Success story :
Insurance Claim System

Revolutionizing insurance operations: building a cutting-edge insurance claim system for seamless policy management and superior customer service

About our Customer

KoreCent were approached by a client who needed to develop an Insurance Claim System. The goal was to provide a platform where insurance companies could create and issue new products, manage policy issuance, and allow customers to apply for policies


The client faced several challenges in their existing system, including:

Lack of a centralized platform: Client needed a single platform where insurance companies could manage product creation and policy issuance, and customers could easily apply for policies

Inefficient customer service process: The existing system lacked a streamlined process for customer support and ticket management

Tedious claim processing: Client needed a system that could handle different types of insurance claims, such as medication and vehicle claims, with specific fields and workflows for each type

Inadequate entity management: Client required a module to manage entities, including identification codes, banking information, kyc information, and relationships

Manual contract management: Needed an automated contract management system to handle request initiation, authoring, negotiation, approval, monitoring, and renewals

The Solution

Service Desk: KoreCent developed a robust service desk within the Insurance Claim System, equipped with advanced ticket management capabilities. The service desk provided a centralized hub where customer service representatives could efficiently process and manage support tickets. It included features such as ticket assignment, prioritization, and tracking, ensuring that customer inquiries were handled promptly and effectively. The system also allowed representatives to access customer information, policy details, and claim history, enabling them to provide personalized and accurate support

Customer Dashboard: The customer dashboard was designed to provide a user-friendly interface for policyholders to access and manage their insurance policies. It offered a comprehensive view of policy details, including coverage, premiums, and renewal dates. Customers could easily submit claims, track the status of existing claims, and view any updates or communication related to their policies. The dashboard also featured a secure messaging system that allowed customers to communicate directly with customer service representatives, enhancing the overall customer experience

Customer Desk Ticket: The insurance claim system included a dedicated module for customer service representatives to categorize and process incoming tickets efficiently. Representatives could easily classify tickets based on their urgency and purpose, such as emergency, sales, or general inquiries. The system provided predefined workflows and automation features to guide representatives through the ticket resolution process, ensuring consistent and timely responses to customer queries. Additionally, the module allowed representatives to assign tickets to specific team members, facilitating collaboration and knowledge sharing among the support staff

customer follow-up ticket: to ensure efficient follow-up on customer inquiries and issues, the system incorporated a customer follow-up ticket module. Representatives could use this module to schedule and manage follow-up activities related to specific customer tickets. The module provided reminders, task assignment, and progress tracking functionalities, empowering representatives to provide timely updates and resolutions to customers. By streamlining the follow-up process, the system enhanced customer satisfaction and reduced the likelihood of tickets slipping through the cracks

Entity Management Module: KoreCent implemented a comprehensive entity management module within the Insurance Claim System. This module allowed insurance companies to manage essential information related to entities, including policyholders, beneficiaries, and third-party entities. It provided features for storing and updating entity details, such as identification codes, banking information, KYC (Know Your Customer) documentation, and relationships between entities. The module also enabled insurance companies to perform quick searches, generate reports, and maintain accurate records of entity interactions throughout the insurance claim process

Policy proposal: The system included a policy proposal feature that empowered insurance companies to create and propose new insurance products to their customers. The feature allowed insurers to define policy parameters, coverage options, pricing, and terms and conditions. Insurance companies could leverage the intuitive interface to configure policy proposals quickly and efficiently. The system also facilitated collaboration between insurance companies and their underwriters, streamlining the approval process for new policies and accelerating time-to-market for innovative insurance products

Claim types (medication and vehicle): To cater to different claim types, the Insurance Claim System offered specialized claim forms and workflows for medication and vehicle claims. For medication claims, the system presented fields such as claim date, TPA (Third Party Administrator) claim ID, benefit ID, claim amount, claim source, policy holder name, insured name, relation name, and more. Similarly, for vehicle claims, the system displayed fields such as claim date, TPA claim ID, benefit ID, claim amount, claim source, policy holder name, insured name, relation name, and additional details like damage survey status and expert information. The system ensured that the necessary information for each claim type was captured accurately, facilitating smooth claim processing and reducing manual errors

Audit management: The audit management feature provided an integrated audit management system to ensure compliance and track activities within the insurance claim process. The feature enabled representatives to monitor and track the entire claim process, from ticket creation to claim approval, and ensured that all activities were recorded and compliant with regulations

Contract management: The contract management module provided a comprehensive contract management solution to handle request initiation, authoring, negotiation, approval, monitoring, renewals, amendments, and expiration. The module automated the entire contract lifecycle, reducing manual effort and improving efficiency. It also ensured that all contracts were compliant with regulations and included all necessary terms and conditions

Broker portal: A portal for brokers to access various types of insurance products, view prices, and manage transactions

The Achievements

The implementation of the insurance claim system provided several benefits to the client:
Streamlined processes: The centralized platform improved operational efficiency by consolidating product creation, policy issuance, customer service, and claim processing into one system

Enhanced customer experience: The customer dashboard and self-service features empowered customers to manage their policies, submit claims, and track their status conveniently

Improved customer service: The service desk and ticket management tools enabled customer service representatives to handle and resolve customer inquiries more efficiently

Accurate claim processing: The customized claim forms and workflows ensured accurate data collection for medication and vehicle claims, reducing errors and speeding up the claims process

Efficient entity management: The entity management module facilitated seamless management of entity information, including identification codes, banking details, kyc information, and relationships

Automated contract management: The contract management module automated the entire contract lifecycle, improving efficiency in request initiation, authoring, negotiation, approval, monitoring, renewals, amendments, and expiration

Empowered brokers: The broker portal provided brokers with easy access to various insurance products, enabling them to offer competitive prices and manage transactions effectively

Overall, the insurance claim system developed by korecent enabled the client to enhance their operational efficiency, improve customer experience, and streamline their operations

Technologies and Tools

Platform: ERPNext
Framework: Frappe
Language: Python, HTML, CSS, Javascript
Industry: Insurance

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