Claims

Claims overview

What Claims is

Claims in 21RISK is a dedicated board for registering and following insurance claims — from the moment a loss happens until the case is settled and closed.

Each claim records what happened, where it happened, and what it costs. Claims sit alongside your other 21RISK data, so a loss at a site can be seen next to that site's risk profile, open recommendations and insurance values.

Claims is a board, but a special one: an organization has exactly one Claims board. It uses board access, sites, statuses, activity logs and effective access like other boards.

Core concepts

ConceptWhat it means
ClaimOne insurance case, registered on a site with a date of loss.
Claims lineThe line of business the claim belongs to: Liability or Property.
Damage typeWhat happened, for example Fire, Recall or Water Damage. The list is configurable per claims line.
Root causeWhy it happened, for example an electrical fault, hot work or a supplier defect — and how sure you are about it. The list is configurable per claims line.
Date of lossThe date the damage occurred. Used for reporting per claim year.
StatusWhere the claim stands. New boards start with Open and Closed.
PaymentsThe dated ledger of money paid on the claim, by the insurer or by you.

Claims lines

Every claim belongs to one of two lines:

  • Liability — claims where a third party holds you responsible, such as product liability, recall or professional indemnity.
  • Property — claims for damage to your own buildings, machinery and stock, such as fire, water damage or storm.

The line matters because damage types are configured per line, and because most claims reporting is split by line.

Damage types

Damage types describe what happened — the kind of loss. They are managed by your organization, so you can match the terminology you already use with your broker and insurer. Why the loss happened is recorded separately, as its root cause.

Each claims line has its own list. When Claims is enabled, both lines are seeded with a starting set:

LineDefault damage types
LiabilityRecall, Warranty, Water Damage, Workers Comp
PropertyDamage, Fire, Earthquake, Earth Movement, Water, Water Damage, Windstorm

To change the list, go to Claims > Settings. You can add a damage type to either line, or remove one you do not use.

Root causes

The root cause records why a loss happened. Fire is the damage type; hot work, a loose electrical connection or a missed inspection is the root cause. Recording it lets you see which causes cost you the most across sites, and what to fix so the same loss does not happen again.

A root cause has three parts:

FieldWhat it holds
Root cause statusHow sure you are about the cause. See the statuses below.
Root causeThe cause itself, picked from your organization's list for the claim's line.
Root cause descriptionWhat happened and why, in your own words — for example a summary of the loss adjuster's report.

The status tells everyone how far the investigation has come:

StatusMeaning
Not known yetThe default. No cause has been recorded.
SuspectedA preliminary cause, for example from the site or the first notice of loss.
ConfirmedEstablished by an investigation, a loss adjuster or an expert report — more likely true than not.
UndeterminedThe loss was investigated, but no single cause could be established.

You pick a root cause when the status is Suspected or Confirmed. With Not known yet or Undetermined the claim has no root cause, but you can still write a description. When the cause firms up — say from suspected hot work to a confirmed permit failure — update the claim. The claim's history, next to the form, shows each change from the old value to the new one, and the activity log names the new root cause.

Root causes come in two levels: a category, such as Electrical, and sub-categories under it, such as Loose or faulty connection. Pick the sub-category when you know it, and the category when you only know the broad cause. Charts and filters on a category include its sub-categories. In the claim form, the root cause picker lists the categories: expand one to pick a sub-category, or type to search them all.

Each claims line has its own list. When Claims is enabled, both lines are seeded with a starting set drawn from fire-investigation, insurer and product-recall cause codes:

LineDefault categories
PropertyElectrical; Hot work and ignition sources; Equipment and mechanical failure; Maintenance, inspection and housekeeping; Design, construction and installation; Operations and handling; Process and hazardous materials; Natural hazard exposure; Intentional acts and security; Third parties and utilities; Other
LiabilityProduct design and engineering; Manufacturing and process control; Suppliers and purchased materials; Contamination; Labelling, packaging and instructions; Storage, handling and customer use; Work equipment and environment; Procedures and training; Management and supervision; External; Other

To change the list, go to Claims > Settings. Each line shows its root causes as a tree: expand a category to see its sub-categories. Add a category with Add category below the tree, and use a category's row menu to Add sub-category under it or to Remove one you do not use. Removing a category also removes its sub-categories. Group owners manage the list; everyone else can see it.

Creating a claim

  1. Open Claims > List.
  2. Select New claim.
  3. Fill in the claim:
    • Name — a short description of the loss.
    • Site — where the loss happened.
    • Claims line and Damage type.
    • Date of loss.
  4. Optionally set the Worst case claim estimate and Deductible (see Claim financials), status, responsible, tags, the root cause, notes and files. You can add the estimate and deductible later, once they are known.
  5. Select Create claim.

The damage types and root causes offered depend on the claims line you pick, so choose the line first.

People outside the claims team report claims on the Claims landing page: a simple page you can share, where anyone with the Create permission reports a loss without seeing other claims.

