Part 8: Building a Claims and Payout Flow

Useful documentation

Overview and success criteria
✅ Below specified claims information can be captured during the claims flow in the claims blocks.
✅ A lump sum payout can be created only after a claim has been approved/goodwill, using disbursement blocks.
✅ The below specified alert banners show at the correct time to indicate waiting period discretions.
✅ The claims assessor checklist, as well as the document labels are configured correctly.

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Watch our explainer videos:

Watch the video Policy Lifecycle: Claimsto learn more about building out the claims flow on the Root platform:

To successfully build a claims and payout flow on Root, follow these steps:

  1. Start by adding all the claims blocks to the claims-blocks.json file to capture the specified claims information.
  2. Create a lump sum payout block to create a payout request on the approval/goodwill of the claim.
  3. Insert alert banners to the claims flow that’ll indicate to the claims agent if a waiting period rule is not adhered to.
  4. Go to the .root-config file to configure the claims assessor checklist, as well as the document labels.

Building a claims flow
Summary
A claim on this product is opened for an individual dinosaur claim. There are two primary claim types:

Claim typeCover insight
IllnessAll policies have this cover.
DeathAll policies have this cover.

Waiting periods

The following waiting periods are applicable to this product, and relative alert banners should be shown if the claim is still within the waiting period.

Dinosaur illness1 month waiting period from the policy start date
Dinosaur death3 months waiting period from the start date

Claim details
The following information needs to be captured as part of the claims flow. The relevant alert banners will also be defined here, for ease of reference.

Give this section a header of Incident description

Title/markdownKeyTypeAdditional detailsDisplay conditions
Claim typeclaim_typeRadio blockIllness or deathAlways display
Date of incidentincident_dateinput.dateYYYY-MM-DDAlways display
Date reportedreported_dateinput.dateYYYY-MM-DDDefault to “date created” (today’s date)
Warning: Claims must be logged within 60 days of the incident occurring.date_warning_pastalertAlert banner: DangerIf the date difference between incident_date and reported_date is greater than 60.
Warning: Claim for illness must be outside of the waiting period of 1 month.date_warning_illnessalertAlert banner: DangerIf the date difference between incident_date and policy.start_date is less than 30.
Warning: Claim for death must be outside of the waiting period of 3 months.date_warning_deathalertAlert banner: DangerIf the date difference between incident_date and policy.start_date is less than 90.
Description of incidentincident_descriptionText boxFree textAlways display
N/Aclaim_type_dividerdividerN/AAlways display

Give this section a header of Payment details

DescriptionKeyComponent typeValuesDisplay conditions
Bank namebank_nameDropdown["absa", "african_bank", "bidvest", "capitec", "discovery_bank", "fnb", "investec", "ithala", "nedbank", "old_mutual", "postbank", "standard_bank", "tyme_bank"]Always display
Branch codebank_codeInput field number632005Always display
Account typeaccount_typeDropdown["savings_account", "cheque_account"]Always display
Account numberaccount_numberInput field number123456789Always display

**Claims assessor checklist**

RefDescription
C1Is the date of claim within 60 days of the incident occurring?
C2Have all the documents been provided?
C3Is this the first claim for the dinosaur?
C4Are all the premiums up to date upon the claim reported date?

Document Labels

RefDocument name
D1Dinosaur Claim form (Mandatory)
D2Proof of Payment (Mandatory)
D3NDR Form (Mandatory)

Payout workflows for approved claims

  • One payout block is required.
  • The cover amount should be the total payout amount.
  • All the information in the payout block should be derived from the claimant information captured above.
  • Note: the payout block will be disabled if the claim does not have a status of approved or goodwill
  • The payout block should have the following properties:
KeyValue
keypayout_block
typepayout_request
titleDinosaur Payout Block
descriptionPayout for the injured or deceased dinosaur
Payee
typepolicyholder
amountThe sum assured amount
percentage100
payment_details
typeeft
details.bank_namebank_name from the Payment details section
details.branch_codebranch_code from the Payment details section
details.account_typeaccount_type from the Payment details section
details.account_numberaccount_number from the Payment details section