Claim Lifecycle

Complete workflow: Creating, managing, collaborating, and resolving claims

Overview

This guide covers the entire lifecycle of a claim from creation through resolution. A single comprehensive document covering how to create claims, manage them, collaborate with teammates, track SLA status, and view progress through multiple visualization options.

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Part 1: Creating Claims

Text Claims

Best for: Detailed descriptions, desk-based reporting, complex situations

Step-by-step:

1. Click “New Claim” -> Select “Text”
2. Enter claim details:
   • Title: Brief summary (e.g., “Assembly conveyor misalignment”)
   • Description: Detailed explanation with context
   • Category: Quality, Safety, Logistics, Maintenance, or custom
   • Department: Which department should handle this
   • Attach files (optional): Upload supporting documents
3. Submit

What happens automatically:

• Reclamia analyzes text and predicts category (AI may override your selection)
• Priority assigned (Low, Medium, High, Critical)
• Sent to appropriate department
• You see the claim on dashboard immediately

Tips for better AI classification:

• Use specific, clear language
• Include relevant details (what, where, when)
• Mention if issue is recurring
• Note any safety concerns in description
• List any affected equipment or people

Voice Claims

Best for: On-site quick capture, hands-free reporting, time-sensitive issues

Step-by-step:

1. Click “New Claim” -> Select “Voice”
2. Click microphone icon and start recording
3. Speak clearly for 15-60 seconds:
   • Describe what you see/experienced
   • What’s affected or who’s involved
   • Any immediate actions taken
   • Example: “Found water leak near Circuit Panel 3 on Line 4, shut off power, area marked unsafe”
4. Stop recording when done
5. Groq Whisper transcribes automatically (usually within seconds)
6. Review transcription:
   • Is it accurate? If not, edit text
   • Add additional context if needed
7. Select category (or accept AI suggestion)
8. Submit

What happens:

• Your voice automatically converted to text
• Text analyzed for category and priority
• Transcription sometimes needs minor edits (background noise, accents)
• Claim created with full audio and transcription

Tips for better voice capture:

• Speak clearly without rush
• Use work site language (team will understand)
• Include “where” information
• Mention time sensitivity
• Note if immediate action needed

Technical details:

• Uses Groq Whisper Large V3 Turbo
• Supports noisy environments
• Best with 15-60 second recordings
• Multiple languages supported (trained on your usage)

Image Claims

Best for: Visual defects, equipment damage, quality issues, screenshots

Step-by-step:

1. Click “New Claim” -> Select “Image”
2. Upload photo (from camera or file)
   • Take clear photo of issue
   • Include context (show full defect)
   • Good lighting helps accuracy
   • Can upload multiple images
3. GPT-4 Vision extracts text automatically:
   • Reads any text visible in image
   • Identifies visual defects
   • Attempts to extract relevant information
4. Review extracted text and make adjustments:
   • Edit if OCR missed something
   • Add description of what you see
   • Note location and impact
5. Select category (or accept AI suggestion)
6. Submit

What happens:

• Image analyzed for defects and text content
• Extracted information fed to AI for classification
• Original image stored for reference
• Claim created with image attached

Tips for better image capture:

• Take photo straight-on when possible
• Include scale reference (hand, ruler)
• Capture full defect in frame
• Ensure good lighting
• Note specific area if large image
• Take multiple photos from different angles

Technical details:

• Uses GPT-4 Vision for image analysis
• Extracts text via OCR
• Identifies visual patterns
• Works with PNG, JPG, WebP formats
• Max 10MB per image

AI Auto-Classification

After submitting any claim type, Reclamia automatically processes it:

Classification includes:

• Category: Quality, Safety, Logistics, Maintenance, Other
• Priority: Low, Medium, High, Critical
• Root Cause Prediction: Suggests likely causes (9 categories)
• Confidence Score: How certain the AI is (0-100%)
• Sentiment: Positive, Neutral, Negative (hints urgency)

How to use classification:

• Review the AI suggestions on claim detail page
• Override if wrong: Click to change category or priority
• Note confidence: Low confidence (below 70%) may need review
• Your correction trains AI: Each override improves future predictions
• Track patterns: High override rate on a category suggests misconfiguration

Multimodal Example

Scenario: Production line issue needs thorough documentation

1. Start with voice while on line: “Saw unusual noise from hydraulic pump, coming from Port side”
2. Add image of the pump location
3. Add text with additional context: “Noise started 2 hours ago, hydraulic pressure reading: 340 bar (normal 300-320)”
4. Reclamia processes all input:
   • Transcribes voice (gets location and symptom)
   • Analyzes image (confirms location)
   • Reads text details (provides diagnostic info)
   • Combines all for classification
5. Result: Highly accurate “Maintenance - Hydraulic System” classification with “High” priority

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Part 2: Claim Management

Viewing Claim Details

Full claim view shows:

