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Health Care Facility | Insurers | Related Initiatives  

Claimant File Ownership


HCAI has developed an improved way of assigning claimant records to users, which will streamline the administrative workflow. After migration, each claimant is assigned directly to a user account. This user is called the "claimant file owner." The claimant's documents will appear on this user’s My Inbox, My Plans, and My Invoices worklists for adjudication.

Before migration, a claimant was assigned to an adjuster profile. Adjuster profiles were separate entities from user accounts, so the user account then had to be granted access to the adjuster profiles so that the user would have permission to view the claimant’s documents. A single user account was often linked to multiple adjuster profiles – typically, one profile per branch.

After migration, adjuster profiles are eliminated. Claimants are instead directly assigned to a user account.

Explore the side menu for walkthroughs of each specific task.

Claimant File Ownership


Assign a Claimant File Owner

Please note: This page is intended for insurers who have already migrated. Do not attempt to set claimant file owners manually if your organization has not yet migrated.

To assign a claimant file owner, you must have the Claim/Claimant Administrator, Form Manager, or Claim/Claimant Editor role assigned.

You can assign the file owner at the time you create a new claimant, or you can edit an existing claimant to assign or reassign the file owner.

To set the file owner for a new claimant:

  1. Visit the Setting up a Claim and Claimant Record page for step-by-step instructions explaining how to set up a new claim-claimant record.
  2. When filling out the claimant’s details, use the File Owner drop-down to select the claimant file owner. (View screenshot).
    • Note: Only users who are eligible to be claimant file owners will appear in the File Owner drop-down list. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.

To edit the claimant file owner of an existing claimant:

  1. Go to the Claims tab and Claimants sub-tab.
  2. Search for the claimant you would like to edit.
  3. On the Claimant Search Results page, click the claimant name.
  4. Locate the File Owner drop-down list and select the new claimant file owner. (View screenshot).
    • Note: Only users who are eligible to be claimant file owners will appear in the File Owner drop-down list. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.
  5. Click “Save”.

Claimant File Ownership


Reassign a Claimant File Owner within an OCF

Please note: This page is intended for insurers who have already migrated.

You can also assign or reassign a claimant file owner directly within a document. To do this, you must have the Form Manager role or Form Adjuster and Claim/Claimant Administrator or Claim/Claimant Editor role assigned.

To assign/reassign claimant file ownership:

  1. Open the document from the Documents tab. You will not be able to assign a claimant file owner if you access the document from the Search tab or Associated Documents section.
  2. Click on Tab 1.
  3. In Part 2: Auto Insurer Information, locate the File Owner Details section.
  4. Click the “Reassign File Owner” button. (View screenshot).
  5. The document will close and you will be taken to the Claimant Details page.
  6. Locate the File Owner drop-down and select the new claimant file owner.
    • Note: Only users who are eligible to be claimant file owners will appear in the File Owner drop-down list. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.
  7. Click “Save”.

To take claimant file ownership:

If an OCF has no claimant file owner (is “unassigned”) or its claimant file owner is no longer eligible (it “needs reassignment”), you can easily take ownership within the OCF. A claimant will need reassignment if its file owner is deactivated, does not have permission to have ownership of claimant files, or does not have access to the claim group that this claim-claimant record belongs to.

  1. Open the document.
  2. On the Summary tab, locate the File Owner field. (View screenshot).
  3. Click the “Take Claimant Ownership” button to become the claimant file owner of the document. The change will be immediate and will automatically save.
    • Note: The “Take Claimant Ownership” button will also appear in the insurer’s signature section of each OCF, where the adjudication decision is recorded. You can take ownership of the claimant from this section instead.
  4. Now that you are the claimant file owner, the “Remove Claimant Ownership” button will appear. If needed, you can click this to stop being the claimant’s file owner. The file owner field will then be blank.

Claimant File Ownership


Restrict a User's Ability to be Claimant File Owner

By default, users with the Form Adjuster role are allowed to be claimant file owners. However, you may want to allow certain users, such as support staff, to adjudicate documents without allowing them to be the official owner of claimant files. 

If you want to ensure that support staff are not made the owner of any claimant files, there is a setting in each user account that will prevent this. Users configured in this way can adjudicate documents on behalf of the claimant file owner. However, they cannot be made the claimant file owner.

To update this setting, you must have the User Administrator role assigned.

  1. Go to the Manage tab and User Management sub-tab.
  2. Search for the user you wish to update.
  3. On the Search Results page, click on the user’s name.
  4. On the Add/Edit/View User Details page, scroll down to the Adjusting Roles section. Next to “Allow this user to have ownership of claimant files?” select “No”. (View screenshot).
  5. Click “Save”.

Claimant File Ownership


Jump to:

HCAI has developed an improved way of assigning claimant records to users, which will streamline the administrative workflow. After migration, each claimant is assigned directly to a user account. This user is called the "claimant file owner." The claimant's documents will appear on this user’s My Inbox, My Plans, and My Invoices worklists for adjudication.

Before migration, a claimant was assigned to an adjuster profile. Adjuster profiles were separate entities from user accounts, so the user account then had to be granted access to the adjuster profiles so that the user would have permission to view the claimant’s documents. A single user account was often linked to multiple adjuster profiles – typically, one profile per branch.

After migration, adjuster profiles are eliminated. Claimants are instead directly assigned to a user account.

Assign a Claimant File Owner

Please note: This page is intended for insurers who have already migrated. Do not attempt to set claimant file owners manually if your organization has not yet migrated.

