Overview

This manual provides a step-by-step guide for handling insurance claim sales within The Edge POS system. It covers all essential processes, from initial setup of miscellaneous sale codes for insurance claims to handling payments, applying discounts, managing customer contributions (excess), and issuing refunds to insurance companies.

The guide begins with a one-time setup for Miscellaneous Sale Codes required for processing insurance-related transactions. Once these codes are configured, they streamline the handling of insurance claims, including excess payments, insurance discounts, and general claim processing.

Each major section details the full workflow:

• Processing Insurance Claims for Insurance Companies: Instructions on setting up claim vouchers and processing payments, with example scenarios to clarify excess and discount applications.
• Handling Customer Transactions: Steps to manage sales to customers using their claim vouchers, including how to process underspend and handle any excess charges directly from the customer.
• Issuing Refunds and Clearing Accounts: Procedures for refunding unused claim amounts back to the insurance company, clearing accounts, and updating records.
• Producing Statements: Guidelines for generating detailed statements for insurance companies, covering account charges, payments, and balances.
• Receiving Payments from Insurance Companies: Instructions on recording and clearing payments from insurance companies in The Edge.

This comprehensive manual ensures that insurance claim sales are managed accurately and efficiently, from setup to finalisation.

Important: Do not proceed until the insurance claim has been approved and confirmed by the insurance company!

What is an Insurance Claim?

An insurance claim is a request made by an insured individual to their insurance company to cover the cost of a loss, damage, or replacement of items as per the terms of their insurance policy. In the context of jewellery, this typically occurs when an insured jewellery item is lost, stolen, or damaged. The insurance company evaluates the claim and, if approved, agrees to pay for the replacement or repair of the item, often involving a specific retailer to fulfil the claim.

What is a Sale for an Insurance Claim?

A sale for an insurance claim refers to the process of replacing or repairing an insured item through a retailer, where the insurance company is primarily responsible for payment. The process involves:

1. Claim Payment: The insurance company pays for the cost of the replacement or repair, minus any excess (the amount the customer may need to pay out-of-pocket).
2. Customer Contributions: If applicable, the customer pays an excess amount directly to the retailer.
3. Discounts: Insurance companies may negotiate discounts on the total cost as part of their arrangement with the retailer.
4. Transaction Handling: The retailer processes the transaction in their POS system to reflect both the insurance company’s payment and the customer’s contribution, ensuring accurate accounting and reporting.

This process ensures transparency and proper management of financial responsibilities between the customer, the insurance company, and the retailer.

One-Time Setup for Miscellaneous Sale Codes and Gift Voucher Templates

Before processing insurance claim sales for the first time, you'll need to create a few Miscellaneous Sale Codes in The Edge. These codes are necessary for handling insurance excess charges, discounts, and other related transactions.

Note: This setup only needs to be done once, and once it's set up, you won’t have to repeat it for future insurance claims.

The required Misc Sale Codes are:

• Ins Excess Charge
• Ins Excess Discount
• Ins Discount

See below for instructions on how to setup these Misc Sale Codes. Once these codes are configured, they will be available in the POS for all future insurance claim transactions.

Misc Setup - Ins Excess Charge

1. Go to Edge > Administrative > Misc Sale Codes > Misc Sale Codes.
2. At the bottom left of the Screen click Add
3. Fill in the General Tab

1. Short Name: Ins Excess Charge
2. Description: Collection of Insurance Excess from Customer
3. Set the Department to 29 (Miscellaneous).
4. Check the box GST Applicable.

4. Click OK / Save and Close

Misc Setup - Ins Excess Discount

1. Go to Edge > Administrative > Misc Sale Codes > Misc Sale Codes.
2. At the bottom left of the Screen click Add
3. Fill in the General Tab

1. Short Name: Ins Excess Disc
2. Description: Insurance Company Discount of Excess
3. Set the Department to 29 (Miscellaneous).
4. Check the box Treat as Credit 
5. Check the box GST Applicable.

4. Click OK / Save and Close

Misc Setup - Ins Discount

1. Go to Edge > Administrative > Misc Sale Codes > Misc Sale Codes.
2. At the bottom left of the Screen click Add
3. Fill in the General Tab

1. Short Name: Ins Discount
2. Description: Insurance Company Discount
3. Set the Department to 29 (Miscellaneous).
4. Check the box Treat as Credit 
5. Check the box GST Applicable.

