SymbioSys Claims Management System
Key Insurers Challenges
Timely and accurate claims processing
Manual monitoring of claims
Provision of up-to-date claim status
Claims workbench & worksheet for quick and informed decision
Set up for diverse types of claim payments
Key Business Drivers
Automate management of claim based on Business Rules
Better identification of fraudulent claims
Up-to-date claim status information
Efficient Claims front-office extendable to the distributors or reinsurers
Pro-active document and management
System Overview
“SymbioSys Claims Management System is unified solution for tracking and managing claims. It helps managing claim requests, provides comprehensive claim data capture, aids in assessment of claim request and provides triggers for generating correspondences/ notifications and a comprehensive MIS reporting ”
Key Differentiating Features
Flexible business rules and workflow configuration capabilities
Event wise benefit distribution definition, with detailed affliction schedule definition
Claims Workbench & Worksheet for quick and informed decision
Integration with Scanning /OCR tool for better data entry
Better identification of fraudulent claims and auto alerts to claims approver for exceptional cases
Easy set up for Diverse Types of Claim Payments & Pro-active Document management
Customer centric information for in-depth analysis
Express Claim option for simple and small value claims, and auto Approval of claim based on Business Rules
Assignment and Reassignment of claim using skills and load management with escalations based on SLA’s
Stage Wise Turn Around Time(TAT) analysis
Key Business Benefits
Increased operational efficiency due to automation of routine tasks
Effective Claim Processing
Reduced movement of physical documents and communication cost
Significant Reduction in claims turnaround time
Enhanced customer/partner service
Reduced Time to Market for launching new types of claims
