ClaimContacts

A ClaimContact is a person or organization who has a relationship with a claim. This includes people and organizations who:

  • Are covered by the relevant policy
  • Suffered a covered loss
  • Provide information relevant to the claim
  • Provide a service to address the loss

For example, suppose that Ray Newton has a personal auto policy. He informs the insurer that, while driving his Toyota, he hit Robert Farley's Honda and damaged both cars. Wilma Weeks witnessed the collision. Robert Farley's Honda was repaired at Joe's Auto Body Shop. This claim would have the following ClaimContacts:

  • Ray Newton
  • Robert Farley
  • Wilma Weeks
  • Joe's Body Shop

ClaimContact roles

Claims have child objects, such as:

  • A policy, which contains a copy of information from the policy that is relevant to the claim.
  • One or more incidents, which represent anything that was damaged, stolen, or otherwise representative of the loss (such as a vehicle, a property, or an injured person).
  • One or more exposures, which track a potential payment from one coverage to one claimant.
  • One or more service requests, which are requests to outside vendors to provide service that addresses the loss.

Every ClaimContact must have one or more roles with each object the ClaimContact is related to. A ClaimContact role defines the nature of a relationship between a ClaimContact and the claim.

For example, the Ray Newton claim described previously might have these ClaimContacts with the following roles:

  • The claim itself
    • Ray Newton is the insured, the reporter, and a claimant.
    • Robert Farley is a claimant.
    • Wilma Weeks is a witness.
  • The vehicle incident for Ray's Toyota.
    • Ray Newton is the driver.
  • The vehicle incident for Robert's Honda.
    • Robert Farley is the driver.
  • The exposure to pay Ray Newton from the policy's collision coverage.
    • Ray Newton is the claimant.
  • The exposure to pay Robert Farley from the policy's third-party property damage coverage.
    • Robert Farley is the claimant.
  • The service request to repair Robert's Honda.
    • Joe's Body's Shop is the service vendor.

The ClaimContact data model

In ClaimCenter, ClaimContact information is stored across multiple entities, including:

  • ClaimContact - Information about the contact, such as first and last name
  • ClaimContactRole - Each object the contact is associated with and the role it has on that object
  • Contact - A link entity between the claim, the ClaimContact , and the ClaimContactRole

Additional business functionality

For a more detailed discussion of the business functionality of ClaimContacts, refer to the Application Guide.