micsapp Guidewire Core Workflow B: Claims Processing
Overview
Master the complete claims lifecycle in ClaimCenter: First Notice of Loss (FNOL), claim investigation, reserve setting, payments, and settlement.
Prerequisites
- Completed
guidewire-install-authandguidewire-core-workflow-a - Understanding of claims handling processes
- Valid API credentials with claims admin permissions
Claims Lifecycle States
FNOL -> Open -> Investigation -> Evaluation -> Negotiation -> Settlement -> Closed
[Draft] [Open] [Reserve] [Exposure] [Payment] [Settle] [Closed]
Instructions
Step 1: Create FNOL
POST to /fnol/v1/fnol with loss date, loss type/cause, description, policy number, loss location, and reporter details.
Step 2: Add Exposures
POST exposures to /claim/v1/claims/<claimId>/exposures specifying exposure type (VehicleDamage, BodilyInjury), loss party (insured, claimant), and primary coverage.
Step 3: Add Incidents
POST vehicle incidents with severity, damage description, vehicle details, and operability status.
Step 4: Set Reserves
POST reserves to each exposure specifying reserve line (indemnity, expenses), cost type, category, and amount.
Step 5: Create Payments
POST payments with payment type (partial, final), exposure reference, payee, reserve line, amount, and payment method (check).
Step 6: Close Exposures
POST to each exposure's /close endpoint with the closed outcome (completed, denied, duplicate).
Step 7: Close Claim
POST to /claim/v1/claims/<claimId>/close with outcome. All exposures must be closed first.
For complete TypeScript API calls and Gosu server-side implementations, load the reference guide:
Read(${CLAUDE_SKILL_DIR}/references/implementation-guide.md)
Output
- FNOL claim with claim number
- Exposures linked to coverages
- Reserves set on exposures
- Payments processed
- Claim closed with outcome
Error Handling
| Error | Cause | Solution |
|---|---|---|
Policy not found |
Invalid policy number | Verify policy number and status |
Coverage not applicable |
Wrong coverage type | Check policy coverages |
Reserve exceeds limit |
Over policy limit | Adjust to policy limits |
Payment validation |
Missing required fields | Check payee and amount |
Cannot close |
Open activities/exposures | Complete pending items |
Resources
Next Steps
For error handling patterns, see guidewire-common-errors.
Examples
Auto collision claim: File an FNOL for a two-vehicle accident, create VehicleDamage and BodilyInjury exposures, set reserves of $5,000 for vehicle repair and $2,000 for medical expenses, issue a partial payment to the body shop, then close exposures and the claim after settlement.
Property damage claim with subrogation: File an FNOL for water damage at a commercial property, create a PropertyDamage exposure, set indemnity reserves, process payments to the restoration contractor, pursue subrogation against the responsible party, and close the claim with recovered amounts.