CermatiCermati Protect

Claim Submission Flow

Claim Submission

To submit a claim, customers need to choose which transaction they want to claim, choose the claim type, and then fill in the claim form. Claims that have been successfully submitted will have DATA_SUBMITTED status.

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Claim submission flow

Claim Cancellation

Customers can cancel claims that they have created as long as the status is still INITIATED. Cancelled claims will not be processed any further.

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Claim cancellation flow

Data Incomplete and Additional Data

After submitted, the claim will be reviewed by Cermati Claim Team and Insurer. Under the review process, the customer may be asked to revise the submitted data or provide an additional data if necessary.

In that case, the claim will be updated to one of these statuses:

  1. DATA_INCOMPLETE:
    The claim is being reviewed by Cermati Claim Team and they determine that some of the data need to be revised. For example, the image that was originally submitted by the customer is blurry.

  2. ADDITIONAL_DATA:
    The claim is being reviewed by Insurer and they require the customer to add an additional data to support his/her claim.

In both cases, Cermati will send notification to partner about the status together with the reason. The customer needs to revise the claim form based on that reason and resubmit the claim.

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Data incomplete flow

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Additional data flow

Claim Reminder and Expiration

Every few days since the claim is created, Cermati will send reminder for the customer to complete the claim form. The reminder will be sent to partner and it needs to be forwarded to the customer. If the customer does not submit the claim within the specified time frame, the claim will be marked as expired by Cermati.

These reminders are intended for claims with INITIATED and DATA_INCOMPLETE status. Reminder interval and expiration period vary between products.

Reminder specification will follow https://docs.cermati.com/reference/claim-event-notification.

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Claim expiration flow

Claim Status Notification

Cermati will send notification to partner every time there is any change in claim status.

The specification for the notification can be seen at https://docs.cermati.com/reference/claim-event-notification.