Exploring ACM use case scenarios
The Auto Insurance Claim case is used as the user case scenario to demonstrate case patterns. An Insurance Claim case will be created to demonstrate the milestone pattern and other patterns and features, as follows:
- A customer calls the insurance company's Customer Service Representative (CSR) to initiate a claim request. CSR will perform the following actions:
- CSR will raise a claim on behalf of the claimant, who is a policyholder with the insurance company.
- CSR will update the Sensitivity information (Expert or Regular).
- If the Sensitivity of the case is Expert, then an Expert agent is assigned, else a Regular agent will be assigned to the case. Also, the Service Level Agreement (SLA) associated with the user task will be different going forward.
Also, if the case sensitivity is
expert
, the SLA associated with user tasks will take two days; else, it would be seven days.
- CSR will initiate the claim case by submitting the First Notice of Loss (FNOL).
- Once...
- CSR will raise a claim on behalf of the claimant, who is a policyholder with the insurance company.