optimum insurance business solutions
TRANSCRIPT
OPTIMUM INSURAN
CE BUSINESS
SOLUTIONS
COMBINING HUMAN &
DIGITALSKILLS
KRISHNA. S. BURLIInsurance Data Execution Assistance
By
Innovative Digital Evaluation & Aggregation
web : krishna-burli.braned.me 2
LITIGATIONSIN CASE OF SETTLEMENT AMICABLE TO BOTH THE INSURED & THE INSURER,
MATTER GETS CLOSED. HOWEVER,IF THERE IS ANY DISPUTE ON THE ADMISSIBILITY OR
THE QUANTOM OF CLAIM AMOUNT, THE LITIGATION TAKES THE LEGAL PATH &
WILL BE CONCLUDED EITHER BY COURT OF LAW OR BY ARBITRATION, AS PER THE PROVISIONS MADE
IN THE POLICY, WHICH ITSELF IS A LEGAL DOCUMENT
OUT OF COURT SETTLEMENTSTHE CLAIM CAN BE SETTLED
OUT OF COURT, ON A/C PAYMENTS CAN BE MADE FOR IMMEDIATE RELIEFS
IN CASE OF BIG CLAIMS, AFTER GETTING SATISFIED ON THE GENUINENESS & THE URGENCY
OF INDIVIDUAL CASES
OTHER AGENCIES INVOLVEDTPA’s, TAC, IRDA,
CONSUMER FORUM,OMBADSMAN,
EXPERS IN LAW,TECHNICAL EXPERTS
GENERAL INSURANCE BUSINESS AT A GLANCE
THE GAME
INSUANCE COMPANY’S JOBS
Issuing the policy document as per the proposal form details
Endorsing the policy as per the intimation of additions/deletions
Process the claim as per the Survey report/Investigation report
In case of differences, corroborate the Survey report & Insured’s versions
Speedy claims processingLegally go on as per policy issued, in
case of litigation INSURED’S JOBS.Filling the proposal form details.Intimating Additions/Deletions.Declare Sum Insured adequately.Wherever possible, selection of risk .Complete the claim form properly.Proper documentation as required by Insurance Company, such as FIR, Police Report, Policy copy etc..Establishing the cause of accident with proper logical reasoning with required documents..Substantiating the claim amount by proper bills & documents.Clarifying the surveyor’s doubts
SURVEYOR’ JOBAssess the loss with proper documentation
as per policy conditions, without any bias,
as a third party (legally) &
Submit to the Insurance Company.
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BUSINESS SOLUTION
Bridging the Gaps in business processes
BetweenClient &Insurer
Based on the contract combining human & digital skills
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INSURANCE BUSINESS Insurance Business involves1. Underwriting
Identification of Risk Evaluation of Risk Pricing of Risk Terms & conditions of Risk Coverage
2. Contract Administration Preparation of Policy with proper terms & conditions Endorsements for changes of conditions / alterations Legal validation
3. Claims process Intimation in prescribed claim form Documentation to prove cause & extent of loss Documentation to prove the adequacy of sum to get
proper Indemnity
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COMBINING HUMAN & DIGITAL SKILLS
Basically Insurance Business deals with documents & in business optimization process now a days IT enabled services are used both by Insurers & Clients, as digitalization has made the handling of documents convenient to both.
However, Digitalized ITESs do not talk to each other properly, meaning, EXCHANGING of required INFORMATION is manual (& hence involves Human skills), not electronic.
Whenever any information is required by the INSURER, that is converted in to PDF or Paper form or INTERPRETED by HUMAN skill (Resource) & entered in to corresponding SYSTEMs.
This leads to “Interpretation of POLICY RULES at various stages, leading to “Room for different Analysis” of the same information.
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SYSTEMS OF CARRIERS & CLIENTSSystems of carriers & clients should be
designed, as far as possible, in such a way that they talk to each other themselves on the INFORMATION requirements & EXCHANGE themselves to speed up INSURANCE BUSINESS involving, U/W, Policy Admn. & Claims processing.
Aggregation & Risk Management plays an Important role & needs to be embedded in the solution design.
At the end, with HUMAN SKILLS, IDEA has to be Insurance Digitalization Enhancement Ability to optimize the Insurance Business Solution.