Executing the Claim Status Solution Scenario using Business Space

The Claim Status Solution Scenario provides access to the system of the insurance carrier to close the claim or to transfer the claim to an agent. This Claim Status Solution Scenario can be executed in Business Space using the procedure provided here.

An Agent can execute the Claim Status Solution Scenario in Business Space by logging on to Business Space, initiating a request, providing details using forms, and submitting the data for processing. While submitting the data, you can close the claim inquiry or you can transfer the Auto claim inquiry to an Auto LOB Specialist and the Home claim inquiry to a Home LOB Specialist. A LOB Specialist can then use Business Space to view and analyze information using the various graphs and diagrams displayed in the reports generated.

Note: Some of the fields, used in the forms, for this Solution Scenario are programmed using basic validations. You can verify the validation for the field by moving the mouse pointer over the field.

The Submit button in the form is disabled until you provide a value in all such fields in a form.

Table 1. Widgets to roles mapping
Roles/Pages Getting Started My Task Dashboard Performance Analysis Reports Process Process Check
Agent Yes Yes N/A N/A N/A N/A N/A N/A
CSR Yes N/A N/A N/A N/A N/A N/A N/A
AUTO LOB Specialist Yes Yes Yes Yes Yes Yes Yes Yes
HOME LOB Specialist Yes Yes Yes Yes Yes Yes Yes Yes

The roles for the Solution Scenario are given in the following table.

Table 2. Roles and users mapping
Group User User ID Password
Agent Adam Smith and Kim Edward Adam, Kim password
CSR Jay Walk and Saya Khan Jay, Saya password
AUTO LOB Specialist Peter Henderson Peter password
HOME LOB Specialist Susan Thomas Susan password

Before you begin

Ensure that the following prerequisites are complete before you execute the Solution Scenario.
  • Add and configure users and groups.
  • Verify that the Claim Status Solution Scenario artifacts are successfully installed in WebSphere® Process Server.
Note: As part of the installation, the endpoints used within the Solution Scenario are set to the port 9080 by default. If the Solution Scenario EAR files are deployed on different ports, it is recommended to use a monitoring utility, such as TCPMon, to act as a proxy to the actual endpoint.

About this task

Execute the Claim Status Solution Scenario in the Business Space using the following steps.

Updating the claims.csv file

You need to specify the data that you want to enter in the Solution Scenario forms in the claims.csv file. Adding data to the claims.csv file involves extracting and updating the file from the Enterprise Archive file provided with the WebSphere Insurance Content Pack.

Procedure

  1. Go to <Install_path>/assets/solution-scenarios/claim-status/wps/runtime.
  2. Copy the claim-summary-app.ear or the claim-summary-mock-app.ear file and save it as claim-summary-app.zip.
  3. Extract the compressed claim-summary-app.zip file.
  4. Go to claim-summary-app/copiedjars/ClaimSummary/lib.
  5. Rename claim-summary-resource-9.0.jar to claim-summary-resource-9.0.zip.
  6. Extract the compressed claim-summary-resource-9.0.zip file to a <temp-location>.
  7. Open the <temp-location> and copy the claims.csv file from the <temp-location> folder to the <Install_path>/assets/solution-scenarios/claim-status/wps/runtime folder.
  8. Open the claims.csv file.
  9. Add the data that you want to use while executing the Solution Scenario.
    Note: The first row denotes the column names for the data. Add rows, at the end of the file, for the data that you want to enter in the Business Space forms.

    The 'firstname' and the 'claim number' must be unique.

    Ensure that you enter dates for the current month because only the data for the current month is displayed on the dashboard.

  10. Replace the claims.csv file in claim-summary-resource-9.0.zip with the one that you updated.
  11. Rename claim-summary-resource-9.0.zip to claim-summary-resource-9.0.jar.
  12. Replace the claim-summary-resource-9.0.jar file in the claim-summary-app.ear and the claim-summary-mock-app.ear files at the following path.
    Table 3. Path for replacing jars
    Enterprise Archive file Path
    claim-summary-app.ear claim-summary-app/copiedjars/ClaimSummary/lib
    claim-summary-mock-app.ear claim-summary-mock-app/copiedjars/ClaimSummaryMockServicesModule/lib
  13. Deploy the two files so that the updated data is available for the Claim Status Solution Scenario.

