Working with PeopleSoft Enterprise Policy and Claims Presentment Self-Service

This chapter provides an overview of PeopleSoft Enterprise Policy and Claims Presentment Self-Service and discusses how to:

Work with PeopleSoft Enterprise Policy and Claims Presentment Self-Service transactions.
Change policies.
Report a First Notice of Loss (FNOL).
View claims.

Understanding PeopleSoft Enterprise Policy and Claims Presentment Self-Service

This section lists prerequisites and discusses:

Self-service access.
Self-service management.

Self-Service Access

Two types of self-service users can access the site:

Guest users.
Registered users.

Guest User Access

When users first access the site, they are automatically logged in using the INSGUEST ID that is identified in the configuration properties file. As long as that ID has the appropriate permissions, users can use the site with limited access.

Then, users can sign in with their own user ID and password to further identify themselves and get additional access. Even after users sign in with their own user IDs, the guest ID controls certain site characteristics, such as the site language.

If you have more than one guest ID, users can switch to a different one by selecting a value from the drop-down list box on the page. Depending on how you define guest IDs, the IDs may control the site language, the business unit whose data appears, or other site characteristics.

Registered User Access

Visitors can register as personal users by clicking the Personal User Registration link and establishing a personal user ID. This prompts the system to create a consumer record for that person, and the registration causes the system to create a user ID that is associated with the new consumer record and that the visitor can use to sign in on subsequent visits to the site. The user ID is cloned from the guest ID that was active when the user registered. Menu navigation options, and in some cases, page appearance depend on the user's role or roles.

Users who forget their passwords can click the Password Hint link to request a new password.

Self-Service Management

The self-service menu enables the self-service user to perform these transactions:

Menu Item	Description
Policy Administration	Modify policies.
Browse Catalog	View product catalogs, view information about product offerings, and request quotes online.
Profile	Change the username, password, default address, phone number, and email address; view and maintain an address book; and view internal contact information.
Customer Selection	Select the role for the current transaction.
Contact Us	Create an email that will be directed to the appropriate area in the organization.
Customer Care	Create FNOL, update claims, and log complaints.

Prerequisites

Self-service functionality for PeopleSoft Enterprise Policy and Claims Presentment is based on core functionality for case and product catalog. Detailed information on setting up and managing self-service is available in these PeopleBook chapters:

Process	Details	More Information
Setting up customer self-service	Define guest IDs. Set up user registration features. Set up Contact Us features.	See Setting Up Customer Self-Service.
Working with customer self-service	Sign in to PeopleSoft self-service. Register as a personal user. Maintain name and sign-in information. Maintain a customer's contact and address information. Maintain a customer's address book. View internal contacts. Send messages.	See Working with Customer Self-Service Transactions.
Configuring self-service	Hide specific fields in self-service case components. Configure 'Contact me' notifications. Associate solutions with reasons that self-service users provide for closing cases. Update descriptions of the predefined searches that the users of self-service components use. Set up FAQs and troubleshooting guides.	See Configuring Self-Service Applications.
Working with self-service transactions	Create an FNOL. Manage existing FNOL. Search for solutions. Use FAQs and troubleshooting guides.	See Self-Service for Customers.

Changing Policies in Self-Service

The self-service user can make changes to policies online.

This section discusses how to change policies.

Pages Used to Change Policies in Self-Service

Page Name	Object Name	Navigation	Usage
Policy Administration	RBI_CHG_POLICY_SS	Click the Policy Administration link on the main menu in self-service	Access the Change Policy component.
Change Policy	RBF_PROD_APPLY_SA	Click the Change Policy button on the Policy Administration page in self-service	Modify policies.

Administering Policies in Self-Service

Access the Policy Administration page.

Account Number

Select a policy number that is associated with the user's role. You can modify only those policies that are authorized for the user in the security matrix.

Modification Type

Select the action that is associated with the product.

Defines the changes a policy owner can make to the policy.

Change Policy

Click to submit the policy change request. When the user clicks this button, more information will be captured to complete the change and a confirmation number is returned. If the Policy change requires re-quoting, a new quote provided. After the quote is accepted and purchased, a change policy request is sent to the legacy system to modify the policy. The legacy system updates the policy and sends the changes back to the PeopleSoft Enterprise CRM system. The PeopleSoft Enterprise CRM system subscribes to the published changes to the policy and eventually updates the policy.

