claims

Claims

Full and comprehensive claims administration including:

  • Lodging claim
    • this includes a custom letter going out to client asking for more particulars based on type of claim
    • automated validation of premium received, cover at incident date and other set parameters according to policy wording
  • Processing of claim
    • including workflow to allocate tasks to individuals, e.g. more documents required
  • Custom rules for system calculated claim payout
  • Custom validations for system determined claim approval, which could include:
    • Is the claim within waiting period?
    • Has the policy holder reached his claim payout limit for the year?
    • etc
  • The system calculates both the amount to pay and whether to pay or not
    • This can be overridden by a manager should the need arise
  • Up to 4 levels of approval for claim, depending on product setup
  • Attach relevant documents to claim
  • OWLS can ensure the required types of documents are attached before claim can be approved for that type of claim
  • Multiple Excess structures can be catered for
  • Ombud claims and Ex gratia claims are also enabled
  • Service Providers and their invoices can also be captured, with further levels of approval if required
  • Claims payment timing (approval can be done today, but the payment only made next week) can be delayed should the need arise.
  • Claims recoveries

There are multiple benefits already on the system (but it is easy to add more), these include:

  • Commercial
  • Heavy Commercial Vehicles
  • Goods in Transit
  • Aviation
  • Airport
  • Medical Gap
  • Credit Life
  • Tyre and Rim
  • Dent and Scratch
  • Vehicle Shortfall
  • Gadget
  • Cell Phone
  • Marine
  • Equestrian Mortality / Health
  • Legal
  • Dental
  • etc (over 100 to list)