Claims Management Module

Claims can be accessed remotely so as to enable seamless business continuity at all times, and real-time data availability for our clients. The functionality of the system is flexible enough to accommodate all classes of business and all types of business users, from insurers, to brokers to insureds and captive companies.

By having a fully electronic and workflow driven claims management system, a full audit trail of all correspondence and activity is also remotely accessible and enables automation of KPI statistics. The electronic claim file have been structured to enable comprehensive collation of claims data, tailored to client requirements, so as to produce granular reporting of losses, causes, trends and other business MI.

Pursuant to the underwriting platform and direct policy feeds, the system is also built to produce automated compliance reports such as Solvency II bordereaux, complaints reports, sanction screening and reporting, root cause analysis and monitoring of distribution channels.

The system is highly sophisticated, enabling fully electronic, paperless claim files that capture analytical loss data and KPIs, with correspondence encrypted and emailed directly to and from the files, removing the time and cost of administration in its entirety, whilst ensuring remote access to all correspondence. The data field criteria within the claims files can be tailored not only to the type of class but to individual preferences and requirements to ensure that the essential data needed for effective management of the business is captured for analysis.

The system has proved to be capable of accommodating claims arising from over 30 classes of business for both insurers and insurance brokers. From the ability to either feed policy data from the underwriting platform, or import directly into the system from an outside source, it is also an invaluable tool for underwriters to conduct triangulations and monitor distribution channels and income streams, alongside analysis of claims against a vast range of variables at the touch of a button.

The system can provide an immediate real-time download of the MI reports that can be tailored to the individual requirements of our clients.

To increase efficiency and security, and eliminate the time and cost of administration, claims handlers can email directly to and from not only the individual claims e-file, but each sub-folder within the e-file carries its own unique email address, where each email is individually encrypted at rest, following the principles of ‘zero-knowledge privacy’. The system recognises incoming and outgoing emails and sets automated task alerts to inform the relevant person of incoming mail, whilst automatically monitoring activity levels for KPI and SLA compliance purposes. The direct email function is also enabled within the underwriting platform, with all correspondence relating to a particular placement recorded against that risk record.

KPI & workflow

MI & Classes
of Business

Cloud Backup,
Availability & DR

Data Security &
Intrusion Monitoring

Conduct Risk

Solvency II Reporting