ClaimsPay FAQs

One Inc helps insurers address several big challenges in claims payments:

1. Retention – Customers need their money fast and expect smooth, convenient peril resolutions. Traditional methods for paying claims, particularly mailing checks, fail to deliver on these expectations. A friction-less claims experience – where a policyholder gets their money faster and via their preferred payment method – is the "moment of truth" experience that inspires customer satisfaction, loyalty, and brand advocacy.
2. Costs – Printing and mailing checks is expensive, extends cycle time, and exposes you to increased claim severity by keeping the claim open longer. Processing claims payments digitally via ACH and ClaimsCard® significantly minimizes the cost. 
   Since a fast and convenient claims experience also reduces policyholder churn, insurers  enjoy continued revenue from policyholders who would otherwise have walked away. Insurers also save resources associated with closing out accounts, sending refunds, and sales costs associated with replacing lost policies.
3. Security and Compliance – Fraud is prevalent, protecting payment instrument data is a requirement, and mitigating organizational risk is resource-intensive. Processing claims payments digitally reduces the risk of fraud since sensitive financial data never traverses the insurer's network. Financial information is always tokenized and stored by One Inc, significantly increasing data security and simplifying compliance.
4. Operational Efficiency – ClaimsPay^® streamlines operational efficiency by providing automation and self-service tools for insurance carriers to shift simple, routine transactions from claims adjusters to the payees. Payees can view open claims, approve claims payments, and change payment and communication preferences through a self-service portal without the assistance and time commitment of an insurance adjuster or call center. On the administrative side, insurers can report and reconcile payments quickly and accurately across both inbound and outbound payment types, methods, channels, and batches.

1. Payments to policyholders
2. Payments to non-policyholder claimants
3. Payments to lienholders
4. Payments to mortgagees
5. Payments to service providers (e.g., law offices, disaster recovery services, body shops, healthcare)
6. Payments to vendors (e.g., third-party adjusters, appraisers)
7. Payments to unbanked claimants
8. Payments to policyholders in CAT situations
9. Payment and approvals to multiple parties with interest in a single claim

1. Multiple payment methods – ACH, virtual ClaimsCard®, physical ClaimsCard®, Push-to-Debit, Venmo, PayPal, and paper check.
2. Digital engagement – SMS and email notifications sent to all parties on the claim throughout the payment process, including status updates, payment confirmation, and instructions to access funds.
3. Multi-party – Digital approval workflow and payment disbursement to multiple people/vendors/service providers on a claim.
4. Reporting and reconciliation –Payment data is updated in real time. Batch reporting can be accessed daily and downloaded to Excel for easy reconciliation with other systems. 
5. Integration – ClaimsPay^® integrates directly into any existing claims management system. Simply create the user interface that fits your adjusters' workflow within your claims system and call our API.
6. Self-service portals – Claimant and vendor portals for approving or contesting payment amounts, accessing or transferring funds digitally, and viewing EOB/remittance documents and transaction history.
7. Configurable branding –Configurable email templates and modals/portals to match your company's branded look and feel, including color palette, logos, and messaging for a consistent user experience.
8. Reoccurring claims payments - One Inc tokenizes, securely stores, and saves financial instruments for future or recurring claims payments.
9. Two-factor authentication – Approvers and payees authenticate themselves with a code provided via phone or text to avoid fraud. 
10. Data security – Sensitive data is tokenized and stored following the highest security standards set forth by regulatory and compliance best practices, such as the PCI DSS, Nacha, and SOC 2 – simplifying your PCI compliance and reducing security risk.
11. Vendor onboarding and payments  – One Inc handles all your payments to vendors and drives adoption of vendors accepting instant digital payments.

