Claims Module

The Claims module in Umbrella is where all protection claims are submitted, managed, and resolved. Each claim is tied to a specific policy, which is tied to a specific product and order. This module gives your team a clear, auditable process for handling warranty, accident, shipping, and rebate-related issues — all in one place.

Accessing Claims

From the Umbrella sidebar, click Claims.
You’ll land on the Claims Dashboard, which includes:

• A searchable list of all submitted claims
• Filters by status (Pending, Approved, Denied, Closed)
• Sort by claim date, value, plan type, or customer
• Quick access to “View Claim” for any entry

You’ll also see a real-time counter for open or pending claims in the left sidebar.

Claim Lifecycle Overview

1. Claim Submitted
   • Submitted by the customer (via branded portal) or manually by your team
   • Based on a live, active policy
   • Includes evidence (photo, video, description, delivery data)
2. Claim Reviewed
   • Automatically or manually reviewed depending on plan settings
   • Rules can approve low-value or common claims instantly
   • Otherwise, claims are routed to your review team
3. Claim Resolved
   • Resolution selected (Reship, Store Credit, Refund, Repair)
   • Timeline recorded
   • Customer notified via your store’s native email/SMS system

Inside a Claim Record

Clicking on a claim opens a full Claim Detail View, including:

1. Claim Information

• Claim reason (e.g. Accidental Damage, Product Failed, Lost in Transit)
• Customer’s message (e.g. “My lamp fell off the table and broke.”)
• Uploaded evidence (images, videos, PDF documents)
• Submission date, claim ID, and policy reference

2. Product & Policy

• The item covered by the claim (product image, name, SKU, price)
• Linked policy: protection plan name, term, status, expiration
• Quick links to:
  • View full Policy
  • View Shopify order
  • View product in your store

3. Resolution Options

From the claim screen, your team can:

• Reship (create a replacement order in your store)
• Issue Credit (via Shopify gift card or manual refund)
• Deny Claim (with optional message)
• Request More Info (coming soon)

Every resolution creates a clear audit trail and updates the claim status accordingly.

Claim Statuses

Umbrella tracks every claim and updates statuses automatically:

• Pending – Awaiting review
• Approved – Claim accepted and resolution triggered
• Denied – Claim rejected based on policy terms
• Closed – Claim resolved and finalized
• Reshipment Created – New order has been issued (optional intermediate status)

These statuses show up across modules (Orders, Policies, Dashboard) and are filterable in the Claims view.

Auto-Approval Rules

Umbrella allows you to automate common claims based on:

• Claim value (e.g. auto-approve under $100)
• Claim reason (e.g. Lost in Transit)
• Customer type or history
• Required evidence (e.g. photo only → auto-approve)

These rules reduce manual workload and improve customer experience.

Timeline Tracking

Each claim has a detailed activity log that shows:

• Claim submission timestamp
• Status changes (e.g. Approved, Denied)
• Actions taken (e.g. Reshipment created, Credit issued)
• System messages (e.g. “Gift Card failed – issue manually”)

This ensures full transparency for support teams and audit compliance.

Best Practices

• Set up clear auto-approval logic for low-risk claims
• Use image/video evidence requirements to prevent abuse
• Route claims to your CX or operations team based on value or category
• Use the Timeline to troubleshoot failed reshipments or credits
• Review denied claims periodically to identify trends or bad actors

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