Transforming Claims Management with IBSuite

Transforming Claims

Management

with IBSuite

Insurance Business Applications – Confidential 2

Contents

Introduction………………………………………………………………………………………………………. 3

Insurance Business Applications and IBSuite…………………………………………………… 4

IBSuite Capability Model………………………………………………………………………………….. 5

IBSuite Claims Management……………………………………………………………………………. 6

Supporting Capabilities……………………………………………………………………………………. 7

Handling Claims on Policies External to IBSuite……………………………………………… 10

Automation, IoT and AI…………………………………………………………………………………….. 11

Native Cloud and True SaaS…………………………………………………………………………….. 12

Service Model…………………………………………………………………………….…………………….. 13

Summary………………………………………………………………………………………….……………….. 14

Insurance Business Applications Confidential www.ibapplications.com V 1.2 - June 2021

http://www.ibapplications.com/


Introduction Claims management is probably the

most critical service component in

the insurance lifecycle and, as

customers expectations evolve,

having smooth, responsive and

modern claims management

processes is critical for achieving

customer loyalty, share of wallet

and a positive word of mouth.

The transformative capabilities of

technologies, including advanced

analytics, Internet of Things (IoT),

and Artificial Intelligence (AI) are

shaping the evolution of claims

processing capabilities and

customer satisfaction.

For incumbents, transforming

claims capabilities has ranked high

on the technology and business

agenda, but integrating these

technologies on legacy platforms

often requires long and costly

projects that even if they achieve

the proposed change, would leave

behind a complex, rigid

architecture, difficult to maintain

and adapt to the constant changes

in technology and customer

demands. That is why the adoption

of these technologies is still in its

early stages, industrywide.

However, their adoption is

accelerating leveraging new digital

core systems and claims

management packaged solutions.

IBSuite Claims, one of the IBSuite

core insurance modules, not only

provides you a feature-rich claims

management system, but also the

flexibility to quickly integrate and

replace components and partners,

enabling you to define your own

claims processes leveraging the

latest market innovations.

Welcome to the beginning of an

amazing journey.

Welcome to IBSuite, the proven

next-generation cloud insurance

platform.


IBA and IBSuiteInsurance Business Applications

(IBA) is a cloud native P&C and

General Insurance Platform

company, focused on enabling risk

carriers, insurtech companies,

affinity partners and agents to

digitalize and automate their

operation, becoming more efficient

and agile.

IBA provides a proven end-2-end

core platform that takes care of the

insurers immediate need to liberate

themselves from the rigid and

inefficient legacy technology, avoid

building technical debt, stay current

and compliant and be able to launch

new products and business models

fast.

IBA has standardized its platform to

work across languages, currencies

and different cultures, where

integration is simple and easy and

never a matter of hard-coding.

IBSuite does not stand in the way of

integrating to the many developing

ecosystems or insurtech companies.

In fact, we make it simple. IBSuite

promotes new integrations and

collaborative work with an

ecosystem of partners and are

constantly testing new

developments and technologies.

Founded originally in Denmark and

with offices around the World, IBA

is a true believer in being a global

citizen with local presence.

When choosing IBSuite, you will not

only get a proven insurance

platform but a team that has

extensive insurance expertise; a

team that will guide you through

the implementation. Our proven

Engagement, Delivery and

Operation Model (EDO) provides a

clear and transparent path from the

early engagement to project

planning, implementation,

migration, go-live and beyond.

We are your trusted partner.


IBSuite Capability Model IBSuite is a complete end-to-end

core insurance platform which is

feature rich. It has core capabilities

(figure 1) supporting the complete

lifecycle of the insurance business

and the flexibility to be configured

to match the process you define,

customized when necessary and

extended through a very powerful

integration layer. It has standard

integrations to key business

management systems like CRM,

general ledger and payroll systems

as well as regulatory bodies and

service providers (e.g. digital

payments / signature) in each

geography.

