Optimum insurance business solutions

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.


BUSINESS SOLUTION

Bridging the Gaps in business processes

BetweenClient &Insurer

Based on the contract combining human & digital skills


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


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.


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.