Insurance - Claims /

Below you can find more information about the Claims module

About

The software handles the claims entire life cycle from the declaration date to the closing date taking into consideration the payments and the recoveries, expert fees, medical fees, and juridical fees. It is completely integrated on onā€line basis with the underwriting system, the accounting and the reinsurance.
The main features of this module are the following:

Multiple input channels

The insurance company knows whenever a claim has happened by these means:

      1. Insured declaration
      2. Expert report
      3. Hospital fees
      4. Third party complaint / insured persons

When the declaration is done by the insured or upon the expert report reception and after the verification of all the information of the policy, the company can now open a claim and generate a number to it.

Various Controls on payment

The payments and the recoveries of the claims are entered once by the accounting or by the claims department following the policy of each company. They update the claim and generate the corresponding accounting entries.

Complete Operation Management

The claim module manages all the required operations:

      • Experts
      • Hospitals
      • Claim declaration
      • Input of estimations
      • Hospital bordereaux
        • preparation
        • payment

Reports and inquiries

      • Experts
      • Hospitals
      • Claims list
      • Outstanding claims
      • Payments
      • Recoveries
      • Labels
      • Statistics:
        • Outstanding claims by broker (accounting year)
        • Paid claims by broker (accounting year)
        • Recoveries by broker (accounting year)
        • Outstanding claims by broker (underwriting year)
        • Paid claims by broker (underwriting year)
        • Recoveries by broker (underwriting year)
        • Claims by broker