Reclassifying a Claim

The Reclassify Case action available from the Actions menu will allow the user to set a new claim reason.  When the action is taken, the claim questionnaire will be displayed in a new window and the user will be prompted to answer the required questions for the chosen claim reason.  The user is not required to complete the questionnaire.  However, they are encouraged to provide as much information as possible.  When the reclassification action is processed, the Claim Category and Claim Reason (both displayed in Case Assets) are updated.  Reclassification is only allowed when there are no disputes in active recovery.  If one, or more, disputes are in recovery, recovery must be cancelled before reclassification can be completed.

Re-routing Work

When a claim is reclassified from one claim category to another, work routing rules are re-evaluated to re-assign work, as needed.  For example, if a fraud claim on a credit card is reclassified to a non-fraud reason, the open assignments may be moved from work queues with a “.CreditFraud” suffix to workbaskets with a “.CreditNonFraud” suffix.  The exact suffix will depend on your configuration and will ensure that the assignments are worked by users in the appropriate work group.  

Automated Actions

When a claim is reclassified from non-fraud to fraud; it will kick off both fraud reporting and the block and reissue flow as needed.  Additionally there is a client level setting that can be enabled for clients who only perform dispute status maintenance on non-fraud claims.  When the setting is enabled and a claim is reclassified from non-fraud to fraud it will evaluate if the dispute is in dispute status.  In the event it is dispute status will be removed and provisional credit will be issued are required. 

Workflow

References