CARGO INSURANCE CLAIMS MANAGEMENT PROCESS

Created by ChecklistGuro (https://checklistguro.com)

[ ] Retrieve Claim Details: Fetch the initial claim submission data and associated shipment information from the Claims Data Model.
[ ] Fetch Policy Coverage: Retrieve the specific insurance policy details to verify coverage limits and terms.
[ ] Calculate Estimated Loss Value: Calculate the total loss by summing itemized damages and adding estimated shipping/handling costs.
[ ] Update Claim Status to 'Under Review': Update the status field of the claim entry to indicate the assessment phase has begun.
[ ] Assign Claims Adjuster: Create a task for the Claims Department to assign a qualified adjuster to the case.
[ ] Retrieve Evidence Documentation: Fetch all uploaded photos, inspection reports, and shipping manifests linked to the claim.
[ ] Conduct Physical Inspection: Create a task for the field agent to perform a physical inspection of the damaged cargo.
[ ] Create Inspection Report: Create a new entry in the Inspection Reports data model containing findings from the field agent.
[ ] Determine Deductible Amount: Calculate the portion of the claim that the policyholder must pay based on policy rules.
[ ] Calculate Net Payable Amount: Subtract the deductible from the total estimated loss value to find the final payout amount.
[ ] Update Claim Assessment: Update the claim entry with the final calculated loss and the adjuster's recommendation.
[ ] Manager Approval Task: Create a task for the Claims Manager to review and approve/deny the settlement amount.
[ ] Finalize Claim Status: Update the claim entry status to 'Approved' or 'Denied' based on the manager's decision.
[ ] Notify Claimant of Decision: Send an email to the policyholder informing them of the claim outcome and the payout details.
[ ] Create Payment Instruction: Create an entry in the Finance Data Model to trigger the actual disbursement of funds.
[ ] Update Claim to 'Closed': Update the claim status to 'Closed' once the payment instruction is successfully created.
[ ] Monthly Claims Volume Report: Aggregate all closed claims in the current month to calculate total payout volume and frequency.
[ ] Generate Monthly Loss Ratio Report: Create a summary report comparing total premiums collected vs. total claims paid for management review.

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