🛡️ Insurance · State Machine
Insurance Claims Lifecycle
The states of an insurance claim from first notice of loss to payment or closure, including investigation and appeals.
Drawing diagram…
What this diagram shows
- Simple claims are fast-tracked straight to approval
- Suspicious claims go to investigation
- Rejected claims can be appealed once
Prompt used
State machine for an insurance claim: Reported (first notice of loss), Documents Pending, Under Assessment, then Fast-Tracked for simple low-value claims or Surveyor Assigned for others. Suspicious claims go to Under Investigation. The claim is Approved (full or partial) and Paid, or Rejected. A rejected claim can be Appealed, which goes back to assessment. All end in Closed.
Mermaid code
stateDiagram-v2 [*] --> Reported Reported --> DocumentsPending DocumentsPending --> UnderAssessment: Documents received UnderAssessment --> FastTracked: Low value, clean history UnderAssessment --> SurveyorAssigned: Needs inspection UnderAssessment --> UnderInvestigation: Fraud signals SurveyorAssigned --> Approved SurveyorAssigned --> Rejected UnderInvestigation --> Approved UnderInvestigation --> Rejected FastTracked --> Approved Approved --> Paid Rejected --> Appealed: Within 30 days Appealed --> UnderAssessment Paid --> Closed Rejected --> Closed Closed --> [*]
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