• Title and description
• Category and priority badges
• Current status (OPEN, IN_PROGRESS, RESOLVED, CLOSED)
• SLA deadline and status (On-time, At-risk, Overdue)
• Assigned team member
• Created by and date
• All attachments and evidence
• Complete activity log

Visual indicators:

• RED = Critical priority, Overdue SLA
• ORANGE = High priority, At-risk SLA
• YELLOW = Medium priority, On-time
• GREEN = Low priority, On-time

Assigning Claims

Assigning to team member:

1. Open claim detail view
2. Click “Assign to” section
3. Select team member from list
4. Selected member gets notification immediately
5. Status updates on claim: “Assigned to John”

Auto-assignment:

• Business rules can auto-assign based on criteria
• Example: “If category = Quality, auto-assign to John”
• Example: “If priority = Critical, auto-assign to manager”

Re-assigning:

• Can reassign anytime if person is overwhelmed
• Original assignee gets notification
• New assignee notified
• Activity log tracks all assignments

Status Workflow

Claims move through four statuses:

OPEN (New, awaiting attention)

• Default state when created
• Not yet assigned or just assigned
• Next step: Assign to someone or start working

IN_PROGRESS (Being worked on)

• Someone is actively solving the issue
• Click status -> “Start Work” to move here
• Shows team is engaged
• Next step: Resolve the issue

RESOLVED (Solution found, pending verification)

• Issue is fixed or solution determined
• Click status -> “Mark Resolved”
• Add resolution notes explaining what was done
• Customer/manager reviews
• Next step: Close or reopen if unsatisfactory

CLOSED (Resolved and verified)

• Issue completely handled
• Cannot reopen (creates new claim if issue returns)
• Stored in history for learning
• Final step: Complete workflow

Status transition example:

OPEN (just created)
  ->
(assign to John)
  ->
IN_PROGRESS (John starts work)
  ->
(John fixes issue)
  ->
RESOLVED (solution documented)
  ->
(manager verifies)
  ->
CLOSED (workflow complete)

Adding Context & Notes

Update claim with progress:

1. Click claim detail
2. Find “Update Status” or “Add Note” section
3. Type message: “Checked hydraulic pressure, normal. Testing valve response.”
4. Updates status while keeping context
5. Status note appears in activity log

Multiple updates:

• Keep adding updates as progress happens
• Each update has timestamp
• Shows complete progress trail
• Team can follow what’s being done

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Part 3: Real-Time Collaboration

Comments & Conversations

Adding a comment:

1. Scroll to “Comments” section
2. Type in comment box:
   • Share findings: “Traced issue to faulty sensor”
   • Ask questions: “Can you check the power supply?”
   • Provide guidance: “Follow safety procedure 4.2 before accessing”
3. @mention to notify specific people:
   • Type @John in comment
   • John gets instant notification
   • Comment highlighted for him
4. Attach files:
   • Upload supporting docs
   • Embed images
   • Link procedures
5. Submit comment
   • Appears immediately
   • Notifications sent to mentioned people

Comment threads:

• Comments appear in chronological order
• Indented replies create threads
• Easy to follow conversation
• Full history never deleted

Example conversation:

Manager: "This looks like a repeat from March. Can you check history?"
  -> John: "Checked - yes, same sensor failed before. Ordering replacement."
  -> Manager: "@Maintenance team, this is urgent. Reply when you get part?"
  -> Maintenance Lead: "Part arriving tomorrow. Temporary sensor installed for overnight."
Manager: "Good. Let's prevent this happening again @Operations"

Reactions & Quick Feedback

React to comments:

1. Hover over comment
2. Click emoji icon
3. Select emoji: +1 checkmark heart etc.
4. Shows at comment for quick visual feedback

Use cases:

• +1 = “Got it, sounds good”
• checkmark = “Confirmed, all good”
• heart = “Thanks for help”
• tada = “Great work, let’s ship”
• warning = “Urgent attention needed”

@Mentions & Notifications

Notifying specific people:

• @Manager: “This needs executive decision”
• @John: “Can you handle this or should I?”
• @Facility-B: “@Facility-B team, similar issue at your location?”

