Property Claims Management

Client: Prodatex - Belgium

Client Requirements: Easy to use and effective claims management system, taking care of all the steps of the process and including all the users and actors.

Solution: Property Claims Platform (PCP).

Since the insurance market is very competitive, and the administration costs continue to rise, in order to stay in the game it is necessary to increase efficiency of the claims management process. Thanks to PCP users may be sure that they will get a fast and personalized assistance they have been looking for.

PCP system deals with the process of claim settling for the insured, analyzing the complete claims cycle. It is role-based for each user has his function. We can define users of the system as the physical operators, and these are an insurer, a broker and a supplier (it can be a single person or an entire company). What is more, each user of the PCP can have one or more roles such as: a claim reporter, an acceptor, a damage estimator, a repairer and a payer.

One of the main advantages of this solution is that it makes the data exchanging more efficient, which simplifies the whole process. It has two interfaces for the communication with the users: web forms and a messaging system. Both interfaces use the same database where all data is stored. The messaging system is not used directly by the users, instead it is a Business to Business interface. It allows PCP to directly exchange information with other back office information systems operated by the users. Information is exchanged by sending and receiving XML messages.

There are five main steps necessary to settle the reported claim. The first step is the claim registration. The claim is reported by the insured – the client of the insurance company and the owner of the insurance policy. It can be reported to the insurance broker, the assistance company (external CC), the insurance company, or directly to the supplier.

After the registration the reported claim has to be checked against the policy coverage – if the policy covers the reported damages, the claim is accepted.

After the acceptance of the claim the size of the damage has to be estimated. The insured has to decide whether he or she prefers the damage to be repaired by a supplier appointed by the insurance company (Repair in Kind) or whether he or she prefers to receive a financial compensation from the insurance company.

If the insured chooses the Repair in Kind option, the insurance company has to find a supplier that will repair the damage. The supplier may use subcontractors to fix the damage (damage settlement).

After the damage has been fixed, the repair invoice is paid directly by the insurance company to the supplier (payment).

The described process is shown in the picture below.

In order to make the system more flexible to meet the users needs, there is a possibility to add and modify components required for the claims processing needs.

Thanks to using PCP system the client could automate the procedures and optimize the routine work. PCP also provides the client with fast and easy access to data which accelerates the decision processes and improves the decision quality.