Insurance Claims
Track insurance claims for restoration and mitigation work without losing carrier, adjuster, deductible, and approval details in email threads.
When to use this
Use Insurance Claims when your company handles jobs where an insurance carrier may pay part or all of the bill, such as water damage, fire or smoke restoration, mold remediation, or hail-roof work.
The workspace is designed to keep the claim number, carrier, adjuster contact, date of loss, deductible, approved amount, and claim status close to the related customer and job.
Before you start
- Confirm Insurance Claims is included in your plan and enabled in Settings → Features.
- Make sure Customers is enabled, because each claim must be attached to a customer.
- Gather the carrier name, claim number, policy number, date of loss, adjuster details, deductible, and any approved scope notes before entering a claim.
- Decide whether your office tracks approved dollar amounts on the claim record or only on the related invoice.
Create a claim
- Open Insurance Claims from the main navigation.
- Click New claim.
- Choose the Customer and, when applicable, the related Job.
- Enter the required Claim number and Carrier.
- Add optional details such as policy number, adjuster name, adjuster email, adjuster phone, date of loss, cause of loss, approved amount, deductible, and notes.
- Click Create.
The Create button stays disabled until the required customer, claim number, and carrier fields are filled in.
New claims start as Open. Each claim record can include:
| Field | Required | Notes |
|---|---|---|
| Customer | Yes | The customer account tied to the loss or repair work. |
| Job | No | Link the claim to a specific job when the work is already tracked. |
| Claim number | Yes | Must be unique per account. Duplicate numbers are rejected. |
| Carrier | Yes | The insurance company handling the claim. |
| Policy number | No | The customer's policy number for reference. |
| Adjuster name | No | The assigned adjuster's name. |
| Adjuster email | No | Email address for the adjuster. |
| Adjuster phone | No | Phone number for the adjuster. |
| Date of loss | No | When the damage or incident occurred. |
| Cause of loss | No | What caused the damage, such as "Burst pipe" or "Hail damage." |
| Approved amount | No | Dollar amount the carrier has approved for the claim. |
| Deductible | No | The customer's deductible on the policy. |
| Notes | No | Internal notes about the claim, scope, or next steps. |
Work a claim through statuses
Claims move through a clear lifecycle. The summary cards at the top of the page show counts for Open, Pending approval, Approved, Denied, and Closed claims, plus the total approved dollar amount.
Use the status tabs to focus on claims at a specific stage:
- All — every claim in the system.
- Open — new or in-progress claims that have not been submitted for approval.
- Pending approval — claims submitted to the carrier and waiting for a decision.
- Approved — claims the carrier has approved for payment.
- Denied — claims the carrier has denied.
- Closed — claims that are finished and no longer need follow-up.
Status actions
Use the row actions to move claims through the lifecycle:
- Submit moves an Open claim to Pending approval.
- Approve or Deny are available for Open and Pending approval claims.
- Close is available after a claim is Approved.
- Reopen is available for Denied or Closed claims.
- Edit opens the claim details so office staff can update adjuster contact information, amounts, notes, or related customer/job data.
When a claim is approved, ToolbagCRM records the Decided timestamp automatically. When a claim is closed, the Closed timestamp is recorded as well. Re-approving an already-approved claim does not overwrite the original decision timestamp.
Edit a claim
Select Edit on a claim row to update any field — carrier, adjuster contact, dates, amounts, or notes. Edits are saved immediately. Use this when the adjuster calls with updated contact information, the approved amount changes, or the related job needs to be linked after the fact.
Tips
- Enter adjuster contact details as soon as they are assigned so the office can reach the right person without digging through email.
- Record the date of loss and cause of loss on every claim; these fields are easy to forget but hard to reconstruct later.
- Use notes to track what the carrier has promised, what documentation has been sent, and what is still outstanding.
- Review the Pending approval tab weekly so claims do not sit idle without follow-up.
- Close claims promptly after final payment so the approved-dollar total stays accurate.
Troubleshooting
A status tab says "No claims in this state"
Switch to All or another status tab. Claims may exist in a different lifecycle stage than the one you are viewing.
A duplicate claim number is rejected
Claim numbers must be unique per account. If the API returns a conflict error, search for the existing claim before entering a new one. If two separate claims genuinely need the same carrier reference, add a distinguishing suffix such as -A and -B to keep the records unique.
The Create button is disabled
A customer, claim number, and carrier are all required before a claim can be created. Fill in those three fields and the button will become active.