Claim notification events

Standard claim notification events are triggered according to the table below. For more details about the claims workflow, including details on the various claim statuses and claim approval statuses, refer to the claims guide.

Notification event	Recipient(s)	Trigger(s)
Claim received	Claimant	When a claim is opened. When a claimant without an email address is updated with an email address.
Claim linked to policy	Claimant	When a claim is linked to the policy. This can happen when the claim is opened or when a claim is linked to a policy at a later stage.
Claim sent to review claimant	Claimant	When the agent has captured all the claim information and sends the claim for review by the claim assessor. The claim status changes from `open` to `in_review` .
Claim sent to review	Agent	When the agent has captured all the claim information and sends the claim for review by the claim assessor. The claim status changes from `open` to `in_review` .
Claim decision review	Supervisor	When the claim assessor makes a provisional decision, to be reviewed by the claim supervisor. The claim approval status changes from `pending` to one of `approved`, `repudiated`, `no_claim` or `goodwill`.
Claim approved	Claimant	When a claim approved decision is acknowledged by the claim supervisor. When a goodwill decision is acknowledged by the claim supervisor.
Claim approved beneficiary	Beneficiaries	When claim has beneficiaries and a claim approved decision is acknowledged by the claim supervisor. When a claim has beneficiaries and a goodwill decision is acknowledged by the claim supervisor.
Claim repudiated	Claimant	When a repudiated claim is closed. When a no claim decision is acknowledged by the claim supervisor.

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Acknowledging a claim repudiated decision does not trigger a notification event.
The “claim repudiated” notification is only triggered when a repudiated claim is closed. This allows the claim to be resent for review following repudiation acknowledgement.

If your claims workflow requires further customisation beyond the standard events, you can configure custom notification events for your product. These events can be triggered from the product module code using claim lifecycle hooks or scheduled functions. For example, you can use the “After claim decision acknowledged” lifecycle hook to trigger a custom repudiation notification to the claimant.