Accessing the Claim Status Business Space

When using Business Space to view the Solution Scenario execution, you need to log in to the Business Space. This involves providing login details and viewing various pages that are part of the Claim Status space.

Procedure

  1. Open the Business Space portal.
  2. Log on to Business Space with the User ID as Adam and the Password as password.
    Note: The default password for the user when you configure the Solution Scenario using scripts is password. If you configure the Solution Scenario manually, you must use the password that you specified for the user registry in WebSphere Process Server. For more information, see the Configuring the user registry in WebSphere Process Server section in the Installation Guide.
  3. Open the Insurance Claim Status space.

Accepting claim inquiry details

After logging to the Claim Status space, a Submit Claim Inquiry request can be created. The claim number, if available, can be provided in the Submit Claim Inquiry Request form.

Procedure

  1. Open the My Tasks page.
  2. In the Task Definitions List widget, select the Submit Claim Inquiry check box and click the Create an instance from this task definition icon Create an instance from this task definition icon. The Submit Claim Inquiry Request form is displayed in the Task Information widget.
  3. Provide the required information in the form and click Submit. The View Claim Status task is displayed in the Tasks List widget.
    Note: Select the All - Assess available tasks option from the list that is displayed in the Tasks List widget to view the task.

    The scope of this Solution Scenario is limited. You must select and specify customer details from the claim.csv file. Alternatively, you can use the data given in the following table.

    Table 4. Customer details for the Solution Scenario
    Claim type Name Last name Zip Claim number
    Home craig adams 12321 681015345
    Auto james smith 98789 767075384

Transferring the claim to a claim specialist

After a claim inquiry request is initiated, it can be accepted by the agent. The Claim Status form displays the information related to the claim and gives the agent an option to transfer the claim to a specialist.

Procedure

  1. Select the View Claim Status check box from the Tasks List widget, and select Accept from the Actions list. The Claim Status form is displayed in the Task Information widget.
  2. View the information displayed in the Claim Status form and click Next.
  3. View the accident location details and click Next.
  4. View the contact information and click Next.
  5. View the claim status information and click Next.
  6. Click Transfer To Specialist and click Submit.
    Note: You can click Close and then click Submit to close the claim inquiry.

Closing the claim inquiry

If the claim inquiry is transferred to a specialist, the specialist can either close the request or provide comments about the claim.

Procedure

  1. Log on to Business Space as a LOB Specialist, open the Claim Status space, and then open the My Tasks page.
    Table 5. LOB specialist login information
    LOB specialist User ID Password
    Auto Peter password
    Home Susan password
    Note: The default password for the user when you configure the Solution Scenario using scripts is password. If you configure the Solution Scenario manually, you must use the password that you specified for the user registry in WebSphere Process Server. For more information, see the Configuring the user registry in WebSphere Process Server section in the Installation Guide.
    Note: The Umbrella claim is transferred to the Home LOB Specialist.
  2. In the My Tasks widget, select the Claim Status Issue check box and click Edit from the Actions list. The Claim Status form is displayed in the Task Information widget. View the information displayed and click Next.
  3. View the accident location details and click Next.
  4. View the contact information and click Next.
  5. View the claim status information and click Next.
  6. Specify a comment in the text box provided and click Update Status.
    Note: The scope of this Solution Scenario is limited and the comments that you enter in the text box are not stored in any database. You need to click Submit after you click Update Status to submit the form.

Viewing reports

The Solution Scenario provided with the WebSphere Insurance Content Pack includes different pages that are customized to display reports. These reports can be used for further analysis.

After you submit the request, you can log on using the User ID and password of an Auto LOB Specialist or Home LOB Specialist to analysis the information for the following pages

Note: Only the data for the current month is visible on the dashboards and reports.

Claim Status Dashboard

The Claim Status Dashboard page contains widgets that provide information about alerts, instances, total claims overview, and so on, related to the Claims Status requests raised.

The details for the widgets displayed on the Claim Status Dashboard page are given in the following table.

