Action Items vs. Claim Phases

This may be the most debated use of a ClaimWizard feature -- should you use Action Items or Claim Phases?

Claim Phases are used to showcase a HIGH LEVEL 'bucket' that a claim is currently in.

Action Items are used to indicate each intricate step involved in moving a claim to settlement.

By trying to use Claim Phases as Action Items you lose a LOT of tracking and accountability, as well as the ability to automatically assign tasks to team members and alert when things have gone late.

Action Items are created by YOU and infinitely customizable to meet your specific business and claim processing needs.

Claim Phases are NOT customizable (there are nearly 60, so take your pick from what is in the list!)


Claim Phases are NOT meant to:

  • tell your staff what a claim is waiting on to move forward
  • tell your staff the next steps that should be completed on a claim
  • break down each piece of a higher action, such as
    • 'planning for estimate'
    • 'performing estimate'
    • 'waiting for estimate report'
    • 'sending estimate report to carrier'
    • 'waiting for estimate response from carrier'
  • take the place and functionality of Action Items

Claim Phases ARE meant to:

  • give your team a high-level view of where a claim is in its life cycle, such as Estimation or Appraisal or Billing
  • be used to trigger specific Action Items or Claim Alerts/Conditions
  • alert your staff if a claim is in 'exception' - meaning it is in a part of its life cycle you really don't want it to be in, like Litigation or Collections

Action Items are NOT meant to:

  • alert your staff if a claim is in 'exception' - meaning it is in a part of its life cycle you really don't want it to be in, like Litigation or Collections -- but an AI CAN update a Claim Phase on its own based on things that have/have not happened

Action Items ARE meant to:

  • assign specific tasks to specific people (or roles on a claim, or departments, etc.)
  • be trackable and documented in the Activity Log & Message Archive
  • have 'next steps' and overdue escalation paths
  • have deadlines