Working with the claim list

Claims > List shows every claim on the board. The table works like other 21RISK tables: search, filter, sort, choose columns, and export to Excel or CSV.

Financial columns such as gross paid, gross outstanding and net incurred are available in the column picker, so you can build the view your team needs and save it.

The Root cause status column shows how sure you are about each claim's cause. Not known yet and Suspected stand out in orange and amber, so you can see at a glance which losses still need investigating; Confirmed is green. The Root cause column next to it names the cause. Root cause category and description are in the column picker too, and you can filter on every root cause column.

The same filter set also drives Claims analytics, which shows the filtered claims as totals, damage types, root causes, statuses and loss years.

Select a claim to open it. From the list the claim opens in a dialog; you can also open it as a full page. Both show the same form: claim details on the left, activity and comments on the right.

Deleting a claim

  1. Open the claim as a full page.
  2. Select Delete claim below the form, and confirm.

Deleting removes the claim together with its payments, comments and change history, and it cannot be undone. It needs the Delete permission on the Claims board, or, for a claim you filed yourself, Delete own claims on the Authors row, or, for a claim you are responsible for, Delete assigned claims on the Responsible row. Without it the button is disabled. The deletion is recorded in the board's activity log.

To keep a finished claim out of the way instead, set its status to Closed.

Sites

Claims are filed on the sites on the Claims board. A new Claims board covers every site in your organization. To limit it, open Claims > Settings > Site Access and replace All sites with the sites or site groups you want. Claims already filed at a site you remove leave the board with it, as items do on other boards, and come back if you add the site again.

Unlike on other boards, site access does not limit claims. Anyone who may create claims can file them on any site on the Claims board, including sites they have no site access to: the people who see a loss first often have the least access. Who reads which claims is decided by the board's permissions alone: View shows every claim, View own claims on the Authors row shows the claims you filed, and View assigned claims on the Responsible row shows the claims you are responsible for.

Authors

The people who report losses often need to keep working on the claims they filed, without being allowed to change everyone else's. The Authors row under Claims > Settings > User Access controls that. It is always there, right below the owners, and applies to whoever filed a claim, for that claim.

Select Edit on the Authors row and choose what authors can do with their own claims:

ChoiceWhat authors can do with the claims they filed
View own claimsSee them in the list, in analytics and in the claim dialog.
Edit own claimsChange them, comment on them and record payments.
Delete own claimsDelete them.

The Authors row does not give anyone access to the Claims board. Who can file claims still comes from users, user groups and responsibilities with the Create permission. A new Claims board starts with nothing ticked, so authors can do exactly what their other access allows.

To let people report losses and follow up only on their own claims, give them a Custom grant with only Create (on the Claims board, Custom may leave out View), and tick View own claims on the Authors row, plus Edit own claims if they should keep their claims up to date. Editing and deleting your own claims also needs View own claims, or View on the whole board.

The Effective Access tab lists the Authors row as a source, and shows its permissions in the View Own Items, Update Own Items and Delete Own Items columns.

Responsible

A claim is often handled by someone outside the claims team, such as a site manager or a broker contact. Instead of giving that person access to the whole Claims board first, set them as the claim's Responsible. The Responsible row under Claims > Settings > User Access decides what they can then do with it. It is always there, right below the Authors row, and applies to whoever is set as Responsible on a claim, for that claim.

Select Edit on the Responsible row and choose what responsible people can do with their claims:

ChoiceWhat they can do with the claims they are responsible for
View assigned claimsSee them in the list, in analytics and in the claim dialog.
Edit assigned claimsChange them, comment on them and record payments.
Delete assigned claimsDelete them.

Unlike the Authors row, the Responsible row gives access to the Claims board on its own: someone with no other access sees the Claims board as soon as they are responsible for a claim, with just the claims they are responsible for. The Authors row does not apply to them through that access, so claims they filed earlier stay out of reach. The access follows the claim. When the claim is handed to someone else, or deleted, the previous responsible person loses it. A new Claims board starts with nothing ticked, so setting someone as Responsible gives them nothing until you tick at least View assigned claims. Editing and deleting also need View assigned claims, or View on the whole board.

Who is responsible for a claim is changed by people who can edit every claim, and by the claim's author with Edit own claims. Someone who can edit a claim only because they are responsible for it cannot hand it over, so the Responsible field is locked for them. And only someone who can edit every claim can make themselves responsible, when filing a claim or later, so the Responsible row never widens what the Authors row allows.

The Effective Access tab lists the Responsible row as a source for everyone who is responsible for a claim, and shows its permissions in the View Assigned Items, Update Assigned Items and Delete Assigned Items columns.

Statuses

A new Claims board is created with two statuses:

StatusMeaning
OpenThe claim is active and being handled.
ClosedThe claim is finished.

Statuses are board statuses, so you can rename them or add your own — for example an intermediate Under assessment — under the board's status settings.