Claims Management Workflow Template

An excellent customer treatment can make the difference between a company and its competitors, lead to customer loyalty and influence customers’ purchase decisions.

It is important to concentrate your efforts on ensuring your customer’s high satisfaction thanks to faster and better answers to their requests, including both suggestions and claims.

This can be achieved by focusing your employees on finding suitable responses rather than spending too much time in the management of them.

Comindwares claims management workflow template and form sample will help you to manage claims, complaints and suggestions through the definition of a clear information flow, the responsibilities of each activity required to solve them and the control of the process through traceability.

The combination of the template’s features will allow you to make the correct decisions and easily identify what changes should be made in order to maintain or improve the image that your customers have about your company.

Claims Management Workflow ExampleComindware

Claims Management Workflow Example

The process starts, when a Request is submitted. A Customer Service Agent receives the Request and classifies it as a Claim or Suggestion.

If the Request is a Suggestion, it is analyzed and a response is given immediately.

If the Request is a Claim, it is recorded and an immediate response is given, if possible. If not, the Agent identifies if more information must be obtained (via phone call or email) or if the case must be escalated to another area or person.

When a solution is found, it is sent to the Requestor for review.

Then the case is reviewed in order to evaluate the service provided and to identify issues or inefficiencies that should be improved. If the solution to the case should be documented in the Knowledge Base, the documentation details are recorded. Finally, the case is closed.

Agile Insurance Claim ProcessComindware

Claims Management Form Example

This form is used to enter the reasons of the claim and claiming person details. Some of the fields, such as Creation Date, Creator are filled automatically. Drop down field allows to choose a channel of claim receipt and fields like Current Assignee and Workflow step are read only and provided for assignee information.

In addition to Customer Information and Description, there are tabs for:

  • adding comments and sharing documents
  • subtasks creation and management
  • workflow review and checking its current stage
  • learning who did what and when and checking for bottlenecks

Powerful supplement for your insurance claim management software. Risk-free trial!


  • Organize request information
  • Reduce communication issues
  • Increase claims and complaints attention rates
  • Improve your management indicators through SLAs compliance
  • Eliminate lost requests

Your company definitely has specific claim processing workflows and forms. Comindware Tracker will allow you to mirror what you are doing within your claims process, optimize it on-the-fly and automate other things you are to accomplish.

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