Insurance Claim Management

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One of our Brisbane, Australia based client working as Third Party Agent in Insurance Claim processing business, wanted to develop a website to help him process insurance claims of lost jewellery items. Client’s business requirement was to act as an intermediary between insurer, insurance company and jeweler and provide all necessary support in claim processing through the website.

The client’s goal was to automate the claim processing flow described below:

• Insurer places claim with insurance company for lost jewellery
• Insurance company generates claim id and sends draft to client
• Website will get all details about lost jewellery from insurer and raises the claim
• Website gets quote from different jewelers and chooses the suitable one
• Website provides jeweler details and generates invoice to insurance company

TatvaSoft analyzed the requirement and developed the web application – Insurance Claim Management with following features:

• Claims management:
  • Manage claim details such as type, insurer, validator, allocator, status, claim and policy number etc.
  • Mail validation and claim validation reports
  • Contact logs with details such as client name, contact date, contact person, Claim ID and number etc.
  • Event logs detailing event type, status, responsible user etc.
  • Release claims and make quotes available
• Quotes management:
  • Quotes categorization as awaiting quotes, submitted quotes, expired quotes
  • Insurer details and lost item details
  • Retail and wholesale value of lost item
  • Raise the quotes given by jeweler to insurance company
• Instore credit for awaiting quotes, submitted quotes, expired quotes
• Manual quotes generation in case of known jewelers
• File upload and exchange
• Email templates
• Content management system
• Detailed reporting module

• Fully functional website providing intermediary services to insurer, insurance company and jeweler with separate logins for each user
• All types of reports based on criteria such as total invoiced, active claims, under investigation claims, insurer invoice, claim progress report etc.
• Efficient settlement of claims with invoice generation facility including commissions and taxes calculations.

• Server: Linux
• Web Server: Apache
• Programming Language: PHP 5
• Database: MySQL 5
• Framework: Zend PHP