To assign a claimant file owner, you must have the Claim/Claimant Administrator, Form Manager, or Claim/Claimant Editor role assigned.

You can assign the file owner at the time you create a new claimant, or you can edit an existing claimant to assign or reassign the file owner.

To set the file owner for a new claimant:

  1. Visit the Setting up a Claim and Claimant Record page for step-by-step instructions explaining how to set up a new claim-claimant record.
  2. When filling out the claimant’s details, use the File Owner drop-down to select the claimant file owner. (View screenshot).
    • Note: Only users who are eligible to be claimant file owners will appear in the File Owner drop-down list. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.

To edit the claimant file owner of an existing claimant:

  1. Go to the Claims tab and Claimants sub-tab.
  2. Search for the claimant you would like to edit.
  3. On the Claimant Search Results page, click the claimant name.
  4. Locate the File Owner drop-down list and select the new claimant file owner. (View screenshot).
    • Note: Only users who are eligible to be claimant file owners will appear in the File Owner drop-down list. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.
  5. Click “Save”.

Reassign a Claimant File Owner within an OCF

Please note: This page is intended for insurers who have already migrated.

You can also assign or reassign a claimant file owner directly within a document. To do this, you must have the Form Manager role or Form Adjuster and Claim/Claimant Administrator or Claim/Claimant Editor role assigned.

To assign/reassign claimant file ownership:

  1. Open the document from the Documents tab. You will not be able to assign a claimant file owner if you access the document from the Search tab or Associated Documents section.
  2. Click on Tab 1.
  3. In Part 2: Auto Insurer Information, locate the File Owner Details section.
  4. Click the “Reassign File Owner” button. (View screenshot).
  5. The document will close and you will be taken to the Claimant Details page.
  6. Locate the File Owner drop-down and select the new claimant file owner.
    • Note: Only users who are eligible to be claimant file owners will appear in the File Owner drop-down list. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.
  7. Click “Save”.

To take claimant file ownership:

If an OCF has no claimant file owner (is “unassigned”) or its claimant file owner is no longer eligible (it “needs reassignment”), you can easily take ownership within the OCF. A claimant will need reassignment if its file owner is deactivated, does not have permission to have ownership of claimant files, or does not have access to the claim group that this claim-claimant record belongs to.

  1. Open the document.
  2. On the Summary tab, locate the File Owner field. (View screenshot).
  3. Click the “Take Claimant Ownership” button to become the claimant file owner of the document. The change will be immediate and will automatically save.
    • Note: The “Take Claimant Ownership” button will also appear in the insurer’s signature section of each OCF, where the adjudication decision is recorded. You can take ownership of the claimant from this section instead.
  4. Now that you are the claimant file owner, the “Remove Claimant Ownership” button will appear. If needed, you can click this to stop being the claimant’s file owner. The file owner field will then be blank.

Restrict a User's Ability to be Claimant File Owner

By default, users with the Form Adjuster role are allowed to be claimant file owners. However, you may want to allow certain users, such as support staff, to adjudicate documents without allowing them to be the official owner of claimant files. 

If you want to ensure that support staff are not made the owner of any claimant files, there is a setting in each user account that will prevent this. Users configured in this way can adjudicate documents on behalf of the claimant file owner. However, they cannot be made the claimant file owner.

To update this setting, you must have the User Administrator role assigned.

  1. Go to the Manage tab and User Management sub-tab.
  2. Search for the user you wish to update.
  3. On the Search Results page, click on the user’s name.
  4. On the Add/Edit/View User Details page, scroll down to the Adjusting Roles section. Next to “Allow this user to have ownership of claimant files?” select “No”. (View screenshot).
  5. Click “Save”.

Search by Claimant File Owner

Please note: This page is intended for insurers who have already migrated.

You are able to search for claims, claimants, and documents by selecting one or more claimant file owner(s) as the search criteria. This search will return a list of claims, claimants, or documents that are assigned to the specified file owner(s).

To search for claims or claimants:

  1. Go to the Claims tab and the Claims or Claimants sub-tab.
  2. Locate the File Owner drop-down and select one or more file owners. Click outside of the drop-down list to close it. (View screenshot).
  3. On the Claimants search screen you are also able to check off the following items in the File Owner drop-down:
    • Not Matched: To search for claimants with no matched documents.
    • Not Assigned: To search for claimants with no claimant file owner assigned.
    • Needs Reassignment: To search for claimant that have a claimant file owner assigned who is no longer eligible. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.
  4. Click “Search”.
  5. A list of claims or claimants that are assigned to the specified file owners will appear. If you do not have permission to view some of the claims or claimants, you will see a notification explaining that some items have been excluded from the search results. Contact a User Administrator to change your user permissions if required.

To search for documents:

  1. Go to the Search tab.
  2. Locate the Claimant File Owner drop-down and select one or more file owners. Click outside of the drop-down list to close it. On this list you are also able to check off the following items: (View screenshot).
    • Not Matched: To search for documents that are not matched to a claimant.
    • Not Assigned: To search for documents whose claimants are not assigned to a claimant file owner.
    • Needs Reassignment: To search for documents whose claimants are assigned to a claimant file owner who is no longer eligible. Eligible file owners are not deactivated, are allowed to have ownership of claimant files, and have access to the claim group that this claim-claimant record belongs to.
  3. Click “Search”.
  4. If you do not have permission to see some of the documents assigned to those Claimant File Owners, you will see a notification explaining that some documents have been excluded from the search results. Contact your User Administrator to change your user permissions if required.
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