Connected Claims Features

Open Connected Claims and navigate between the 4 main pages: HOME, CUSTOMER, TASKS, and CONFIGURATION to access the records and tasks you have permission to view. From HOME, access the insurance modules you need to process the claim through the entire claims lifecycle.

View actionable dashboards with key metrics and graphs in each insurance module that you have permission to view. Dashboards bring together all the data from your claims systems, policy systems and 3rd-party applications.

Access and view current insurance & claim articles and news for a specific industry.

View a complete list of all claims records. Drill down into a specific claim to see relevant details, related entities and workflows, documents, audit logs, and more. Report a self-service claim for any contact, customer, or line of business (LOB) in the Connected Claims system.

View a complete list of customer records and key metrics that provide a snapshot of the active customers in your claims pipeline on the CUSTOMER tab. Easily view any cases and claims that are open for the customer. Drill down into a specific customer to view relevant details and update the customer record.

View a complete list of your inspection workforce, including the inspector's primary location, customer feedback rating, availability status, and more.

Create workflow templates that automatically assign tasks based on the types of customer requests selected. Note that workflow templates for some LOBs come pre-configured for easy updating.

Report new claims and work orders

View of all the relevant information about a case, including case details and notes, litigation details, payment details, and much more. Users with access can also manage case documents, submit requests for missing information, and respond to clients.

Add notes to a specific claim, including important information or reminders regarding the claim.

From the Documents tab, you can view existing documents associated with a specific claim and add new documents to the claim.

After viewing the details for a specific claim and identifying missing information, use the Request for Missing Information feature to select the information you want the insurer to submit and send the request to the insurer via an automated email.

Follow up on communication between you and your customers by composing emails from the Communications tab on the claims record.

View a complete list of your tasks and details for all insurances modules that you have permission to access. Select and open tasks to take action or complete them. Filter the tasks list by case number, module, status, priority, deadline, and assigned group.

Create an on-demand or ad hoc task for a specific claim at an immediate point in the claims process or after a specific phase in the claims process.

Complete data entry tasks associated with processing claims. Review, approve, or deny logged claims, work orders, payment tasks and field inspections for claims assigned to you.

Reassign one or more open tasks to a different user or group.

View payment information for a specific claim made during the claims process. Add recovery payment details for a specific claim.

Appian Connected Claims offers connection capabilities with Amazon Connect. This means if you have Amazon Connect services set up, you can integrate them into your Connected Claims solution to facilitate streamlined communications and a seamless customer experience.

Appian Connected Claims offers connection capabilities with Amazon S3 (Amazon Simple Storage Service). This means if you have Amazon S3 services set up, you can integrate them into your Connected Claims solution. Allow users to access your S3 objects directly from the solution and upload documents to a S3 bucket with server-side encryption and a Public or Private configuration.

Appian Connected Claims offers connection capabilities with Amazon Comprehend, which is a natural language processing (NLP) service that uses machine learning to find insights and relationships in text. If you have Amazon Comprehend services set up, you can integrate them into your Connected Claims solution. Allow users to detect the text language, extract key phrases, places, people, brands, or events, identify the entities in the text and use them to map to customers and products, understand the sentiments of a text snippet, and automatically organize a collection of text files by topic. This integration will also allow you to train the custom classification on your use cases and use custom entity recognition to identify the learned entities.

Appian Connected Claims offers connection capabilities with SurveyMonkey. If you have SurveyMonkey services set up, you can integrate them into your Connected Claims solution to allows users to create and initiate surveys through Connected Claims. Get all of your survey details in one centralized location, including contact data and list for all users, survey responses, survey trends, and more.

Appian Connected Claims offers connection capabilities with WhatsApp. If you have WhatsApp services set up, you can integrate them into your Connected Claims solution to establish a claim intake and communication channel that allows fast, simple, secure messaging and calling between your insurers and customer service personnel.

Appian Connected Claims offers connection capabilities with Spixii. If you have Spixii services set up, you can integrate them into your Connected Claims solution. Spixii conversational process automation, with pre-built integration using APIs, ensures the gathering of all the FNOL details through its expert chat bots. Your claims information goes straight from the chat bots into your Connected Claims solution, where your operational claim teams have a 360-degree view of each claim.

Appian Connected Claims offers connection capabilities with Google Maps. If you have Google Maps services set up, you can integrate them into your Connected Claims solution to provide location and directions services from Google Maps directly in Connected Claims. Get step-by-step transit directions between 2 or more location points, trip distance and time, location timezone, and geocoding location information. You can also set up the integration to auto-complete location names and addresses into auto-complete picker or search field.

Appian Connected Claims offers connection capabilities with Twilio Utilities. If you have Twilio Utilities services set up, you can integrate them into your Connected Claims solution to add voice, chat, and SMS messaging capabilities to the solution using the Twilio service. Provide your customers with multiple ways to communicate with you. Use your customer data to track all of your customers interactions. This integration requires you to have your own Twilio account.

Appian Connected Claims offers connection capabilities with DocuSign. If you have DocuSign services set up, you can integrate them into your Connected Claims solution to capture your customer's electronic signatures on important claims documentation. This integration requires you to have your own DocuSign account.

Appian Connected Claims offers connection capabilities with Salesforce. If you have Salesforce services set up, you can integrate them into your Connected Claims solution to generate revenue faster by converting leads to customers. Through the seamless integration of Salesforce's sales opportunity system you can capture and view lead data to generate, qualify, manage, and route them to your sales teams. This integration requires you to have your own Salesforce account.

Appian Connected Claims offers connection capabilities with Google Cloud AutoML. If you have ave your own Google Cloud AutoML account and services set up, you can integrate them into your Connected Claims solution to enable AI and machine learning capabilities. Use Google’s AutoML service in your Connected Claims solution to build, train, and predict on custom image, text, or translate models and capture model details including metadata about the type of model.

Appian Connected Claims offers connection capabilities with Google Cloud Translate. If you have your own Google Service account and Google Cloud Translate services set up, you can integrate them into your Connected Claims solution to allow text translation and language detection. Dynamically translate between thousands of language pairs using the power of Google’s pre-trained neural machine translation.

Appian Connected Claims offers connection capabilities with Twitter. If you have your own Twitter account, you can integrate it with your Connected Claims solution to allow users to search and post directly to Twitter from the solution.

View and update existing lines of business, or add a new line of business to your organization's claims process.

Create and manage the claim journey (workflow) for different lines of business and add relevant process models to each claim journey.

Configure and manage different business rules for all claims processes.

Ability to setup common phases of the evaluation that end-users should select from during evaluation setup.

Configure rules to manage claim assignments

Configure and manage dynamic questionnaires and surveys that exist throughout the claims process.

Configure, update, and manage all communication templates by template type (task, assignment, email, WhatsApp, etc.)

Configure business rules for reserves and payment authorization.

Manage field work types associated with inspections and the field inspector skills for task assignments.

Manage field service workers by updating, adding, or deleting a field service worker record.