User guide

For BimaHaq staff & partners

The case manager (ops) workspace

Work the queue, move cases forward, draft with AI and approve before anything is sent.

As a case manager you own the operational queue: pick up cases, advance their status through guarded transitions, reply to customers, request documents, and deliver AI-drafted work only after a human has reviewed it. This guide walks each ops journey in order, with the exact route and control for every step.

Workspace: /opsSign in: You do not self-register. An admin invites you; set your password from the email link, then sign in at /auth/login — you land on the /ops case queue.

Fees mentioned in this guide

Claim Review₹749
Claim Review + Expert Call₹1,499

Prices are indicative and shown from our live catalogue. Final price is confirmed at checkout.

1. The big picture

Everything starts on the case queue at /ops. From there you branch into the workspace you need — case detail, the WhatsApp and support inboxes, the Claim Review and consult queues. Nothing AI-generated ever reaches a customer without you approving it first.

A case manager's day

StartLand on the case queue (/ops)

DecisionWhat needs you now?

a customer waiting: go to Reply / request documents
a draft due: go to Draft with AI (Claim Review, consult, inbox)
an SLA breach: go to Clear SLA breaches & support tickets

Open a case: assign, advance status

Input / outputReply / request documents

Draft with AI (Claim Review, consult, inbox)

DecisionReviewed & edited?

no — keep editing: go to Draft with AI (Claim Review, consult, inbox)

Deliver / send the human-approved text

Clear SLA breaches & support tickets

DoneQueue clear

Diagram source (mermaid)

flowchart TB
  queue(["Land on the case queue /ops"])
  pick{"What needs you now?"}
  case["Open a case: assign, advance status"]
  reply[/"Reply / request documents"/]
  draft["Draft with AI Claim Review, consult, inbox"]
  approve{"Reviewed & edited?"}
  deliver["Deliver / send the human-approved text"]
  sla["Clear SLA breaches & support tickets"]
  done(["Queue clear"])
  queue --> pick
  pick -->|"a case to advance"| case
  pick -->|"a customer waiting"| reply
  pick -->|"a draft due"| draft
  pick -->|"an SLA breach"| sla
  case --> reply
  reply --> draft
  draft --> approve
  approve -->|"yes"| deliver
  approve -->|"no — keep editing"| draft
  deliver --> sla
  sla --> done

Compliance: AI never issues a claim verdict and never auto-sends anything customer-facing. Every AI output — a Claim Review, a consult note, a WhatsApp draft — lands in an editor for you to review and edit; only your delivered text reaches the customer.

Note: SLA badges tick live (every 60s) and render green/amber/red/breached. They drive sort and urgency across the queue, the support desk, the Claim Review and consult queues.

2. Signing in to your workspace

Case managers are invited, not self-registered. Once your account exists you sign in like any user and land straight on the ops queue.

1
Set your password
Open the invite email from the admin and follow the link to set your password (or use the magic link).
Sign in /auth/login
2
Sign in
Enter your email and password; if two-factor is set up, enter the 6-digit code.
Sign in /auth/login
→ You land on the /ops case queue

Note: All /ops routes are role-guarded (case_manager or admin) and noindex. The mobile bottom nav only appears for those roles — if you cannot see it, you are on the wrong account.

3. Pick up a case and advance its status

The queue at /ops is your landing workspace. Read the summary tiles, filter to what needs you, open a case, assign it to yourself, then move its status through the guarded transition modal — which can also send an optional customer message.

1
Scan the queue and its SLA counts
Read the summary tiles — My open, Unassigned, SLA breached, My tasks — and the live SLA badge on each row.
My open /ops
2
Filter to what needs you
Pick a status tab, toggle Mine or Unassigned, set Priority/SLA/Sort, or type in search.
Mine /ops
3
Open a case
Click the case row to load its detail page.
Case row /ops
4
Assign it to yourself
Use the assignee control under the case header.
Assignee /ops/cases/[caseId]
5
Set priority or risk flags if needed
On the Overview tab, change Priority or tick a risk flag such as Ombudsman-eligible.
Priority /ops/cases/[caseId]
6
Open the transition modal
Click the transition launcher in the case header.
Transition status → /ops/cases/[caseId]
7
Choose the next status
Pick a target grouped by open / in-progress / awaiting / closed; note any "note req" or "outcome req" hints.
Transition target status /ops/cases/[caseId]
8
Fill required fields and an optional customer note
Add the internal note, a resolution outcome if it is a closing state, and an optional message to the customer.
Internal note /ops/cases/[caseId]
9
Apply the transition
Confirm to apply.
Apply transition /ops/cases/[caseId]
→ Status moves; the internal note is logged

