Client

Industry: Healthcare & Insurance

Client is USA based and serves few of the Fortune 500 companies in the Insurance industry. They wished to develop a web-based product to automate insurance process. They required a system capable of managing insurance policies, claim management, risk management, incident management and Certificates of Insurance. They wanted it to be adaptive, customizable, and innovative.


Challenge

The client works as a third party agent in insurance claim processing business, wanted to develop a website to help him process insurance claims of lost jewelry items. Client's business requirement was to act as an intermediary between an insurer, insurance company and jeweler and provide all the necessary support for claim processing through the website.

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

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

Solution

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 jeweller to the insurance company
  • Instore credit for awaiting quotes, submitted quotes, expired quotes
  • Manual quotes generation in case of known jewellers
  • File upload and exchange
  • Email templates
  • Content management system
  • Detailed reporting module
Other Features:
  • Customized news display based on user type and role
  • Conduct online test and display results for participants according to user type and role
  • Display and manage the documents with multi-language support.
  • Perform project management activities as development plan, task assignment, report generation etc.
  • Develop the business strategy based on goals, project status and other parameters
  • Runtime creation of RSS based on user preferences
  • Organize and manage events, event categories, etc

Technology

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

Result

  • Fully functional website providing intermediary services to an insurer, insurance company and jeweller 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.
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