Claims Admin

Claims Admin allows you to process insurance claims by collecting the claim’s data, validating it, approving it, and evaluating and issuing the claim payments in accordance with the insurance policy’s coverage.

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Typically a claim will be made by an insured or 3rd party, and the insurer will check that the claim falls under the protection of the policy and evaluate the claim before making a payment to the insured or 3rd party.

 

Claims is designed to support any organisation directly involved in claim processing by allowing you to set up a fully digital claim journey in your FintechOS Portal environment.

 

The Claims digital journey can be fully customized in FintechOS Studio, enabling you to match your specific requirements and your preferred claim workflow. By using Claims as a foundation you will shorten your implementation time and ensure that each component fulfils your specific needs. Additionally, by using Claims with other FintechOS Automation Processors  you will be able to digitize other workflows and improve accuracy, while reducing the amount of time spent on routine business operations.

 

KEY FEATURES

  • Notification of loss,
  • Automated data validation
    • and, if necessary, manual validation;
  • Claim statement generation,
  • Payment scheduling.

The Claims digital journey is designed to offer you a streamlined route for processing claims. The solution includes the following key workflows:

  • First Notification of Loss – for collecting information about the incident, the policy, the notifier, the other parties involved, including the option to continue to create claim or cancel the notification steps. Creating a First Notification of Loss is a mandatory first step for any claim to be processed by the system. All the information that you enter in this step is available to be re-used during the Claims digital journey, in auto-complete and read-only fields.
  • Claim flow – for creating, documenting and managing claims, with options that allow the upload of supporting evidence – documentats, images, video etc. and tools to facilitate the assessment of the claim. A claim can be configured anytime after the FNOL is initiated. The Claims configuration menu is contains eight tabs to help you complete claim processing.
  • Payment Proposal flow – used to generate and schedule claim payments. A payment can be configured anytime after the FNOL is initiated. The Payment flow has four steps and helps you manage any payment.
  • Rejection, Journal & Third Party Details – pages for adding supplementary information and managing the related documents and any third party details, if applicable.

The complete documentation is availble here.

Dependencies: Standard SysPack v21.1.6002 or higher

Insurance Apps Dependencies: Policy Admin V3.0.0

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Tags

automateclaims, claimsadmin, coreadmin, coreinsurance, digitalinsurance

Team

FintechOS