For insureds/claimants:

1. ACH bank transfer
2. Physical ClaimsCard® (powered by Mastercard^®) 
3. Push-to-Card (debit or prepaid)
4. Venmo
5. PayPal
6. Check PrintNow
7. Paper check

For vendors/service providers (businesses):

1. ACH bank transfer
2. Virtual ClaimsCard® (powered by Mastercard^®) 
3. Paper check

For mortgagee/lienholders:

1. ACH bank transfer
2. Paper check

Checks can be mailed to Canada, Mexico, and Europe. Digital payments are not available outside the U.S. at this time.

Your team designs and builds the user experience for your claims adjusters within your claims management system and then connects to One Inc via APIs.

Our claims payments solution sits on top of your claims system, which will always remain the system of record, so there is minimal information manually entered and no need for a user to log into to a separate application.

Some typical integration points include, but are not limited to:

• Claims systems integration
• Posting disbursements back to the claims systems
• Policy/billing system integration

Yes. We provide user interfaces with configurable colors, logo and text as needed by the supported options:

• Claim party portals for collecting approvals and payment method and payment channel preferences
• Payee email templates (payee-facing)
• Vendor onboarding communication

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One Inc now offers a service for printing and mailing paper checks! However, if you would still like to print and mail your own checks, you may do so. If a payee selects check as his/her preferred payment method, our system will tell your system of the selection, and you can process the check as you do today.

In the case when a payee is utilizing ClaimsCard® within the self-service portal and wants to convert it to a check, One Inc will facilitate the process of sending that check.

All payment instrument data submitted by payees is captured by One Inc and tokenized. Sensitive data never traverses your network. The only data you store is a token representing a payment instrument. One Inc stores a matching token. Any sensitive data stored on One Inc’s servers is stored following the highest security standards set forth by regulatory and compliance best practices, such as the PCI DSS, Nacha, and SOC 2 Type 2.

For a payee to provide their bank account, they need to go through two-factor authentication using identification criteria provided by you. They will also need to enter an identification code we send them via text or phone call. 

The default is 3 attempts.

Yes. The timeframe is configurable.

No.

It is best practice to simply remove the ability for an adjuster to manually input bank account information. For that reason, bank account information is captured through a secure link sent to the payee, which requires two-factor authentication.

Yes. We will work with the customer to research the root cause of why the money was sent to the incorrect account. Then, with our support and accounting teams, we will determine the correct course of action. Often, the process of recovering the money will have to go through the receiving bank and your customer would need to perform the necessary actions to recover money themselves. These situations are handled on a case-by-case basis.

Yes. There is a secondary API call which allows you to attach as many documents to the claim payment as needed. These attachments, i.e. terms and conditions and EOB/remittance documents, will appear in the payment portal and will be printed if ClaimsCard® or check are selected.

1. Verification Step 1 – Payees are asked for their claim number.
2. Verification Step 2 – The payee selects how they would like to receive an identification code (i.e. text or phone call).
3. Verification Step 3 – The payee enters the unique identification code received via  text or phone call.
4. Payee selects preferred payment method (ACH bank transfer, virtual ClaimsCard®, physical ClaimsCard®, Push-to-Card, Venmo, PayPal, or check.)
   Note: If you select to continue printing and mailing your own checks and the claimant prefers check, One Inc will tell your system that the payee has selected check. Then, you send it through your existing process for sending checks.
5. The payment is processed. If the method is bank account, physical ClaimsCard®, Push-to-Card, Venmo, PayPal, or check, confirmation is sent via the claimant's preferred communication channel. If the method is virtual ClaimsCard® (applicable only to vendors/service providers), confirmation is sent via email with a link to access the card and view transaction activity in an online portal.

Not yet. We are currently working on a solution for this use case.

You will initiate the Payment Master API Request, which will define the primary and secondary payees, as well as vendors. The role will determine the actions each party will have to complete in order for the claim payment to be processed.

1. Claimant receives an email/text from the insurance company requesting digital approval of claim payment details.

2. Claimant authenticates him/herself.

3.Claimant confirms the claim payment details and then digitally approves the payment out to the vendor/service provider. Claimant can also reject or dispute the claim payment, in which a payment status of rejected will be sent to the core claims system.

