2. Understand the importance of data protection legislation and enforcement.
3. Explain the roles of external support services used in the claims process.
4. Describe the claims function as it appears in functional and divisional structures.
In our consideration of the Information Technology (IT) recommended for the Claims department, this cannot be viewed in isolation but must encompass the entire company’s IT needs. In addition, we should also consider the other stakeholders who assist in the settlement of claims. There input must be considered and incorporated into or managed by the claims handling system.
Analysis of Claims:-
The role of IT:
Characteristics of claims and their impact on Claims Handling Systems:-
a. Volume of Claims:
Thousand of claims are being made daily, an insurer’s system must be able to
i. process large numbers of claims reserving and processing.
ii. There will possible many claims’ payments
iii. As you pay claims, there will also be opportunities for recoveries (including reinsurance recoveries)
iv. The system must also be able to cope with peak periods for certain claims eg: during winter, motor
claims may be peak, during Christmas, liability claims may peak. The IT historical system can show such
b. Complexity of Claims
As a result of the above, a claims system must be able to process a large amount of data, quickly, accurately, and in a meaningful manner. Hence the review of claims system, though is key, It is never a replacement for experienced claims staff.
Major components of a general insurance claims Handling Systems:-
a. The system chosen will vary by a number of factors such as the structure of the company, the type of business written and management decision to the extent to which their system should be developed.
b. For all Claims, irrespective of the class of business, the following information are recorded:
i. The name of the Policyholder
ii. The policy number and claims reference
iii. The details of the claim including the dates.
c. In addition the above, the following underwriting information will also ne necessary:
i. A description of the Risk
ii. A description of the cover provided
iii. Supporting Risk Information
iv. Are there other co-insurers? Their share of the risk and reference