Reporting a FNOL in Self-Service

Access the policy through the My Policy pagelet to create a FNOL.

This section discusses how self-service users:

Review financial account information.
Review insurance policy details.
Report FNOL.

Pages Used to Report a FNOL in Self-Service

Page Name	Object Name	Navigation	Usage
Financial Account	RBF_FIN_ACCOUNT_SS	Click the policy number link on the My Policies pagelet in self-service	Review policy details.
Insurance Policy	RBI_POLICY_SS	Click the View Policy button on the Financial Account page in self-service	Review covered assets, coverages, deductibles, limits, and options for the selected policy.

Reviewing Financial Account Information in Self-Service

Access the Financial Account page.

View Policy

Click to access the Insurance Policy page.

View Claim Summary

Click to access the Claim Summary page.

Note. System administrators can use Insurance Translate Values to define valid prompt values for various fields in the application. The navigation is Set Up CRM > Product Related > Financial Services > Insurance Translate Values. This enables administrators to add, remove, or change values without logging into PeopleSoft Application Designer. This applies to both Financial Account and Policy pages (Agent-facing and Self-Service). The component name is RBI_XLAT_VALUE_INS.

See Working with Policies.

Reviewing Insurance Policy Details in Self-Service

Access the Insurance Policy page.

View Billing History

Click to access detailed billing history by date range.

View Payment History

Click to access detailed payment history by date range.

Change Policy

Click to initiate a policy modification request such as changing an address or adding an authorized driver.

Create First Notice of Loss

Click to create a new FNOL.

Details

Click to access asset information details.

Reporting FNOL in Self-Service

Access the Create First Notice of Loss Page

Note. These screen shots are only examples. You must set up an application form or branch script for self-service users to be able to create a FNOL.

Policy Number	Enter the policy number, which comes from the Financial Account component.
Policy Name	Enter the policy name, which comes from the Financial Account component.
Policy Status	Enter the policy status, which comes from the Financial Account component.
Beneficiary Name	Enter the beneficiary who is designated for the policy, if applicable.
Insured Name	Enter the name of the insured, who may or may not be the policy owner.
Registration Name	Enter the name that the insurer gave to the account while registering it.
Owner Name	Enter the policy owner's name.
State	Enter the state of issue for the policy.
Save for Later	Should not be used when creating a FNOL.
Driver's License	Enter the insured driver's license number.
DL Expiry Date (driver's license expiration date)	Enter the driver's license expiration date.
Accident Date	Enter the date of the accident.
Details	Enter details of the loss.

Viewing Claims in Self-Service

The self-service user can view claims information using the Claims link on the self-service homepage.

This section discusses how to review claim details.

Pages Used to View Claims in Self-Service

Page Name	Object Name	Navigation	Usage
Review Claim	RBI_CLAIMHDR_SS_PG	Click the claim number link on the My Claims pagelet in self-service	Review claim details and access the FNOL that is associated with the claim.

Reviewing Claim Details in Self-Service

Access the Review Claim page.

Claim Number

Displays the unique identifier for the claim.

Account Number

Displays the policy number for the claim.

Customer

Displays the customer's name. This should be the policy owner.

Contact Name

Displays the name of the contact who represents the customer, if applicable. This could be a contact for a consumer, company, partnership, or alternate capacity.

Claim Date

Displays the date when the claim was filed.

Description

Displays a brief description of the claim.

First Notice of Loss

FNOL which triggered the creation of the claim.

View Claim Details

Click to view detailed information about the claim.

View Policy	Click to access the Insurance Policy page.
View Claim Summary	Click to access the Claim Summary page.

View Billing History	Click to access detailed billing history by date range.
View Payment History	Click to access detailed payment history by date range.
Change Policy	Click to initiate a policy modification request such as changing an address or adding an authorized driver.
Create First Notice of Loss	Click to create a new FNOL.
Details	Click to access asset information details.

Claim Number	Displays the unique identifier for the claim.
Account Number	Displays the policy number for the claim.
Customer	Displays the customer's name. This should be the policy owner.
Contact Name	Displays the name of the contact who represents the customer, if applicable. This could be a contact for a consumer, company, partnership, or alternate capacity.
Claim Date	Displays the date when the claim was filed.
Description	Displays a brief description of the claim.
First Notice of Loss	FNOL which triggered the creation of the claim.
View Claim Details	Click to view detailed information about the claim.