4.Vendor/service provider receives claim payment via their default/preferred payment method.

1. Claimant receives an email/text from the insurance company requesting digital approval of claim payment details. 
2. Claimant authenticates him/herself.
3. Claimant confirms the claim payment details, digitally approves, and selects the designated payees. Claimant can also reject or dispute the claim payment. If he/she contests, the adjuster will be notified. This will halt the process for other parties on the claim until a resolution is determined.
4. Designated payees receive an email/text with claim payment details, authenticate themselves, and select preferred payment method.
5. Designated payees receive claim payment via their preferred payment method.

1. Primary contact (claimant) receives an email/text from the insurance company requesting digital approval of claim payment details. 
2. Primary contact (claimant) authenticates him/herself.
3. Primary contact (claimant) confirms the claim payment details, digitally approves, and selects additional approvers and the designated payee(s). Claimant can also reject or dispute the claim payment. If he/she contests, the adjuster will be notified. This will halt the process for other parties on the claim until a resolution is determined.
4. After payment approval is received from primary contact (claimant), additional contacts (claimants) receive email/text requesting digital approval of claim payment details.
5. Additional approvers authenticate themselves and digitally approve the claim payment(s).
6. After all approvals have been received, designated payee(s) receive email/text with claim payment details, authenticate themselves, and select  preferred payment method.
7. Designated payee(s) receive claim payment via their preferred payment method(s).

If a payee has already made a payment method selection and has provided information required to receive a payment through that method (such as bank account and routing number to receive a payment via ACH), the payee will see the previously bank account(s) or debit card(s) in the payment selection screen. 

Yes, but it is configurable. You can determine to allow approval and payment links to expire and trigger a system notification or you can configure the system to cut a check if no action is taken by the approver/payee.

There is a resend email API call. You can send as many emails as you want. However, we strongly recommend you limit it.

Yes. You are able to receive a copy of all communication sent to claim parties. 

All claim payment communication to claimants is sent via email or text and is branded for your organization. Vendors and service providers without an email on file may receive onboarding communication and payment notification by mail (branded for your organization).

No. For vendors and service providers receiving the ClaimsCard®, standard credit card processing fees apply.

The decision to enroll is decided by the payee and insurer. One Inc is involved after the decision to enroll in digital claims payments is made. However, the ability to un-enroll is possible. You would need a business process that allows you to do so (if you don’t have one already). For example, in your claims system you may have a dropdown list “Preferred Payment Method.” This would include tokens we’ve created and a physical check option. We don’t stop you from selecting the physical check option. If you select physical check, your claims system would go back to sending physical checks.

They will be prompted to approve or contest the payment amount after authenticating themselves into their respective self-service portals.

After receiving a link to their account via email and/or text, they will be required to go through an authentication process.

They, along with all others associated with the claim, will be notified via email. 

All approval parties will be notified via email and the adjuster will be notified via the API call. This will halt the process for other parties on the claim. Consequently, payments will not be disbursed until the reason for contest is resolved by the adjuster and all parties requiring approval have submitted an approval.

For insureds/claimants:

1. ACH bank transfer
2. Physical ClaimsCard® (powered by Mastercard^®) 
3. Push-to-Card (debit or prepaid)
4. Venmo
5. PayPal
6. Check PrintNow
7. Paper check

For vendors/service providers (businesses):

1. ACH bank transfer
2. Virtual ClaimsCard® (powered by Mastercard^®) 
3. Paper check

For mortgagee/lienholders:

1. ACH bank transfer
2. Paper check

The physical ClaimsCard® is a preloaded card that can be used to make in-store and online purchases wherever Mastercard^® is accepted. Funds balance can be accessed through a secure, self-service portal and transferred to a bank account or check.

The virtual ClaimsCard® is an instant digital payment method only available for vendors/service providers and must be processed through their point of sale (POS) terminal.

The benefit of a ClaimsCard® is the instant payout capability. As soon as the claim is approved and the adjuster initiates the payment, the funds are instantly available on the payee’s ClaimsCard® for use.

