Case management

What is case management?

Case management is a way of handling work that centres on a single case: a claim, a complaint, a permit application, a social-services file, or a fraud investigation. The person working the case decides, as they go, which actions the situation needs. The full path is not fixed in advance.

This suits knowledge work where new documents, conversations, and events keep changing what the sensible next step is. A fixed workflow assumes you know the route before you start. A case assumes you will learn the route while you work.

The system keeps everything that belongs to the case together: the file itself, the people involved, the tasks, the decisions taken, and the history of what happened. It supports the caseworker instead of forcing every possible route into one rigid sequence.

The case file, goals and activities

The case file holds the information tied to the case: forms, documents, facts, messages, and the relationships between records. Access often varies by role and by the sensitivity of each field.

Goals describe when the case has reached a usable result. For an insurance claim, that might be a reasoned decision and either a correct payout or a documented rejection.

Activities can be mandatory, optional, or made available by an event. A new medical report can make an extra assessment either possible or required. A caseworker can run several activities in parallel and come back to earlier ones when new information arrives.

Milestones mark real progress without pretending every file follows the same line. They tell a manager where a case stands without implying it moved through one fixed set of stages.

A worked example: an insurance claim

A customer submits a claim with photos and a description. The system opens a case and checks the basic details. A caseworker decides whether an on-site inspection is needed.

If the damage is small and the paperwork is complete, the claim can go straight to assessment. If there is injury, conflicting statements, or a high amount, extra activities become available: an expert inspection, legal advice, and requests for further documents.

A timer watches the legal and internal deadlines throughout, but the order of the investigation tasks still depends on what each step turns up. The final decision points back to the supporting documents, the checks that were run, and the person authorised to decide. A good audit trail shows not only the status changes but also why an activity was added or skipped.

Case management versus a fixed workflow

A fixed workflow describes a predictable order of tasks and decisions. It fits repeatable work with known routes, such as a standard approval. A workflow engine is happiest when the steps rarely surprise you.

Case management fits work where information appears along the way and an expert has to judge what is needed. Modelling every branch in advance makes such a process unreadable and squeezes out the judgement that made it work in the first place.

The two belong together. A case can start fixed subprocesses for document verification, payment, or escalation. Use structure where it is reliable and leave room for discretion where context decides.

CMMN and BPMN

CMMN, short for Case Management Model and Notation, is an Object Management Group standard for modelling cases and less predictable knowledge work. It is built around case files, activities, events, and room for the caseworker to decide. The first version was published in 2014 and version 1.1 followed in 2016.

BPMN models a process with a control flow you design up front. The two standards were meant to complement each other: a BPMN process can open a case, and a case can run a structured BPMN subprocess. A notation on its own is not a working system, though. You still need a user interface, document storage, security, search, and reporting around it.

Where case management runs

Many teams run case management on a business application platform rather than building one from scratch. On Microsoft Dataverse and Dynamics 365 Customer Service, a case is a first-class record, and a business process flow guides an agent through stages such as identify, research, and resolve while still allowing exceptions. The wider Microsoft Power Platform, with Power Apps and Power Automate, is a common way to add forms, automation, and integration around those cases.

What to watch out for with case management

Do not over-model. The point of a case is discretion. If you pin down every branch, you have really built a fixed workflow with extra steps, and caseworkers will fight it.

Protect sensitive files. Cases often hold personal and confidential data. Apply least privilege at the file, document, and field level, and record who viewed, changed, or relied on information in a decision.

Compare like with like. Measure throughput time, waiting time, rework, and outcomes per case type. Averaging a fraud investigation together with a routine claim gives you a number that means nothing.

Watch for patterns worth standardising. Activities that keep recurring in the same order are candidates to become a fixed workflow or an automation later. Process mining can surface those patterns. Keep room for professional judgement, but make deviations explainable.