Searching for a Claim or Claimant Record

Searching for a claimant to match with an OCF

Usually, a user would be searching for a claimant in HCAI if an ‘unmatched’ document is received and no possible or no correct matches are listed.

To search for a claimant when matching an OCF, you must have the Form Manager role.

1. Open the unmatched OCF.

2. If the OCF is unmatched, you should immediately see the Match Claimant screen. If the OCF is currently matched to the incorrect claimant, you can go to Tab 1, Part 1: Applicant Information and click “Unlink Claimant Data” and then “Link Claimant Data” in order to reach the Match Claimant screen.

3. Look at the ‘Submitted Applicant’ section for possible claim search criteria, such as claimant name or date of birth.

4. Click the ‘Search for Claimant’ button (View Screenshot).

5. The “Search for Claimants” screen will appear.

6. Enter relevant search criteria (e.g. name or date of birth).

7. Click <Search>. The screen will refresh and search results will be listed in the ‘Possible Match’ screen (View Screenshot).

8. Review possible matches; if a match is correct, click ‘Match’. The document is now matched to the claimant.

Searching for claims or claimants (general)

There are many reasons why you would want to search for a claim or claimant aside from matching. For example, to view a list of all open claimants assigned to a file owner, to view a list of claims for a particular individual, or to update the name or address of a claimant. Searching for a claimant will also allow you to view their Claimant Financial Summary, which provides a summary of the amounts proposed and approved for the claimant.

The search results list for claims and claimants are numbered and can be sorted by clicking on the column headings. As always, the more specific you can be when entering your search criteria, the more specific your search results will be.

To search for a claim

To search for a claim in the ‘Claim Search’ window, you must have the Form Manager, Form Adjuster, Claim/Claimant Administrator or Claim/Claimant Editor role.

1. Click on the Claims tab, the Claims Search screen will appear.

2. In the ‘Search for Claims’ section, enter relevant search criteria (View Screenshot).

3. Click the ‘Search’ button. The screen will refresh and search results will appear.

4. Click on the Claim number hyperlink if you wish to review claim information (View Screenshot).

5. The Claim Details screen will appear.

   Please note: If the Associated Claimants section contains claimant records that the Form Adjuster does not have permission to view, the claimants’ names and dates of birth will be masked for privacy.

6. If you make any changes to the Claim Details, ensure you press <Save> once complete (View Screenshot).

Please note: Non-integrated insurers can also transfer a claim by updating the branch/claim group, and file owner section of the claims detail screen. Please see Transferring a Claim.

To search for a claimant

1. Click on the Claims > Claimants tab, the Claimant Search screen will appear.

2. In the ‘Search for Claimants’ section, enter relevant search criteria, click the ‘Search’ button (View Screenshot).

3. Screen will refresh and search results will appear.

4. To view the Claimant Financial Summary, click on the ‘View Report’ hyperlink in the Financial Summary column. Visit the Claims Tools page to learn more about the Claimant Financial Summary.

5. To review claimant information, click on the ‘Claimant Name’ hyperlink.

   1. The ‘Claimant Details’ screen will appear.

   2. If you make any changes to the Claimant Details tab, ensure you press the ‘Save’ button once complete (View Screenshot).

Up to 100 search results can be displayed on a single screen. These search results which are displayed on the screen can be downloaded in .csv format by clicking the ‘Download Report’ button. (View Screenshot)