4. Click OK / Save and Close

Adding/Editing Gift Voucher Message Templates

1. Open POS
2. At the Top Right of the Screen Click Sell Gift Voucher
3. In the Gift Voucher details screen, Click the Select a Standard Message button
4. From the Gift Messages screen

1. if you are wanting to Add a New Gift Voucher Message 

1. At the bottom left of the screen Click Add

2. if you are wanting to edit or de-activate an existing Gift Voucher Message

1. Select the Message you want to Edit or de-activate
2. Then Click Edit at the bottom Left of the screen

5. Fill in the Information on the screen as required

1. Inactive – Check this to Deactivate the Gift Voucher Message
2. Type – Short (20 Characters) Description of the Message
3. Message – The Full Gift Voucher Message

Please See Below Examples of Gift Vouchers that are used for Insurance Claim Sales

IMPORTANT: The gift voucher messages provided above are intended as a general guideline. It is recommended to customise the message to suit your specific needs and meet the requirements of the insurance company.

Processing an Insurance Claim Sale for Insurance Company

Example Scenario: Processing a claim for a $5,000 with a $500 excess and the Insurance Company expects a 10% discount post excess.

Setting up the Claim Voucher

1. Open POS
2. Select the Salesperson 
3. Find Cust and locate the Insurance Company. 
   Note: If the Insurance Company does not yet have an account in The Edge you will need to create one. Please Contact Customer Success if you are unsure how to process this
4. At the Top Right of the Screen Click Sell Gift Voucher

5. Fill in Gift Voucher Details:

1. Recipient

1. Select the Drop-down Arrow on the Recipient Field
2. Select Find Customer
3. Fill in the Criteria and Click OK
4. Select the Customer in the List press Select

• If the customer does not exist, you can click Fast Add at the bottom of the screen to add a New Customer

2. Gift Amount – Enter the total Insurance Claim Amount in this field (For this Scenario the Gift Amount would be $5000.00)
3. Message

1. In the Gift Voucher details screen, Click the Select a Standard Message button and choose the "Claim – Insurance" template. 
2. Enter the Excess Amount to Pay (If no Excess to be charged put $0.00) and Claim Number in the message box. (This information will appear on the Insurance Company’s statement in the next billing cycle.)

4. Click OK

Handling Customer Excess:

If the customer is required to pay an excess before finalising the Insurance Company sale, This amount will be paid by the customer directly to the store and not by the Insurance Company.

1. Click Misc Sales
2. On the sale line that just appeared click the Dropdown and Select “Ins Excess Disc”
3. On the right side of the sale line enter the excess amount. (For this Scenario the Ins Excess Disc sale line would be $500.00)

Finalizing the Insurance Claim:

The Due field (after applying the discount and excess discount) should display in the Bottom Right Corner as the amount the insurance company will cover (Pre-Discount – Discount is applied when clearing the Insurance Account in 6. Handling Payments from the Insurance Company.)

1. At the Bottom Left of the POS Screen Choose Cust. A/c’s as the payment type
2. Ensure you amount is what is expected as per the Due Field (For this Scenario The Amount and Due should show $4500)
3. Click OK

4. Click Finished

Note: When you check the insurance company’s account, the balance will reflect the full amount minus any excess.

Processing Insurance Claim for Customer

When the customer come into the store to spend the Insurance Claim follow this procedure

Setting up Sale

1. Open POS
2. Select the Salesperson
3. Click Find Customer use the name of the customer entered in section 2.1 Setting up Claim Voucher
4. Scan or enter the item(s) that the customer is wanting to purchase
5. Once all Items are entered, in the Payment type section select Gift Voucher as the payment method.
6. From the list select the Insurance Gift Voucher (Do NOT click Finished yet)

Note: Watch the Message beside the Gift Voucher for any Excess to be charged

How to process Underspend

Underspend is when the customer does not use the entire Claim amount in 1 transaction (There is still a Negative amount Due).

1. At the Top Right of the Screen Click Sell Gift Voucher
2. Fill in Gift Voucher Details:

1. Recipient

• Select the Drop-down Arrow on the Recipient Field
• Select Find Customer
• Fill in the Criteria for the same customer you are currently selling to and Click OK
• Select the Customer in the List press Select

2. Gift Amount – Enter the Amount Due as a Positive amount. E.g. If amount due is 
   -$1500.00 enter the Gift amount as $1500.00
3. Message

• In the Gift Voucher details screen, Click the Select a Standard Message button and choose the "Claim – Underspend" template.
• Claim Number in the message box.

4. Click OK

If the customer has an excess charge

If the customer is required to pay an excess before finalising the sale, this amount will be paid by the customer directly to the store and not by the Insurance Company.

1. Click Misc Sales
2. On the sale line that just appeared click the Dropdown and Select “Ins Excess Charge”
3. On the right side of the sale line enter the excess amount.

