Loss claims notification at renewal

At renewal, PolicyCenter checks for underwriting issues. One of the checks is to search for claims from the claim system. By default, the search uses the start and end dates of the policy period currently in force.

After the claim search, PolicyCenter creates one or more claims underwriting issues. PolicyCenter attaches claims underwriting issues to the renewal policy transaction. Typically, PolicyCenter creates an underwriting issue for any occurrence of claims within the requested date range. In many cases, the claims underwriting issue is not severe enough to block automated renewal. Claim underwriting issues and authority grants (described below) determine whether an issue blocks renewal.

The following table describes claims underwriting issues.

Claims underwriting issue	Description
`Claim total incurred`	This issue appears if at least one claim is found in the requested date range. The message displays the value of the highest cost claim returned. This issue blocks bind.
`Ratio of claims total incurred to a policy written premium`	This issue appears if the search returns at least one claim and the policy has a written premium for the in-force policy period. The message displays the sum of total incurred values for all returned claims divided by the written premium. This issue blocks bind.
`Incidence of claims`	This issue appears if the search returns at least one claim and the policy has a written premium for the in-force policy period. The message displays the number of claims returned from search divided by the written premium. This issue blocks bind.
`Manual claim review needed`	This issue appears if the search matches more claims than the system is configured to retrieve. This issue blocks bind.
`Unable to retrieve claims information`	This issue appears if the search was unable to retrieve claims information. This issue blocks bind.

Authority grants determine which claims underwriting issues block automated renewal. Claims underwriting issues require underwriter approval if the issue triggers an authority grant and the issue blocks bind.

The following table lists the authority grants of specific users.

User	Authority Grants
Renewal workflow	`Claim total incurred` > $10,000 `Ratio of claims total incurred to policy written premium` > .5 (.5 = 50%) `Incidence of claims` > .0005 (5 claims / $10,000 of premium)
Underwriter 1 & Underwriter 2	`Claim total incurred` > $20,000 `Ratio of claims total incurred to policy written premium` > .90 (.90 = 90%) `Incidence of claims` > .0010 (10 claims / $10,000 of premium) `Manual claim review needed` `Unable to retrieve claim information`
Underwriter Supervisor	`Claim total incurred`: no limit `Ratio of claims total incurred to policy written premium`: no limit `Incidence of claims`: no limit `Manual claim review needed` `Unable to retrieve claim information`

Approvals

If a claim underwriting issue blocks during automated renewal, PolicyCenter creates an activity for the underwriter to review the issue and suspends automated processing. To avoid the need for additional review, the underwriter can grant approval for a higher amount than the current value. When all issues are cleared through issuance, the underwriter has two choices. The underwriter may then select to renew the policy manually or place the policy back into the automated renewal flow.