This will occur for payments with the status Draft, Approved, or Posted. The following fields will be locked in the claimant’s Party Detail dialog box so changes can’t be made:
- Date of Birth.