Table 6. Claim Status Dashboard page - widgets
Widget Description
Nationwide Distribution of Total Submitted Claims The map displays the total number of claims submitted for 20 states.
Claim Amount Overview - Current Month The full gauge diagram displays an overview of the claim amount for the current month.
Total Claims Overview - Current Month The widget displays an overview of the total claims for the current month.
Instances The widget displays the claim duration, claim key, and so on.
Alerts The widget displays the business measure alerts.
Note: You can drill down to view and further analyze the attributes of report values. To drill down, double-click a drillable field on the graph or diagram that you want to analyze. To return to the previous level, right-click a value and click Drill Up. You can also click Display menu icon from the Instances widget title bar, and click Refresh.

Performance

The Performance page can be used to view widgets. This page displays a bar graph and gauge diagrams that you can use to analyze the claim status.

The details for the widgets displayed on the Performance page are given in the following table.

Table 7. Performance page - widgets
Widget Description
Total Submitted Claims on Different LOBs - Current Month The bar graph displays a total of the claims submitted for each line of business in the current month.
Claim Summary for Different LOBs - Current Month The half gauge diagrams display the claim summary for each line of business.
Total Paid Claims on Different LOBs - Current Month The full gauge diagrams display the claims paid for each line of business.
Note: You can drill down to view and further analyze the attributes of report values. To drill down, double-click a drillable field on the graph or diagram that you want to analyze. To return to the previous level, right-click a value and click Drill Up. You can also click Display menu icon from the Instances widget title bar, and click Refresh.

Analysis

The Analysis page contains widgets that provide information about LOB distribution, total claims paid, and so on, related to the claim inquiry request raised.

The details for the widgets displayed on the Analysis page are given in the following table.

Table 8. Analysis page - widgets
Widget Description
LOB Distribution The pie chart displays the number of claims for the line of business.
Claim Status Distribution The pie chart displays the claim distribution grouped by the line of business.
Total Claim Amount Paid per LOB The bar graph displays the total claim amount paid for each line of business.
Note: You can drill down to view and further analyze the attributes of report values. To drill down, double-click a drillable field on the graph or diagram that you want to analyze. To return to the previous level, right-click a value and click Drill Up. You can also click Display menu icon from the Instances widget title bar, and click Refresh.

Report

The Report page contains widgets that provide information about the trend of submitted claims and the trend of claims amount related to the claim inquiry request raised.

The details for the widgets displayed on the Report page are given in the following table.

Table 9. Report page - widgets
Widget Description
Trend of Submitted Claims The 3D-line graph displays a trend for the claims submitted.
Trend of Claims Amount The 3D-line graph displays a trend for the claim amounts.
You need to complete the following steps if no data is displayed in the widget.
  1. Click Edit page.
  2. Click Display menu icon from the Instances widget title bar.
  3. Click Edit Settings, select the required month range, click Apply, and then click OK
  4. Click Save Format, click Save, and then click Finish Editing.
Note: You can drill down to view and further analyze the attributes of report values. To drill down, double-click a drillable field on the graph or diagram that you want to analyze. To return to the previous level, right-click a value and click Drill Up. You can also click Display menu icon from the Instances widget title bar, and click Refresh.

Viewing the Claim Status process flow

The Claim Status process flow can be viewed as published using WebSphere Business Compass or as an inflight process that displays the services used and the sequence in which they are processed.

View the Claims Status process flow on the following pages.

Claim Status Process

The artifacts, users, and roles used in the Solution Scenario can be viewed in the Claim Status Process page.

The details for the widget displayed on the Claim Status Process page is given in the following table.

Table 10. Claim Status Process page - widgets
Widget Description
Draft Artifacts Navigate and view the artifacts used in the Solution Scenario.
Review Access Control Navigate and view the users and roles provided for the Solution Scenario.

Claim Status Process Check

The Claim Status Process Check page contains a process flow that shows the sequence of the services executed for every claim inquiry request raised using the Solution Scenario. The human tasks that show the order flow for this process are displayed in green on this page.

The details for the widgets displayed on the Claim Status Process Check page are given in the following table.

Table 11. Claim Status Process Check page - widgets
Widget Description
Diagrams The inflight process displays where you are in the process and highlights the activity that is in a pending state. Select an item from the Instances widget to view the runtime transaction flow in this widget.
Instances The instances of the requests and responses created can be viewed in this widget.