Motor Claims Process

• Utilize standardized First Notice of Loss document to formalize claims initiation. Can be completed as paper, eform at branch office, Workshops or on the ePortal.
• Notices originating as physical paper at branch offices are captured in the OnBase content management system electronically (imaging).
• Notices originating as physical paper at broker can be uploaded via broker portal or captured at the branch office directly in the OnBase content management system electronically (imaging).
• On receipt of the notice and police report, the OnBase enterprise content management system automatically creates an electronic claims worksheet.
• Business rules are processed against the notice to automatically determine if the claim is for an active policy and if premium has been paid by integration to core Insurance System such as PREMIA.
• If the policy is active, additional business rules are processed against the electronic forms to automatically determine claim assignment based on claim type, amount or related values.
• A notification is sent to users in regards to the pending assignment and notification or letter is created and sent to the broker/insured to acknowledge receipt of the claim notice.
• The system manages service level agreements for new claims upon receipt of the claim in the system.
• During the work process, an electronic claims folder is created automatically by the system and users review and process the claim from the electronic inbox.
• During the work process, an electronic claims folder is created automatically by the system.
• Decisions, instructions and related details are added to the electronic claims worksheet or the electronic folder during processing.
• As new supporting documents are received, the claims handler is notified for review. Missing information is highlighted in the system or the related electronic claims folder. New documents, communications (emails) and related content is added to the electronic folder by the user. All information is maintained in a single location.
• Correspondence and letters are created from process templates and are auto-filled with information to reduce user interactions.
• During the work process, the claims file can be referred to a manager or another party (surveyor, other)
• Photos can be uploaded directly into OnBase via web, digital camera, or tablet.
• Electronic reminders can be created to prompt follow-up activities against the claim.
• Alerts and notifications can be created to ensure claims processing is aligned with defined service levels.
• If a claim is approved, the broker is notified and the work management process for payment requests is initiated.
• If a claim is denied, the broker is notified and a denial letter is automatically created by the system for distribution to the insured.
• During the process, electronic business activity monitoring is available to management and business development executives to maintain visibility across the work process.
• A status of the claim and pending decision is made available from the portal application (ePortal) throughout processing to enable better service transparency to external (and internal) parties.

Benefits

Document creation: Allows for the automated or ad hoc generation of correspondence requiring specific legal wording or criteria-based generation.

Pending task-related actions: Manage these directly in OnBase with automated notifications built into the workflow to manage follow-up requests and diary alerts.

Work distribution: Easily managed by authority levels, skill sets, type of claim or other business rules.

Approval requirements: Managed throughout the process to ensure that internal controls are maintained.

Automated tasks: Automate manual repetitive tasks, freeing up adjusters to focus on high value work.