Claim Status

Status	Definition	Action Required from
INITIATED	Claim has been created but will not be processed until the required data are submitted by the Claimant.	Claimant
EXPIRED	The Claimant has not completed all of the necessary claim data within the agreed time frame based on the insurance product terms.
DATA_SUBMITTED	Claim data has been filled and submitted by the Claimant.	Cermati
DATA_ON_REVIEW	Claim is under review by Cermati Claim Team.	Cermati
DATA_ON_REVIEW_BY_SYSTEM	Claim is under review by System.	Cermati
DATA_INCOMPLETE	Claim has been reviewed by Cermati Claim Team but requires additional documents to proceed further.	Claimant
DATA_COMPLETE	Claim has been reviewed by Cermati Claim Team and proceeded to the Insurer for further analysis and confirmation.	Insurer
ADDITIONAL_DATA	Claim has been reviewed by the Insurer but requires additional documents to proceed further.	Claimant
CLAIM_APPROVED_BUT_DOCUMENTS_FOR_CLAIM_PAYMENT_NEEDED	Claim has been approved by the Insurer, but requires documents from the Claimant to process the claim payment.	Claimant
DOCUMENTS_FOR_CLAIM_PAYMENT_SUBMITTED	The required documents to process the claim payment have been submitted by the Claimant.	Insurer
APPROVED	Claim and documents to process the claim payment have been approved by the Insurer. Claim is currently in the claim payment process.
REIMBURSEMENT_TRANSFERRED	Final status. Claim has been paid by the Insurer to the Claimant.
REJECTED	Claim has been rejected by the Insurer.
CANCELLED	Claim has been cancelled by the Claimant. Cancelled claims will not be processed any further.
JUNK	Junk or testing claim.

PIC	Definition
Claimant	Insured of insurance product who files a claim for insurance coverage benefits.
Insurer	Insurance Company that underwrites the insurance product.
Cermati	Cermati internal team (e.g. Claim Ops, etc).