For individual claimants who select Push-to-Card, PayPal, or Venmo, funds are instantly available for use. ACH bank transfers take 1-3 business days. Checks take 7-14 business days. Funds issued to a physical ClaimsCard® in CAT situations are instantly available. 

For vendors/service providers, funds are instantly available for use with the virtual ClaimsCard®. ACH bank transfers take 1-3 business days. Checks take 7-14 business days.

Note: If a claim requires actions from multiple parties on the claim, the payment disbursement process will not begin until all required approvals have been completed.

You would make a claim payment to an unbanked payee in the same way as any other individual claimant. The unbanked payee has the option to select from several payment methods that do not require a bank account:

1. Physical ClaimsCard®
2. Venmo
3. PayPal

There are two scenarios in which a payment will fail:

1. Failure at Gateway – If this occurs, you will know in the response of the real-time API call that creates the transaction.
2. Bank Returns the Transaction – If this occurs, you will receive an email notification that a transaction has been returned. You will also be able to run a ‘Returned Transaction Report’ inside One Inc Digital Payments.
3. When using an approval request to allow payees to select their payment method and it fails, they will be notified and we'll send an update to your service. 

This is a very rare situation. We have a duplicate payment check in our system that checks payment method and amount with a configurable time element (default is 2 minutes). If payment method and amount are the same and time between transactions is less than 2 minutes, it will block the transaction.

If you catch it immediately, we have void capabilities through our API and the money will not be sent to the payee. You would have to void the payment before the batch closes.

If you catch it after the batch closes, it will be a manual process triggered by you and the One Inc Support Team.

In an approval-request scenario, there is duplicate check criteria around claim number, total amount, and the same group of account identifiers. If a duplicate occurs in this situation, the API call will error.

Yes, you will set up the recurring schedule of payments in your system. When it’s time for the payment to be made, your organization will have it set up to call the ‘Make Payment’ API appropriate to the correct payment method.

Future scheduled payments will be managed in your existing claims system(s).  Our solution provides the ability to capture the electronic payment method details (e.g., bank account and routing number) as well as process the disbursement on its scheduled payment date. 

For security and fraud reduction reasons, there are limits to how much money can be transferred to each payment method type in a single transaction. Please give us a call about the limits and what flexibility may exist to satisfy your business needs.

ClaimsPay®  will send a Bank Transaction File at a configured time every day which includes all transactions initiated since the last batch close. Transactions can also be viewed in the Reporting portal or Payment portal.

Future scheduled payments will be managed in your existing claims system(s).  Our solution provides the ability to capture the electronic payment method details (e.g., bank account and routing number) as well as process the disbursement on its scheduled payment date. 

This is a very rare situation. We have a duplicate payment check in our system that checks payment method and amount with a configurable time element (default is 2 minutes). If payment method and amount are the same and time between transactions is less than 2 minutes, it will block the transaction.

If you catch it immediately, we have void capabilities through our API and the money will not be sent to the payee. You will have to void the payment before the batch closes.

If you catch it after the batch closes, it will be a manual process triggered by you and the One Inc Support Team.

Please note that some payment methods, like Push-to-Card and ClaimsCard® are instant and cannot be voided. 

For individual claimants who select Push-to-Card, PayPal, or Venmo, funds are instantly available for use. ACH bank transfers take 1-3 business days. Checks take 7-14 business days. Funds issued to a physical ClaimsCard® in CAT situations are instantly available. 

For vendors/service providers, funds are instantly available for use with the virtual ClaimsCard®. ACH bank transfers take 1-3 business days. Checks take 7-14 business days.

Note: If a claim requires actions from multiple parties on the claim, the payment disbursement process will not begin until all required approvals have been completed.

Funds are automatically disbursed to all payees via their payment method of choice immediately following the submission of the last required approval from all parties on the claim.

No. For vendors and service providers receiving the ClaimsCard™, standard credit card processing fees apply.

