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Creating Claims Approval Flow

Set up a Claims Approval Flow to route claims requests automatically to the right approvers.

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Written by Gutsy Support

Setting up a Claims Approval Flow allows you to automate the approval process based on specific conditions, such as position, department, or claim type. Each claim request will automatically route to the appropriate approver, saving time and ensuring consistent approval logic across your organisation.

💡 Note: Before creating a Claim Approval Flow, ensure you have already created your Claim Types.


1. Navigate to Approval Flow Page

  1. From the side navigation bar, click Claim and select Approval Flow from the dropdown.

  2. Click ➕ New under Claim Application to create a new Claim Approval Flow.

2. Fill in the Approval Flow Details

In the pop-up window, fill out the following fields:

a. Name: Enter a name to differentiate this claim approval flow.

b. Description: Add notes for clarity.

c. Assign Companies: Select the companies this flow applies to.

d. Click Get Started to proceed.

3. Set the Starting Point (Trigger)

You’ll be directed to the workflow canvas. The starting point is labelled “New claim submitted by employee”, which represents when an employee submits a claim request.

📝 Note: Employees who require approval will not be assigned automatically.

For existing employees, please assign the approver directly from their employee profile or using the Mass Edit Employment Details function.

For new employees who have not yet been onboarded, you can assign it during the onboarding process; either single or through mass onboarding.

Click ➕ Condition to define who this flow applies to:

  • Position (e.g., Supervisor, Manager)

  • Department (e.g., HR, Operations)

  • Employee Group (e.g., Full-time, Part-time)

  • Employee Tag (e.g., Contract, Probation)

🖇️ Reference Guides:

👉Follow this guide to create a Position

👉Follow this guide to create a Department

👉Follow this guide to create an Employee Group

👉Follow this guide to create an Employee Tag

Example:

You can select “Position” → “Executives”.

Add multiple conditions if this flow applies to several roles.

4. Configure Claim Type Conditions

  • Move down to the Condition box.

By default, it applies to all Claim Types unless you specify otherwise.

  • Click ➕ Condition to add rules

  1. Select Other Claim Types → toggle ON → choose from dropdown (e.g., Medical Claim, Food Claim). You can choose more than one claim type.

  2. Claim amount is greater or equal to → toggle ON → enter the threshold (e.g. $100).

  • You can also combine conditions using AND / OR logic.


Logic Description

AND Connector

When you select AND, it means both conditions must be met before the request proceeds to the next approval stage.

Example Scenario:

  • You toggle on “Select other claim types” and choose Medical Claim with All Category.

  • You also toggle on “Claim amount is greater or equal to” and set it to $100.

  • You then select AND as the connector.

Result:

  • ✅ If an employee submits Medical Claim for $200, both conditions are met - the request will proceed to the next approver for this condition.

  • ❌ If an employee submits Medical Claim for $50, the conditions are not met - the request will not proceed and will return to the default approver for action.


OR Connector

When you select OR, it means only one of the conditions needs to be met before moving to the next approval stage.

Example Scenario:

  • You toggle on “Select other claim types” and choose xxx Type.

  • You also toggle on “Claim amount is greater or equal to” and set it to xxx.

  • You then select OR as the connector.

Result:

  • ✅ If an employee submits Medical Claim for $50, this fulfils one of the conditions, and the request proceeds to the next approver.

  • ✅ If an employee submits Food Claim for $200, this also fulfils one of the conditions, and the request proceeds.

  • ❌ If an employee submits Food Claim for $50, neither condition is met - the request will revert to the default approver for approval.


🗑️ To remove a condition, click the Bin icon.

➕ To add more, click the +Condition button and repeat the steps.

  • Click the + icon to set up the approver before the request reaches its final approval stage.

5. Set the Approver Workflow

In the Approver box

  1. Click Edit status to adjust the Status Name (default: Wait to approve) and optionally, change the Colour for easier visual tracking.

  2. Choose the Approver Type:

    • Employee

    • Position

    • Department

    • Employee Group

    • Employee Tag

  3. Based on your choice, fill in the specific approver (e.g., “Position → Manager”).

    To add additional tiers, click the ➕ Approver

  4. Choose the other approver and set the condition:

    • Must Approve: Both approvers are required to approve the claim before it is considered fully approved.

    • Can Also Approve: Either one of the approvers can approve the claim for it to be fully approved.

With the condition above, both approvers will receive the claim approval notification at the same time.

If you prefer to have the second (or next) approver receive the notification only after the first approver has approved the claim (sequential approval), click the “+” icon to create a new approval box and set up the next approver tier accordingly.

6. Finalise and Save

  1. The final workflow should end with the Approved box. Review the flow to ensure all conditions and approvers are correct.

  2. Click Create to complete the setup.


Great! You now know how to create and configure Claim Approval Flows for your team efficiently!

👉 You may follow the guide here to assign the Claim Approval Flow to the employees.

Still exploring? Head over to our Help Centre for more in-depth guides and FAQs.


If you have any questions, feel free to reach out to us at support@gutsyhq.com. We'll get back to you from there.

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