Cargo Insurance Claims Management Process

Start of the Workflow/Process.

Fetch the initial claim submission data and associated shipment information from the Claims Data Model.

Retrieve the specific insurance policy details to verify coverage limits and terms.

Calculate the total loss by summing itemized damages and adding estimated shipping/handling costs.

Update the status field of the claim entry to indicate the assessment phase has begun.

Create a task for the Claims Department to assign a qualified adjuster to the case.

Fetch all uploaded photos, inspection reports, and shipping manifests linked to the claim.

Create a task for the field agent to perform a physical inspection of the damaged cargo.

Create a new entry in the Inspection Reports data model containing findings from the field agent.

Calculate the portion of the claim that the policyholder must pay based on policy rules.

Subtract the deductible from the total estimated loss value to find the final payout amount.

Update the claim entry with the final calculated loss and the adjuster's recommendation.

Create a task for the Claims Manager to review and approve/deny the settlement amount.

Update the claim entry status to 'Approved' or 'Denied' based on the manager's decision.

Send an email to the policyholder informing them of the claim outcome and the payout details.

Create an entry in the Finance Data Model to trigger the actual disbursement of funds.

Update the claim status to 'Closed' once the payment instruction is successfully created.

Aggregate all closed claims in the current month to calculate total payout volume and frequency.

Create a summary report comparing total premiums collected vs. total claims paid for management review.

End of the Workflow/Process.