Advancing a case

StartFilter the queue

Open the case

Assign to yourself

Input / outputOpen transition modal

Pick target status

DecisionRequired fields filled?

no — note / outcome required: go to Pick target status

Apply transition

DoneStatus advanced

Diagram source (mermaid)

flowchart TB
  q(["Filter the queue"])
  open["Open the case"]
  assign["Assign to yourself"]
  modal[/"Open transition modal"/]
  pick["Pick target status"]
  valid{"Required fields filled?"}
  apply["Apply transition"]
  done(["Status advanced"])
  q --> open
  open --> assign
  assign --> modal
  modal --> pick
  pick --> valid
  valid -->|"yes"| apply
  valid -->|"no — note / outcome required"| pick
  apply --> done

Watch out: A closing transition needs a resolution outcome — without one the modal shows "Select a resolution outcome." and blocks submit. A transition that requires a note blocks on a blank note. If there are no legal transitions, you see "No transitions available from this state."

Watch out: The claim-status select on the case header blocks illegal next states (shows an error). Only the "Override transition rules (force)" checkbox unlocks the full list — use it deliberately.

Compliance: A transition logs an internal note visible to the ops team and, separately, an optional customer-facing message. The customer message is opt-in, never automatic.

4. Reply to a customer and request documents

Use the Customer Messages tab to reply, optionally attaching case documents. Use the Doc Requests tab to formally ask for a document — a formal request notifies the customer, posts a system message, and flips the case to documents-insufficient.

1
Open the message thread
Click the Customer Messages tab (opening it marks the thread read).
Customer Messages /ops/cases/[caseId]
2
Attach a case document (optional)
Toggle the paperclip and pick up to 3 case docs.
Attach /ops/cases/[caseId]
3
Type and send the reply
Write in the composer and send. Enter sends; Shift+Enter adds a newline.
Send /ops/cases/[caseId]
4
Formally request a document
Switch to the Doc Requests tab and start a new request.
Request a document /ops/cases/[caseId]
5
Fill the request
Choose the document type, describe what to upload, and set an optional due date.
Send request /ops/cases/[caseId]
6
Send the request
Confirm to notify the customer.
Send request /ops/cases/[caseId]
→ Customer notified; case flips to documents-insufficient

Watch out: Creating a document request is not silent: it notifies the customer, posts a system message, AND auto-flips the case to documents-insufficient. Cancel a pending request you no longer need from its row (it asks you to confirm).

Note: If the customer has no thread yet, the Messages tab shows "No thread yet." The composer is rate-limited — sending too fast shows "Slow down — try again in a moment."

5. Draft and deliver the written Claim Review

In the Claim Review queue, open an in-review item. The AI copilot auto-generates a draft on first open; you edit it, then Deliver. Only the delivered text reaches the customer — this is the human-approval-before-send gate for the written Claim Review (₹749).

1
Open the Claim Review queue
Reach it from the bottom-nav Docs tab; the default filter is In review.
In review /ops/strategy-docs
2
Open a request to review
Open the request — this auto-generates the AI draft if none exists yet.
Review & deliver /ops/strategy-docs
3
Regenerate the AI draft (optional)
Regenerate if you want a fresh draft. Without an AI key it produces a template scaffold instead.
Regenerate /ops/strategy-docs
4
Edit the document text
Edit in the document editor. You need at least 40 characters to deliver.
Document editor /ops/strategy-docs
5
Deliver the human-approved document
Deliver once you are satisfied.
Deliver document /ops/strategy-docs
→ The delivered text reaches the customer

Claim Review: draft → approve → deliver

StartOpen in-review queue

Input / outputOpen request (AI drafts)

can't fulfil: go to Cancel — voids credit, manual refund

Edit the draft

DecisionAt least 40 characters?

