Claims Lifecycle Management
Claims is the largest cost center for insurers and the process most vulnerable to unnecessary loss cost. It is also the most interactive customer service process, one that demands a positive customer experience. Exigen’s Claims Lifecycle Management assures maximum cost containment and the highest levels of customer support for insurers’ most mission-critical business process.
The Exigen Claims Lifecycle Management solution is powered by Exigen Insurance Process Backbone (IPB). The IPB is an open platform that provides a complete set of claims functions from its own core of services or through seamless services-oriented integration of existing or external systems. Exigen Claims Lifecycle manages the handling of claims from first notice of loss though settlement and closure. It streamlines business processes for all internal and external stakeholders such as contact center staff, adjusters, agents and brokers, insureds, claimants and third parties.
By streamlining the traditionally high number of tasks associated with claims, Exigen Claims Lifecycle Management accelerates claims resolution and reduces administrative and settlement costs. The solution also provides unprecedented business control — all claims processes and performance can be monitored in real-time. The IPB’s business rules engine allows claims management to refine processes to meet changing business needs, increase claims efficiency and improve the customer experience.
Core Functions and Process Templates
- Claims notice of loss, evaluation, opening, triage and assignment
- Claims reserves and financial management
- Claims investigation and adjudication through settlement
- Claims vendor management
- Claims recovery identification and support
- Claims authority management
Key Features
- Support for all claims processes with easy to use "smart forms" for data entry and validation:
- First notice of loss with the option to save and retrieve incomplete loss reports
- Policy validation and coverage verification
- All claims adjudication, investigation and inquiry transactions
- Claims financial transactions such as reserve allocations and adjustments, issuance of loss and expense payments, and recurring payments
- Support for salvage, subrogation, and recovery operations
- Customized workspaces that reflect the individual profile of each user (including roles, skill levels, and scope of responsibility and authorization)
- User views of claims history, such as activity and interaction history; claims contact information about primary parties for the claim, such as insured and claimants; and secondary stakeholders, such as 3rd party providers, attorneys, and authorities
- Business-administered rules for consistent application of company and mandatory claims guidelines
- Rule-based application of claims authority with user defined authority levels allows consistent application of reserve authority and payment, authority
- Prioritized queues with itemized task lists for all applicable current and future activities with detailed measurement, monitoring, reporting and escalation of service levels associated with each task and activity
- Automatic generation, capture and management of all documents related to claims organized into an electronic claim file folder supporting multiple claims suffixes
- Progress notes and annotations with the ability to hide selected information based on authorization levels
- Comprehensive business activity tracking provides accountability of performers and processes for: regulatory audit, performance management, and activity based costing
