| 1 |
Open a claim file from anywhere… |
| Claim Opening |
Give users as well as other partners such as agents, garages, loss adjusters and doctors a secured access to open a claim with limited authorizations to reduce claim processing cycle time and improve quality. Let them use the document imaging module to upload supporting documents and reduce the paperwork. |
| 2 |
Add provisions automatically or manually… |
| Reserves |
You can set initial reserve amounts based on the claim intimation and modify the provision using reserve decrease/increase mechanism. The type of reserve can be a recovery as well.
Reserve can also be set to pay for other expenses like fees to investigate a claim and other expenses.
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| 3 |
Choose the most effective and convenient payment method… |
| Payments |
Settle a payment as lump sum amount or define an annuity payment schedule in the form of installments, while approving the claim. The system automatically generates the annuity payments at due date.
The system automatically raises a payment voucher and the appropriate accounting entries for all approved claims. No payment is allowed if the claim is not approved with sufficient provision amount.
Process the payment by choosing the most appropriate method, to you and to the beneficiary: cheque, account (credit note) and EFT. There is also an option to reverse a payment.
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| 4 |
Automatically setup the payment amount for any added victim… |
| Victims |
You can add unlimited number of victims in the same claim. You can also enter as many as you want of medical certificates and entitled beneficiary of the victim - even if they are not named in the policy.
Automatically calculate indemnity amount based on medical reports and victim details.
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| 5 |
Manage online provider’s mission management process… |
| Providers |
You can assign unlimited number of missions per victim to doctor, lawyer, loss adjuster or any other provider and capture (manually or online) unlimited number of reports per mission. All online processing updates and initiations are controlled in terms of authorized limits and access rights. |
| 6 |
Automate reinsurance claim transactions… |
| Reinsurance |
During the claim process, the system performs reinsurance computation and allocation automatically per outward policy and participant and generates the reinsurance bordereaux. |
| 7 |
Record claim events and view claim details at event time… |
| Claim Events |
Track all movements on a claim and detailed information can be provided online as well. Any claim event is recorded with date and user who initiates it. You can view the claim details and situation at the event time. |
| 8 |
Consult the list of all claims registered under the same policy… |
| Claims History |
You can view the list of all claims linked to the policy, life insured or a member in case of group policy. You can view any claim details and status. |
| 9 |
Close claims with or without a payment… |
| Claim Closing |
Close any claim with or without payment using different processes. The eventual outstanding reserve is automatically set to zero when the claim file is closed. Closed claims are available for view only or to be reopened if required by authorized users. |
| 10 |
Reopen a closed claim if needed with required controls… |
Claim
Re-Opening |
After the settlement of claim, the amount may be revised. This is usually the case where the claim settlement goes through a court case. You can reopen the claim and use an option available in the system to revise, through a provisions decrease/increase mechanism, the claim amount with the same claim number. |