no — too short: go to Edit the draft

Deliver

DoneCustomer receives it

Cancel — voids credit, manual refund

Diagram source (mermaid)

flowchart TB
  q(["Open in-review queue"])
  open[/"Open request AI drafts"/]
  edit["Edit the draft"]
  len{"At least 40 characters?"}
  deliver["Deliver"]
  done(["Customer receives it"])
  cancel["Cancel — voids credit, manual refund"]
  q --> open
  open --> edit
  edit --> len
  len -->|"yes"| deliver
  len -->|"no — too short"| edit
  deliver --> done
  open -->|"can't fulfil"| cancel

Compliance: The AI draft is never sent. You edit it and click Deliver — only your delivered document reaches the customer. This is claims guidance only, never legal advice, and carries no outcome promises.

Watch out: Delivery is blocked under 40 characters ("The document needs at least 40 characters."). Cancelling a request that can't be fulfilled prompts for a reason, voids the credit, and requires a manual refund — the ops UI never moves money automatically.

6. Work the WhatsApp inbox and leads pipeline

Reply to lead conversations from inside BimaHaq — your first reply stamps the first-response SLA. An optional grounded AI draft drops into the composer for you to edit before sending. Separately, work the CRM Leads pipeline.

1
Open the WhatsApp inbox
Reach it from the bottom-nav Chats tab; the filter toggle starts on “All” — switch it to see only unanswered chats.
Awaiting reply /ops/inbox
2
Open an awaiting conversation
Click a conversation — an "Awaiting first reply" badge flags unanswered ones.
Conversation /ops/inbox
3
Draft with AI (optional)
Generate a grounded suggestion into the composer, then edit it.
Draft with AI /ops/inbox
4
Send the reply
Type and send; a toast reports your first-response time.
Send /ops/inbox
→ First reply stamps the first-response SLA
5
Work the CRM leads pipeline
Filter by stage or owner, open a lead, change its stage or owner, and add a note.
Save note /ops/leads

Compliance: The AI draft is a grounded suggestion to review and edit before sending — it is never sent for you. If it would overwrite text you already typed, you are asked "Replace your draft with the AI suggestion?" first.

Note: Cross-conversation safety: if you switch conversations while an AI draft is in flight, the draft is dropped so it can't land in the wrong composer. An empty inbox shows "No conversations yet"; leads with no matches show "No leads match these filters."

7. Work the support (helpdesk) queue

A two-pane helpdesk over support tickets. Overdue tickets show an OVERDUE badge (computed from the due-by time). Reply sets a ticket to with-customer, or reply and resolve in one step; Resolve and Close change status directly.

1
Open the support queue
Reach it from the bottom-nav Support tab; the default filter is Awaiting reply.
Awaiting reply /ops/support
2
Spot SLA breaches
Look for the OVERDUE badge and due time on each row.
OVERDUE /ops/support
3
Open a ticket
Click a ticket row to load its thread and attachments.
Ticket row /ops/support
4
Write a reply
Type in the reply box; optionally tick Also mark resolved.
Also mark resolved /ops/support
5
Send, resolve or close
Send the reply, or Resolve, or Close the ticket.
Send reply /ops/support
→ Ticket status updates

Note: A closed ticket is read-only — the reply composer and status buttons are hidden. An empty queue for the chosen filter shows "Nothing here — queue's clear."

Watch out: The OVERDUE badge is client-side, from due-by, and only for open / in-progress tickets. Switching tickets while a fetch is in flight discards the stale result so it can't land on the wrong ticket.

8. Run an expert call and deliver the written Claim Review

The callback queue holds paid Claim Review + Expert Call (₹1,499) bookings. Assign or auto-match an expert, save the call transcript, run the AI copilot for an internal brief and draft note, edit it, then Complete and deliver the written Claim Review.

