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Objective

Claims Management System is developed basically for the insurance claim agents/brokers

• To schedule and assign the tasks for their employees and have a track over the same
• To manage all claim related processing activities
• To admin the activities of their employees as a whole.

Scope of the CMS

Reduced paperwork and time involved in coordinating various parties thereby achieving optimized work efficiency and serving the customers promptly.

Environment/Technology

This application works on

1. Scripting Language – PHP
2. Database – Firebird
3. Operating System – Red Hat Linux and
4. Web Server – Apache Tomcat.

Task Scheduling and Tracking

• Claims Management System works as a Task Scheduling and Tracking system that facilitates the user to set the target and continuously monitor the same.
  
  
• It enables to login as an Admin and Standard user.
  
  • As an admin user allows to assign tasks to the subordinates and also to execute their own tasks.
  • As a standard user allows to execute the tasks as an individual.
    
    
• This software has features to escalate the issues to the immediate superior by sending automated e-mail alerts if the task(s) assigned is/are over-due.

Policy Handling

• CMS has features to maintain and modify the database on the different policies and policy related activities.
  
  
• Also empower activities such as creating and maintaining documents and contacts relating to particular policies.

Claims Processing

CMS has the following features:

• To maintain and modify database on different claims sufficed with information on status and financial transactions history.
  
  
• To create and maintain database on contacts, tasks and documents specific to claims.

MIS Reports on Claims

This software is designed to generate reports on claim details in various aspects such as

• for a specific period of time,
• for a specific policy,
• for a specific range of claim amount and
• for a specific claimant

That keeps the management informed on day-to-day status on claim processing activities. It also has the feature to export the report to Excel.

Salient Features of CMS

• CMS can handle Claims for different types of Policies like General Liability Policy, Property Policy, EL Policy, etc.
  
  
• Speed-up the processes by monitoring the status of each sub-process, so that any delay in a particular sub-process can be identified and rectified, and hence the customer is served at right time.
  
  
• Alerts for incomplete tasks on crossing 50% of the allotted timeframe.
  
  
• Displays the task status by colored symbols such as Green, Amber and Red Circle that denotes the level of delays.
  
  
• Multi-level task allotment per Claim can be done. For ex: 'Request Proposal From', 'Provide update on claimant's legal action', ' Provide a copy of the latest technical report' etc.
  
  
• Provision to update the management about the status of tasks, value of claims completed for a period, claim details of an individual, etc, on daily basis.
  
  
• Automated messaging facility to communicate with various interested parties such as Solicitors, Underwriters, Client, Loss Adjustor, etc. via Email, SMS and MMS.
  
  
• Necessary supporting documents like Technical report, Proposal form, etc., can be sent through Email between the departments — the facility that speeds up the claim processing activities.
  
  
• It can b integrated with a Mobile Data collection Module, which is used by the Loss Adjusters.