For most challenges that your claims management operations face, one of our modules holds the solution. As a fully modular application, Claims 2020 appreciates the fact that not all of the industry challenges apply to your specific situation. By building your application from the core modules and a selection of supporting modules, those issues that are of primary concern to your business are automated, whilst those that do not apply (or which you have already covered in other applications and/or processes) are left out – saving you the cost and data space required otherwise.
Claims 2020 is positioned on the balance between comprehensive, pre-made claims systems and fully custom solutions. It aims to include the best of both worlds – the advantages of an out of the box, tested and maintained application, whilst still providing the fit with your business that only custom development provides. The right selection of Claims 2020 modules can reduce your project time by as much as 70%. Read more about our proposition.
Below you will find a short description of the modules that are currently available on Claims 2020. To read a full description, including advantages and pricing of each module, please submit your details by clicking on the button below.
Core application modules
Opening and managing claims is at the heart of any Claims 2020 application. This module provides all the claim registration fields and status progression from notification to closure. Decision management features integrated in this module automate bulk processing. All modules integrate with the claims management functions.
Contracts and policies
This application module provides functionality both for storing and reviewing policies between insurers and customers directly, as well as contracts between insurers and service providers, for example in claims management outsourcing. Features full version control and verification on policy / contract validity.
CRM (Customer Relationship Management)
A complete CRM module that allows for storing, maintaining, and tracking of customer, supplier, or other related party data, both for natural persons as well as organisations. This module also tracks involvement in claims and integrates with, among others, the fraud module to discover data patterns.
HRM (Human Resource Management)
This module allows for storing and tracking employee data similar to the CRM module. It also enables user profiles and dashboards, and application account management. Provides application role access features, enables teams to be created, and represents the organisational structure of your company.
Claims 2020 workflow functionality consists of a fully configurable task management module. It ensures open tasks are assigned and distributed correctly, prioritized against other tasks, and guides claim and other processes. Sequences and triggers tasks based on events such as payment completion, fraud detection, or notification.
This module adds user-specific dashboards and data overviews and filters to the application. The dashboards contain statistical data on the claims management operations as well as task lists etc. Also provides search options to nearly all data overviews to enable easy searching through all application data.
With the file management module it is possible to upload and download many different file types in the Claims 2020 application. These files can be attached to core application data such as claims or relations. Files can be viewed in the application without downloading, and can be indexed to enable search options.
Security is a very important aspect of the Claims 2020 application. Building on the award-winning Mendix platform security framework, this module provides a stacked user role structure that allows for each application user to be given or denied rights to read, modify, create, or delete data – per module, per table, per column.
Supporting application modules
The fraud detection module adds a set of configurable business rules to the application that cross-checks claims and other data such as policies and CRM for suspicious patterns, circumstance and risk of fraud. It quarantines claims that are identified as risk and assigns these to specified fraud handlers.
With this module, full history tracking of claims and related data changes are enabled in the application. This means that all changes are recorded in the system, thereby enabling external auditing of the processes. It also provides an internal auditing tool to assess employees’ claims management performance based on selection parameters.
The finance module adds payment and recovery options to Claims 2020. It allows the registration of financial transactions and specify transaction lines, financial categories and accounts, VAT calculation, automatic deductible / excess, and so on. Furthermore it adds functionality to pre-determine reserve forecasting amounts.
A mobile / tablet version of the Claims 2020 application is available using this module. It enables access to claims management functionality from any location using any device. When used in combination with the self-service portal, it also provides customer claim submission and tracking from mobile devices.
The self-service module is an online portal that can integrate with any website and provide customers with options to submit claims, follow claim status progression, view results and information requests, check policy information, and many more. It integrates real-time with data from all modules.
With the feedback registration module it becomes possible to register and keep track of feedback submitted by customers and others. Feedback can be categorized, linked to tasks, claims, files, and so on, and date tracking facilitates timely follow-up and handling of each item. Correspondence via other modules can be initiated from the Feedback registration module.
Invoice & hour registration
With invoice and hour registration options in the Claims 2020 application, any costs incurred by claims management operations can be calculated and registered per claim. The actual costs of claim handling become visible and users have the option of invoice generation in, for example, cases of outsourcing contracts.
Approved supplier networks
The approved supplier networks module adds options to register and keep track of supplier networks, with rating and performance history. This gives claim managers the possibility of selecting suppliers such as repair shops, garages, and external assessors based on actual data and preference. Includes Google maps for location-based selection.
Adds calendar functionality that integrates with workflow tasks and other modules to map and plan claims management operations. It calculates employee availability and integrates with smart task assignment to ensure work is assigned optimally. Reporting options show trends in work load and forecasting.
This module adds advanced document generation options to the application. It includes configurable document templates and business rules for automatic document generation based on claim triggers and events. Using token replacement tools generated documents are based on real-time application data.
Webservice API integration
Using the Webservice API module, the Claims 2020 application can easily be integrated with any other system that allows a web service connection. It includes both inbound and outbound operations; meaning that it can be used to expose data to external systems as well as allow external sources to trigger events within Claims 2020.
This integration module allows for easy data import via Excel sheets and templates. New data imports and formats can be configured by system administrators and do not require changes to the application. It also provides exporting options to aggregate data from the application in downloadable Excel sheets with a single button click.
Flat-file / ASCII / database integration
Similar to the Excel integration module, except with this module it is possible to import and export several types of files such as flat-file, fixed length, ASCII, or separator-based. This can be used to integrate with, for example, AS/400 based applications and a host of customised legacy systems.
Depending on your hosting type and system architecture, this module can provide LDAP options to integrate with existing sets of user accounts and security, and/or route user login via single sign-on (SSO) procedures. This can be helpful to allow the application to integrate seamlessly into your IT landscape and user protocol.
Using the Email module it is possible to automatically receive claims notification (FNOL) and new claims data via an email connector, as well as initiate, track, and follow up on email correspondence in claims, sending and storing emails directly from within the application, including attachments and automatic replies. It comes with a configured SMTP server for email processing.
First Notification of Loss: web
The FNOL: web module enables claim and task creation triggers (First Notification of Loss) via web service protocol. This allows integration with, for example, OCR scanning tools that can send data to the application for claims processing. Based on configurable parameters this module pre-fills the claim with indexed data from the calling application.
First Notification of Loss: phone
The FNOL: phone module adds onto the other First Notification of Loss modules with caller recognition and registration. It allows for correspondence trails in the application even via telephone, both inbound and outbound. This module is dependent on calling software already in place. It integrates with the other modules to keep a centralized overview of claims correspondence.