Who gets notified:

• Mentioned person: Direct notification
• Claim owner: Sees comment was added
• Assigned person: Sees new comment
• Followers: Anyone monitoring claim

Notification channels:

• In-app notification (real-time bell icon)
• Email (if configured)
• Dashboard alert (shows new activity)

File Attachments

Uploading supporting evidence:

1. Click “Add File” in comments or claim detail
2. Upload image, document, PDF, etc.
3. Files appear in claim for reference
4. Downloadable by any team member
5. Stored permanently with claim

Use cases:

• Defect photos from multiple angles
• Maintenance manuals for troubleshooting
• Test results and measurements
• Vendor documentation
• Before/after pictures

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Part 4: SLA & Deadline Management

Understanding SLA

SLA = Service Level Agreement = Deadline to handle claim

Example SLA Policy:

Priority	Response Time	Resolution Time
Critical	4 hours	8 hours
High	8 hours	24 hours
Medium	24 hours	72 hours
Low	48 hours	1 week

What this means:

• Response Time: Must acknowledge/assign within deadline
• Resolution Time: Must fully resolve within deadline
• SLA Period: Starts when claim created
• Excludes: Weekends/holidays (if configured)

SLA Status Indicators

On-Time (Green)

• Claim is being handled within deadline
• Plenty of time remaining
• Status: “On Track”
• No action needed

At-Risk (Yellow)

• Deadline approaching (typically 2 hours remaining)
• Should prioritize this claim
• Time to take action before overdue
• Status: “Escalation Recommended”

Overdue (Red)

• Deadline has passed
• Immediate action needed
• May affect compliance metrics
• Status: “Breach - Requires Escalation”

Deadline Calculation

System automatically calculates:

1. Claim created: March 15, 10:00 AM
2. Priority assigned: “High”
3. SLA looked up: High = 24 hour resolution
4. Deadline set: March 16, 10:00 AM
5. Status monitored: At-Risk at March 15, 8:00 PM (2 hours before)
6. Alert sent: “@Manager claim overdue” at March 16, 10:01 AM

Customization:

• SLA varies by category
• Example: Safety claims may have 4-hour SLA vs Quality 24-hour
• Can exclude weekends
• Can have custom rules per department

Managing At-Risk Claims

When you see yellow warning:

1. Assess status: Is actual work happening?
2. Communicate: Add comment checking progress
3. Support: Offer help if person is stuck
4. Escalate: Move to someone with more availability
5. Options:
   • Add extra resources
   • Split into multiple claims
   • Escalate to manager for priority
   • Request external support

Example intervention:

Dashboard shows claim at-risk
  ->
Manager clicks claim
  ->
Sees John assigned, status still "OPEN"
  ->
Adds comment: "@John Heads up this is at-risk. Need help?"
  ->
John responds: "Yes, need access to Line 3"
  ->
Manager: "I'll arrange access. Switch to IN_PROGRESS while waiting."
  ->
John: "Done. Will start at 2 PM"
  ->
Status updated, on track now

SLA Compliance Metrics

Dashboard shows:

• Organization SLA Compliance: % of all claims resolved on time
• Department SLA Compliance: By department (Quality, Maintenance, etc.)
• Category SLA Compliance: By claim type
• Individual SLA Performance: By team member
• Trend Analysis: Is compliance improving or declining?

Interpreting metrics:

• 95%+ compliance: Excellent process
• 85-95% compliance: Good, monitor trends
• 75-85% compliance: Needs improvement
• Below 75% compliance: Critical issues, investigate

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Part 5: Visualization Options

Kanban Board View

Visual status management with drag-and-drop

Layout:

+-------------+--------------+------------+------------+
|    OPEN     | IN_PROGRESS  | RESOLVED   |   CLOSED   |
+-------------+--------------+------------+------------+
| Claim #1    | Claim #5     | Claim #8   | Claim #12  |
| Priority    | Priority     | Priority   | Priority   |
| (Drag me)   | (Drag me)    | (Drag me)  |            |
|             |              |            | Claim #15  |
| Claim #3    | Claim #6     | Claim #9   | (archived) |
| Priority    | Priority     | Priority   |            |
|             |              |            | Claim #20  |
|             |              |            | (archived) |
+-------------+--------------+------------+------------+

Using Kanban:

1. View at a glance: See all claims by status
2. Drag to update: Drag claim to new column to change status
3. Quick edit: Click claim card to see/edit details
4. Filter options:
   • Show only my department
   • Show only High/Critical priority
   • Show only assigned to me
   • Hide completed claims
5. Mobile friendly: Works on tablets and phones

Example workflow:

New claim arrives -> Appears in OPEN column
                 ->
Manager drags to IN_PROGRESS -> Assignee notified
                             ->
Person clicks card, marks "Resolved" -> Moves to RESOLVED
                                      ->
Manager verifies -> Drags to CLOSED -> Workflow complete

Calendar View

Timeline-based SLA visualization

Useful for:

• Seeing which claims have upcoming deadlines
• Identifying bottlenecks by date
• Planning workload distribution
• Spotting repeating patterns
• Scheduling resources

Calendar shows:

• Each claim as a block
• Color-coded by priority (red=critical, yellow=high, etc.)
• SLA deadline indicated
• At-risk and overdue flagged
• Grouped by date

Using Calendar:

1. Quick overview: See deadlines at a glance
2. Plan week: What claims are due Friday?
3. Identify peaks: Which days have most claims?
4. Schedule resources: Hire/reassign based on patterns
5. Prevent bottlenecks: Distribute workload evenly

