LEAP Low-code

How It Works: Claims

In this article, we walk you through the ways that the LEAP low-code software platform supports a successful claims management process.

What does LEAP for Claims do?

The LEAP low-code software platform for claims makes managing the claims lifecycle easier and more effective for everyone involved in the claims process.

Who is LEAP for Claims for?

LEAP for Claims is flexible. As a result, we can easily implement your process to ensure the system fits your organisation, rather than the other way around.

As a result, LEAP for Claims is used successfully by all of the following:

  • Insurance companies
  • Third Party administrators
  • Property repair companies (residential, commercial, vehicle, goods, equipment, specialist)
  • Insurance Brokers and MGA
  • Other Intermediaries (leasing, hire, affinity partners, etc)
  • Loss Adjusters
  • Retailers (warranty claims)
  • Corporate In-House Claims Teams
  • Lawyers

Claims Types: any claim type via configuration

At FLOvate, we recognise that no two claims types are alike. In fact, implementing the same claim type can vary considerably between parties. That’s why we base your platform on one of our many claims process templates. Then, we tailor it to fit your organisation perfectly.

We set out a framework for implementing any claim type. This often takes the form of flow charts and simple process documentation. You can either configure the detailed process yourself or have FLOvate analysts do it for you.

First Notification: what data to collect and how to collect it

At first notification, it’s critical to collect information about the cause of the Incident, plus the likely damage/loss that will/may align with the insured peril for insured claims. In addition, you will want to capture information about the parties involved.

LEAP for Claims makes all this very easy to record in the CRM. You can also configure the exact data that you want to record against each contact type.

Moreover, it allows you to capture details of the damage/loss. This can be very useful for determining reserves and subsequent actions. Of course, you may only gather high level information at first notification. However, LEAP ensures  nothing slips through the net.

LEAP for Claims supports a number of different methods to collect first notification data. This ensures you are fully in tune with the needs of your customer.

 

Telephone

We support structured data collection, including Validation, using a Data Collection Wizard. This helps make data collection fast and easy to collect, with configured pages to represent each part of the claim. The Data Collection Wizard is easy to configure. In addition, it can include logic and rules to ensure all necessary available information is recorded.

Data Collection Wizard

Telephone + Electronic

We know that shortening First Notification calls is a KPI for many Claims management organisations. To do this, you need to restrict operators to collecting key data. This is particularly important during surge events.

LEAP for Claims enables this to happen. How? By giving you the option to split the First Notification. Stage one collects critical data, while information for stage two is fulfilled automatically afterwards via an electronic form. Reminders ensure that deadlines are met. Finally, once all is complete, the full NI information updates LEAP automatically, complete with full audit trail.

Data Collection View

Internet

The LEAP API accepts website claims direct into LEAP. Because of this, it removes duplication of effort and improves accuracy. Once configured, the API feature can even generate the necessary online form and required technical framework to publish.

 

Paper (PDF)

LEAP continues to support paper (PDF) claims should you need them. As well as issuing these claims automatically, the system can also part-fill the claim with system information to speed up the process.

Validation: validate claims against entitlement data

This part of the process often involves cross-checking the information against a database of policies / other data in order to validate a person’s and/or company’s right to claim.

As a result, this often calls for integration with a policy/warranty management system. LEAP for Claims supports this in several ways. For example  live lookups through web service integration, and periodic uploads.

In addition, FLOvate also offers a digital policy management solution that can be provided alongside the claims platform.

In summary: whatever your preference, we can include it within your claim workflow.

Assessment: determine what information you require to adjudicate

This part of the claims process typically reviews information gathered during the First Notification stage and assesses claim type and severity. Based on this, or other information if required, LEAP can automatically create a workflow. Triggers ensure that tasks raised during the Investigation stage are completed on time and to a satisfactory level. This can all be easily implemented using FLOvate LEAP Rulesets, which has a simple user interface.

Investigation: collect information required to adjudicate

This stage commonly involves gathering data from the insured party, as well as incident witnesses, experts or other supply chain participants. It’s important that any subsequent investigation is in proportion to the expected cost-of-claim.

Utilising the LEAP Pending Items functionality, it’s easy to keep track. Automation allows the direct upload of data into the system with a full audit trail. Moreover, you can configure LEAP so that items for escalation only progress once they exceed a set timescale or number of attempts.

Repair: you may want to repair rather than compensate

This stage can be as simple as instructing a third party supplier to provide repair services to a damaged property. Yet miscommunication can lead to the repair not happening on time, to budget, or even happening at all.

LEAP for Claims ensures that you retain excellent communication throughout. A configurable supply chain management portal lets you converse with third parties within the confines of the portal. This removes messy email trails and ensures everyone is absolutely clear on what you require. In return, partners can update you in real-time throughout the process.

Adjudication: decide and communicate your position on liability and quantum

Implement using rulesets or assign to an expert. LEAP supports Data Curation. This allows you to create datasets to support AI for later automation using machine learning or other AI technologies.

Do several authorities (both internal and/or external) need to support settlement? No problem. LEAP’s Authority functionality makes this easy to implement.

Negotiation: enable settlement through negotiation

Often, you will spend a period agreeing settlement following the initial offer. Some claims settlement processes have structured offer-acceptance procedures. However, we know that these are exceptions, rather than the rule.

To make this period go smoothly, LEAP can implement automation as well as escalation based on elapsed times.

Where the claimant offers further information to support their claim, then a Data Collection View can be dispatched to gather it. The integrated document production and storage means that all correspondence, both sent and received, is stored for easy access on the claim record.

In a nutshell: we can configure LEAP to model your specific negotiation procedures.

Settlement: action the agreed settlement and communicate details of the resolution

LEAP lets you generate Settlement paperwork automatically, saving time and money. Claims payments are easy to record, both in terms of the recipient and the analysis of the payment components. Moreover, the LEAP Messaging Server enables straightforward integration with external or internal payment gateways.

Claims Financials: enable comprehensive analysis of claims payments and reserves

The LEAP low-code platform has a sub system that implements a financial ledger foundation. Consequently, you can analyse claims payments and reserves using an unlimited number of nominal codes. Although there is not a technical limit on the number of codes, it is usual for each class of claim to have around 200.

As a result, you can analyse claims expenditure to suit your organisation’s precise claims expenditure control framework.

Typical Customisations: a claims process that matches your exact requirements

Typically, each system is adapted to our client’s exact requirements. LEAP powered by FLOvate is designed to be changed. As such, it will always take you longer to decide what you want than it will take us to implement it for you.

We typically customise the following to implement a custom claims process:

  • Cause Codes and Descriptions (by claim type)
  • Data Collected during First Notification
  • Roles defined in the Workflow
  • Roles defined in the Claims CRM
  • Process Stages
  • Communication Templates (for email, SMS and Letters)
  • Information Collected during the Investigation Stage
  • Rules to decide what Information is collected during the Investigation Stage
  • Financial Ledger Codes (both payments and reserves)
  • Authorities required to make Claims Payment

Low-code

Take a look at the general “How It Works: Low-code” for details of individual elements of LEAP functionality.