Finalising Sale

1. Take payment for the excess or overspend using the appropriate tender method at the bottom left of the screen (e.g., cash, credit card).
2. Once the Due is $0.00 click Finished

Note: Follow Procedure 3 - Processing Insurance Claim for Customer repeatedly until the full insurance claim amount has been used.

Refunding Credit Back to the Insurance Company

If the customer does not use the full claim amount, the insurance company has advised they are no-longer proceeding with the claim or the insurance company has adjusted the claim amount, you can return the remaining balance to the insurance company. This is a two-stage process.

Example Scenario: Customer originally had a claim for $5000 and the insurance has adjusted the claim to $3500 requesting a refund of $1500 to their account

Returning the Credit to the Insurance Company

1. Open POS
2. Select the Salesperson 
3. Click Find Customer use the name of the customer entered in section 2.1 Setting up Claim Voucher
4. At the Top Right of the Screen Click Sell Gift Voucher
5. Fill in Gift Voucher Details:

1. Recipient

1. Select the Drop-down Arrow on the Recipient Field
2. Select Find Customer
3. Fill in the criteria to locate the Insurance Company. 
   Select the Insurance Company in the List press Select

2. Gift Amount – Enter the Amount being returned to the insurance company in this field (For this Scenario the Gift Amount would be $1500.00)
3. Message

1. In the Gift Voucher details screen, Click the Select a Standard Message button and choose the "Claim – Insurance Return" template.
2. Claim Number in the message box. (This information will appear on the Insurance Company’s statement in the next billing cycle.)

4. Click OK

6. In the Payment type section select Gift Voucher as the payment method.
7. From the list select the Insurance Gift Voucher
8. At the Top Right of the Screen Click Sell Gift Voucher
9. Fill in Gift Voucher Details:

1. Recipient

1. Select the Drop-down Arrow on the Recipient Field
2. Select Find Customer
3. Fill in the Criteria for the same customer you are currently selling to and Click OK
4. Select the Customer in the List press Select

2. Gift Amount – Enter the Amount Due as a Positive amount. (For this Scenario the Gift Amount would be $3500.00)
3. Message

1. In the Gift Voucher details screen, Click the Select a Standard Message button and choose the "Claim – Underspend" template.
2. Claim Number in the message box. (This information will appear on the Insurance Company’s statement in the next billing cycle.)

4. Click OK

10. Verify Amount Due is $0.00 and Click Finished

Clearing the Insurance Account

1. Open POS
2. Select the Salesperson 
3. Find Cust and locate the Insurance Company. 
4. Click the Make a Payment button.

5. Tick the box for the customer account and click OK
6. Enter the amount to clear from the balance on the right side of the sale line (For this Scenario the Amount would be $1500.00)
7. In the Payment type section select Gift Voucher as the payment method.
8. From the list select the Insurance Gift Voucher and Cick OK

9. Verify Amount Due is $0.00 and Click Finished

Producing Insurance Company Statements

To create a statement for an insurance company in The Edge, follow these steps:

1. From the main screen, navigate to Customer > Statements.
2. In the Statements Criteria screen:

• Date Range: Enter the Start Date and End Date (default is the previous month; statements are typically generated for full calendar months).
• Print Date: Type 0 to select today’s date.

3. On the right side, ensure Customer Account is the only box checked under Account Types.
4. Choose the Output Type at the bottom:

• Screen: Generates a visual preview on screen.
• Auto Email: Sends the statement directly to the registered email on the customer account.
• Review & Email: Provides an on-screen preview and prompts to send each statement via email to the registered address.

5. Click OK

Note: The statement will include details of payments, charges, and the remaining balance on their account.

Handling Payments from the Insurance Company

Scenario: Following the scenario in this manual the insurance claim started at $5000.00 with a $500.00 excess. The claim was adjusted to $3500.00 with a $500.00 excess making the total liable to the insurance company $3000.00. The insurance company expects a 10% discount.

Setting up POS to Clear Money on Insurance Account

1. Open POS
2. Select the Salesperson 
3. Find Cust and locate the Insurance Company. 
4. Click the Make a Payment button.

5. Tick the box for the customer account
6. Enter the amount to clear from the balance on the right side of the sale line (For this Scenario the Amount would be $3000.00)

Apply Insurance Discounts:

If the insurance company expects a discount. The customer should not be made aware of the insurance discount being applied.

1. Click Misc Sales
2. On the sale line that just appeared click the Dropdown and Select “Ins Discount”
3. On the right side of the sale line enter the excess amount. (For this Scenario the Ins Discount sale line would be $350.00).

Finalising Payment

1. Select the payment method in the bottom right of the POS Screen (e.g., credit card, direct deposit).
2. Click Finished