Timeline View

Sequential activity tracking

Shows:

• Every state change and when it happened
• Who made each change
• Comments and updates in order
• Complete claim history
• Audit trail

Reading timeline:

10:00 AM - Claim created by John
          Status: OPEN
          Category: Quality (AI assigned)

11:30 AM - Assigned to Sarah by Manager
          Status: OPEN -> assigned

02:00 PM - Status updated to IN_PROGRESS
          Sarah added comment: "Investigating line 3"

04:15 PM - Comment: "Root cause found: sensor calibration"
          File attached: Sensor_logs.pdf

05:00 PM - Status: IN_PROGRESS -> RESOLVED
          Comment: "Recalibrated sensor, testing now"

Next day 09:00 AM - Status: RESOLVED -> CLOSED
                    Comment: "Tests passed. Issue solved."
                    Manager verified.

Use cases:

• Auditing: Show compliance exactly what happened
• Learning: See how past similar issues were solved
• Accountability: Clear trail of who did what
• Troubleshooting: Replay exact sequence of events

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Part 6: Complete Workflow Example

Real Manufacturing Scenario

The situation: Equipment breakdown on operations

10:15 AM - Employee Reports

• Employee on floor notices equipment slowing down
• Uses phone to create voice claim: “Conveyor belt slowing down, production impact, need urgent fix”
• Groq transcribes voice
• Reclamia classifies: “Maintenance” category, “Critical” priority
• Claim created #42857

10:17 AM - Manager Notified

• Manager gets notification: “Critical maintenance claim”
• Views dashboard, sees claim at top (Critical priority)
• Opens claim to get details
• Immediately assigns to David (lead maintenance tech)
• Adds comment: “@David Conveyor belt slowing. This is blocking production.”

10:20 AM - Maintenance Tech Starts

• David gets notification of assignment
• Opens Reclamia on maintenance tablet
• Reads comment from manager
• Changes status: OPEN -> IN_PROGRESS
• Walks to conveyor and starts diagnosis

10:45 AM - Diagnosis Complete

• David adds comment: “Found loose belt tension. Parts on order.”
• Attaches photo of loose belt
• Notes: “Need 2-3 hours for delivery + installation”

10:47 AM - Manager Takes Action

• Manager sees comment, checks SLA deadline (12:15 PM for critical)
• Realizes we’ll miss deadline if just waiting for parts
• Calls David: Can we temporary bypass?
• David: “Yes, can run reduced speed but no quality guarantee”
• Manager: Contacts quality to get approval
• Posts comment: “@Quality Awaiting bypass approval for 2 hours”

11:00 AM - Quality Approves

• Quality manager adds comment: “Approved. Run reduced speed until belt arrives.”
• David implements temporary fix
• Updates status: IN_PROGRESS with note “Running reduced speed, belt arriving 1 PM”

1:15 PM - Permanent Fix

• Belt arrives earlier than expected
• David installs new belt
• Tests at full speed
• Adds comment: “Belt replaced and tested. Full speed confirmed.”
• Changes status: IN_PROGRESS -> RESOLVED

1:20 PM - Manager Verifies

• Manager gets notification of resolution
• Reviews comments and status
• Production confirms conveyor working normally
• Changes status: RESOLVED -> CLOSED
• Adds note: “Resolved - production back to normal”

Workflow complete: 3 hours from report to resolution

• [checked] SLA met (critical deadline 12:15, closed by 1:20)
• [checked] Cross-functional collaboration (Maintenance + Quality + Management)
• [checked] Transparency (all updates visible)
• [checked] Learning (full audit trail for process improvement)

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Best Practices

Creating Effective Claims

• DO: Be specific and clear
• DO: Include location and timing
• DO: Add evidence (photos, measurements)
• DO: Note impact (safety, production, cost)
• DON’T: Write vague descriptions
• DON’T: Hide important details

Collaborating Effectively

• DO: Respond to comments promptly
• DO: Use @mentions appropriately
• DO: Provide updates as work progresses
• DO: Ask for help when stuck
• DON’T: Wait until deadline to communicate
• DON’T: Ignore notifications

Meeting SLA

• DO: Respond immediately to assignments
• DO: Update status as you work
• DO: Escalate early if you’ll miss deadline
• DO: Communicate blockers
• DON’T: Wait until overdue to escalate
• DON’T: Leave claims unassigned

Documentation & Learning

• DO: Document complete solution in comments
• DO: Attach relevant reference materials
• DO: Note lessons learned
• DO: Link to similar past claims
• DON’T: Close without documenting solution
• DON’T: Hide what went wrong

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Next Steps

• Dashboard Overview - Analyze metrics
• Business Rules - Automate workflows
• User Management - Manage teams
• SLA Policies - Configure deadlines