1
Open the callback queue
Reach it from the bottom-nav Calls tab; the default filter is Pending.
Pending /ops/consults
2
Assign or auto-match an expert
Pick an expert and assign, or auto-match one.
Auto-match /ops/consults
3
Open the note editor
Open the Claim Review editor for the booking.
Close with Claim Review /ops/consults
4
Save the call transcript
Paste the call notes and save. The transcript grounds the AI recap and is never sent to the customer.
Save transcript /ops/consults
5
Run the AI copilot
Generate an internal pre-call brief and draft note, then edit the note.
Generate AI copilot /ops/consults
6
Complete and deliver the written Claim Review
Complete once the note is at least 20 characters.
Complete & deliver note /ops/consults
→ The written Claim Review reaches the customer

Expert call → written Claim Review

StartOpen pending callbacks

Assign / auto-match expert

Input / outputSave transcript (internal)

Run AI copilot (internal)

Edit the note

DecisionAt least 20 characters?

no — too short: go to Edit the note

Complete & deliver

DoneCustomer receives the note

Diagram source (mermaid)

flowchart TB
  q(["Open pending callbacks"])
  assign["Assign / auto-match expert"]
  trans[/"Save transcript internal"/]
  copilot["Run AI copilot internal"]
  edit["Edit the note"]
  len{"At least 20 characters?"}
  deliver["Complete & deliver"]
  done(["Customer receives the note"])
  q --> assign
  assign --> trans
  trans --> copilot
  copilot --> edit
  edit --> len
  len -->|"yes"| deliver
  len -->|"no — too short"| edit
  deliver --> done

Compliance: The copilot brief, draft note and call transcript are internal and never sent — only the completed Claim Review reaches the customer. When an expert supplies their own post-call draft, load it into the note; any expert estimate is wrapped as a non-binding estimate, not a guarantee.

Watch out: Completion is blocked under 20 characters. Cancelling a booking prompts for a reason, voids the credit, and requires a manual refund. If the copilot would overwrite note text you typed, you are asked to confirm first.

9. Privacy & compliance you own

As a case manager you touch customer PII and AI drafts daily. These rules are binding — they are enforced in the UI but you are the human accountable for them.

Human-approval-before-send — never send an unreviewed AI draft. Claim Reviews need Deliver, consult notes need Complete & deliver, WhatsApp AI drops into the composer to edit first.
AI never issues a verdict — the copilot drafts and briefs; it does not decide a claim. You and the specialists own the judgement.
Experts and advocates draft their own work — AI does not write for them; ops/admin approve and deliver.
Claims guidance, not legal advice — stated on the consult and Claim Review queue headers; do not present drafts as legal advice.
No outcome promises, no guarantees — never tell a customer a claim will be paid.
No automated money movement — cancelling a paid item voids the credit and requires a manual refund with a written reason.

Compliance: No percentage-of-claim or success fee, no advocate fee-sharing, and no paid non-advocate representation before Consumer Commissions — BimaHaq guides and drafts, it does not represent customers in those forums.

Note: The internal note on a transition is visible to the ops team; the customer message is a separate, opt-in field. Keep sensitive internal reasoning in the internal note, not the customer message.

Questions people ask

Can I send an AI draft straight to a customer?: No. Every AI output is a draft for a human to review and edit. Claim Reviews need Deliver, consult notes need Complete & deliver, and WhatsApp AI suggestions land in the composer for you to edit before sending. Nothing AI-generated auto-sends.
Why did creating a document request change the case status?: A formal doc request is not silent: it notifies the customer, posts a system message, and auto-flips the case to documents-insufficient. That is expected — use a plain message on the Customer Messages tab if you only want to ask informally.
The transition modal won't let me submit — what's missing?: A closing status needs a resolution outcome, and some transitions require an internal note; the modal names whichever is missing. If it says "No transitions available from this state," there is no legal next status from where the case is now.
Why is my Claim Review delivery blocked?: Length gates: a written Claim Review needs at least 40 characters to deliver, and a consult Claim Review needs at least 20 to complete. Add more substance and the action unlocks.
How do I cancel a paid booking or Claim Review request?: Use the cancel action on the row; it prompts for a reason and voids the credit. The refund is manual — the ops UI never moves money automatically, so hand off the refund to whoever owns payments.

Stuck on something this guide didn't cover?

Reach the platform team through your workspace, or open a ticket in the support queue.

Support queue All guides

This guide explains how to use the BimaHaq platform. It is general information, not legal or financial advice, and describes a process — not a guaranteed outcome.