SchemeServe allows claims information to be captured and managed at several stages of the policy lifecycle.

Claims may appear in the following areas:

• Previous claims during the Get Quote journey
• Claims recorded against active policies
• Custom claims configured within schemes
• Site-level claims 
• Claims reporting

This article explains how claims work and how to record them within SchemeServe.

Types of Claims in SchemeServe

Previous Claims (Get Quote Journey)

Many schemes ask customers about previous claims during the Get Quote journey.

These questions are configured as part of the scheme's rating questions and are used to:

• Assess risk
• Calculate premiums
• Determine eligibility for the scheme

Previous claims entered during the quote process are stored as part of the policy record once the policy is purchased and can be used to trigger certain actions within your scheme build e.g. referrals, declines, loads etc…

These are not the same as claims reported during the policy period.

Claims on Active Policies

Once a policy is On Cover, claims can be recorded against the policy.

Claims are managed from within the Claims tab on the policy record.

Claims may include:

• Claim date
• Claim description
• Supporting documents
• Claim status or notes

This allows brokers, administrators, or authorised users to track claims activity associated with a policy. Further actions can be done off the back of these claims e.g. refer at renewal if any claims in the past 12 months.

How to Report a Claim

1. Find the policy from the cases tab
2. Ensure the policy is On Cover
3. Go to the claims tab inside the policy
4. Add new claim
5. Enter Claim Details:
   You can enter:

• Claim information
• Description of the incident
• Supporting details

You can also upload relevant documents, such as:

• photos
• reports
• supporting evidence

     6. Save the Claim

The claim will appear in the claims table under the Claims tab.

Custom Claims

Some schemes may require custom claim fields as specific fields are needed to report on claims data. These custom claim fields will appear within the claims tab within a policy once a claim is created. 

These are configured from the admin tab under “Claim Fields”:

• Label for field - Add the label which suits this field best
• Type of field - Select the type of field you will need e.g. textbox
• System ID - SchemeServe will automatically create a system ID for you. You can use this in your reporting later if you need to report on this field specifically
   

You'll find your custom built claim fields under the “Details” tab within a claim once you have saved the initial claim data:
 

Custom claims allow schemes to capture the information required by insurers or administrators which SchemeServe currently does not provide fields for.

Site-Level Claims Management

The Claims tab at the top of your screen allows administrators, brokers, and authorised users to manage claims across all schemes on the site. From here you can:

• View all claims recorded on the platform
• Filter claims by scheme, insurer, agent, or client
• Search for specific claims
• Export claims data
• Create new claims

This area provides a central location for claims oversight and reporting.

Understanding the Claims List

The claims list displays recorded claims in a table format.

Information typically shown includes:

• Claim Type – the category of claim
• Insurer – the insurer associated with the policy
• Scheme – the scheme the policy belongs to
• Agent – the agent or broker responsible for the policy
• Client – the policyholder
• Dates – claim-related dates

Filtering Claims

At the top of the page you can filter claims to narrow down results.

Available filters typically include:

• Claim Type
• Allows you to view claims for a specific category, for example:
• Armed Robbery
• Theft
• Property damage
• Other scheme-specific claim types

Insurer

Filters claims by the insurer attached to the policy.

This is useful when preparing claim reports for specific insurers.

Scheme

Filters claims to show only claims associated with a particular scheme.

This is helpful for scheme administrators who manage multiple schemes.

Agent

Filters claims by the broker responsible for the policy.

Client

Allows you to search for claims using a client name or reference number.

Date Filters

Claims can also be filtered by date range, allowing users to review claims within a specific reporting period.

Searching for a Claim

The Jump to Claim search box allows you to quickly find a claim using:

• Claim ID
• Insurer reference

Enter the reference in the search field and click the arrow to open the claim directly.

This is useful when working with claim references supplied by insurers or administrators.

Creating a Claim

Claims can be created directly from the Claims tab.

To create a claim:

1. Click Create Claim on the right side of the screen.
2. Enter the required claim information.
3. Attach any relevant supporting documents if required.
4. Save the claim.

Once created, the claim will appear in the claims list and can be accessed from the Claims tab or from the associated policy record.

Exporting Claims Data

Claims data can be exported for reporting purposes.

Available export options include:

1. Export Results as CSV
2. View Results Fullscreen

Exporting claims data is useful for:

• Insurer reporting
• Internal analysis
• Compliance and auditing

Narrowing Searches Using Tags

The Narrow search by tag option allows users to filter claims using tags that may be assigned to records.

Tags can be used to organise claims based on internal processes or reporting needs.

Claims Reporting

Claims data can be included in SchemeServe reporting. Our guide will show you claim reports and how to build them. In short:

1. Head to reports
2. Create a new claim report
3. Start typing “claim…” to see all your claim field options

Reports may be used to:

• analyse claim trends
• review claims history for schemes
• provide information to insurers
• support compliance or auditing requirements

Broker Claims Reporting

Brokers can add and review claims information associated with policies they manage. This will have to be enabled in the scheme settings under the advanced tab:

When a broker logs in and accesses their policy:

1.  If the policy is On Cover, you will be able to add a claim. You´ll see if a policy is On Cover by looking at the status on the right:

2.  Head to the claims tab. If there are any claims, you will see them in a table format. Head to the claims tab. If there are any claims, you will see them in a table format.

3. To report a claim, head to the right and select “report a claim”:

4. A pop-up will appear asking you to fill in the claim details. You can also upload any files that may be relevant:

5. Once you hit “report claim” at the bottom and refresh, you will see your claim added to the claims table under the claims tab: