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Claims (FNOL and status)

Version: Not versioned (stub)
This version: 2026-09-01
Status: Stub. Scope indicated only; not yet open for comment.
Licence: CC BY 4.0 (text). Schemas, when published, under Apache 2.0.
Conventions: RFC 2119 keywords and addressed roles
Steward: Marrow (onmarrow.com), on behalf of the Agent Mediated Insurance (AMI) working group
Interaction: Claims (FNOL and status)
Action risk class: 3 Claim

This is a scope stub, not a standard. It records the shape of an interaction that will be specified in a later version, so that an implementer building against New Business today can see what is coming and where it will attach. It states no requirements.

Scope​

Claims is the interaction where a customer notifies a loss or checks the status of a claim. It is the only action risk Class 3 interaction: it acts on a loss event, so it carries authenticated identity, explicit scoped authority under claim:fnol, and heightened care. It reads claims and policy data under read:policy. In this version's design intent it is mostly capture-and-handover: the agent assembles the notification and passes it to the carrier's claims function rather than progressing the claim itself.

Distinctive requirements​

These are the requirements that distinguish claims from every other interaction. They will be specified in full in a later version.

  • Authentication to the policy before any claim data is read or created.
  • Heightened vulnerability sensitivity, because a loss event is when a customer is most likely to be vulnerable.
  • No agent opinion on liability or on the validity of a claim.
  • Fraud awareness, and the handling of the signals that go with it.
  • Mostly capture-and-handover to the carrier's claims function.

How far claim:fnol extends before mandatory handover is an open question in the Consent, Authority and Scopes Standard, and is the main thing this standard will have to settle.

Not yet open for comment. Scope indicated so implementers can see the direction of travel.