Investigation

Overview

If the claim decision was set to "AutoPay", the Final Processing flow is executed to process the final credit and resolution notification.

The system then checks to see if any required customer documentation is missing.

If any required documents are missing, the system will delay further processing until the document(s) are received or the configured pend duration expires.

When processing resumes, the Provisional Credit Preconditions are evaluated to determine which of the following actions is executed.

If a user pends the case for Fraud Review and the dispute is accepted, the system will check to see if automatic provisional credit is configured.  If so, the manual review assignment is skipped.

If a user grants credit and approval is enabled, the Provisional Credit Decision Approval Flow flow is executed.

When all steps are complete, the Post Provisional Credit flow is executed.

On non-reg-protected claims, the Investigation step can be skipped and the dispute will route directly to the Disposition step. If the dispute does not have recovery rights, the Final Investigation assignment will generate. If recovery rights exist, then QFD will initiate recovery. 

If enabled and the Provisional Credit is denied, QFD will auto-issue temporary credit to align with Regulation E requirements. 

References