1. Working with your existing commercial bank, identify the commercial account you will use to make claim payments. 
2. Provide One Inc with your authorized company ID to allow One Inc to debit and credit the account. 

Yes, of course! You can use any commercial bank to make payments with One Inc.

No. You do not need to prefund.

1. Each day, claims payments will be included in a batch; once the daily batch closes, these claims are compiled into an ACH file which is processed the next morning. Nacha is filed each night.
2. The payee will receive the claims payment in 1 to 2 business days after batch close.
3. Your designated account will be debited daily based on the previous day's batch. 

Due to our authentication process, returns are unlikely to be a problem. However, if the insured “fat fingers” their bank account information, there is a process in place to resend the payment information email. From a technological perspective, there can be an infinite number of payments to a single claim. From an accounting perspective, the bank will process a return within 2 banking days of the original ACH payment and you will receive the ACH return information from One Inc. At the same time, One Inc will return the funds to you and you can initiate a new claim payment. 

Escheatment on the ClaimsCard® is when a cardholder has unused funds on a card that have been deemed abandoned by applicable law and the unused funds revert or “escheat” to the state as unclaimed property.

Unclaimed or abandoned property laws aim to make it easier for a property owner, such as a cardholder, to later locate his/her property. These laws provide that property that is unclaimed for a specified period of time, often called a dormancy period, is deemed abandoned and escheats to the state. At that point, the holder of the property must turn it over to the designated state agency. A property owner can then reclaim his or her property by filing a claim with the state agency.

Annually, depending on the state deadlines. State dormancy periods are 3 or 5 years, so unused funds on a card will not be eligible for escheatment until after the applicable dormancy period.

Cardholders are required to be notified prior to funds being escheated (from 1-12 months, depending on the state requirements). Notices are sent by the bank to the contact information on file.

If not claimed by a cardholder, funds are delivered to the state agency responsible for escheatment. The state then attempts to notify the reported owner of the funds, and after some period of time, which varies from state to state, the state takes the funds.

A cardholder can reclaim his or her property by filing a claim with the state agency responsible for escheatment.

The state will claim the funds.

1. Claimant receives an email/text from the insurance company requesting digital approval of claim payment details.
2. Claimant authenticates him/herself.
3. Claimant confirms the claim payment details, digitally approves, and selects vendor/service provider/lienholder/mortgagee as the designated payee. Claimant can also reject or dispute the claim payment. If he/she contests, the adjuster will be notified. This will halt the process for other parties on the claim until a resolution is determined.
4. Vendor/service provider receives claim payment via their saved preferred payment method. If preferred payment method is not selected, vendor/service provider receives email with a digital ClaimsCard®. Lienholders and mortgagees receive claim payments via ACH or paper check.

Only claimants can provide approvals at this time. But, we are currently working on a solution for this use case. 

They will be prompted to approve or contest the payment amount after authenticating themselves into their respective claim payments accounts.

After receiving a link to their account via email or text, they will be required to go through a two-factor authentication process including inputting an authentication code received via text or phone call.

If an individual is the primary claimant on the claim, he/she will receive a claim approval request first (via email or text) and determine the payee to receive payment. If there are multiple claimants on the claim, the secondary claimant will then be notified and be able to view the primary claimant's decision and approve or reject the claim payment.

The adjuster will be notified, ending the approval and payment process for other parties on the claim. Once there's a resolution, the adjuster will create a new claim payment approval request and send to all applicable parties. 

Funds are made available to payees immediately following the completed actions by all approving parties on the claim. Funds are disbursed automatically to all payees via their payment method of choice, immediately following the submission of the last required approval from all parties on the claim.

Vendor/service provider payment method preferences are saved after the first payment to the vendor is issued. Vendors/service providers can select to be paid via ACH, virtual ClaimsCard®, or check. When a vendor/service provider provides their bank account and routing number, it is tokenized to be reused for future claim payments.

No, we do not offer this functionality at this time.