Integration to any service provider

of choice is typically part of the

implementation project and we are

happy to explore new services and

partners together with our

customers.

IBSuite’s Core Capabilities enable

insurers of any size to have one

application as the backbone for the

entire insurance operation or

replace critical components,

transforming Distribution, Claims

Management or Policy

Administration.

Figure 1. IBSuite Capability Model ( Level 0)


IBSuite Claims Management IBSuite Claims module can be

implemented as part of a complete

core implementation or integrated

into the customer’s existing

architecture. IBSuite Claims

capabilities include everything from

First Notification of Loss to

settlement of a claim. You can use

all relevant information from the

claimed policy and include

integration to service providers and

industry standard services.

First Notification of Loss (FNOL)

A FNOL can be registered through

different channels. It is

always validated against the

relevant version of the

policy. Relevant claims data and

validations will depend on cause of

loss and involved covers. Standard

reserves can also be applied.

Claim Evaluation

Claim evaluation will involve

evaluation of the customer, the

policy and the size of the claim.

Relevant processes can be initiated,

such as evaluation of fraud scoring.

Information Gathering

IBSuite contains standard concepts

for requesting information from the

customer and interested parties

related to a claim. This

includes processes for chasing and

registering responses and initiating

follow up actions.

Claim Administration

Claims administration includes

managing accept or rejection of

claims, compensation offers, invoice

management, single and

recurring payments, reserve

management and role-based

payment approvals.

Claim Closure

The entire process from logging a

claim to closing a claim can be

automated based on configurable

business rules and processes. Claim

closure allows for automated

settlement and/or claim rejection

with configurable conclusion- and /

or declinature codes etc.


Service Provider Management

Service Providers like Third Party

Administrators (TPA), claims

adjusters, repair networks, road-

side assistance companies and

standard solution providers

for specific countries can be

integrated into an IBSuite solution.

Using our broad library of APIs,

these providers can be given access

to relevant claims information and

integrated with their own systems,

if needed.


Supporting Capabilities

Being part of a complete core

system, IBSuite Claims module

benefits from a robust set of

supporting capabilities to manage

Customers, Workflows, Ecosystem

Integrations and Operations.

Customer Management

IBSuite is a customer centric

platform and has a full range of

capabilities to manage data and

processes for persons and

companies. Many customers use

IBSuite as their only Customer

Relationship Management

application while others integrate

external CRM Systems. IBSuite has

existing integrations that supports

different types of master/slave

patterns for customer information.

Financial Processes

IBSuite has a full set of invoicing,

billing and payment capabilities,

that are used both in Policy

Administration and in Claims

Management, feeding the General

Ledger Application.

Manage Output

IBSuite generates and stores all

output from documents, letters,

notifications, and reports. Incoming

documents and files can also be

stored. Templates can easily be

maintained by our customers.

Standard incoming and outgoing

communication methods, such as E-

Mail and SMS are integrated into

the application, with more

advanced communication methods

supported through our API stack.

Manage Ecosystems

IBSuite integration capabilities

include support for a wide range

of integration patterns, where

integration through REST service is

the preferred option. Integrations

to various common systems and

platforms are already in place.

IBSuite is designed ‘API First’. All

functions in IBSuite are

available through our

comprehensive and well

documented API Catalogue with

more than 500 end-points.


Manage Workflows

IBSuite standard processes can be

modified and amended to fit

specific customer needs. A

comprehensive and highly

configurable case management

solution is part of the platform.

Processes are broken down to small

and independent steps. Process

steps can be configured into more

complex business processes for

example by linking them to cases.

Processes are always available via

API’s and can be automated.

Manage Operations

IBSuite is always up and is running

on the best commercially available

cloud platform in the world and

designed to operate in a multi-

language and multi-

country environment.

Risks are carefully managed, and

compliance is a top priority.

IBSuite has several capabilities to

support and manage automation.

These include independent, and

configurable processes (jobs),

based on schedules or specific

events. Exceptions are managed.

IBSuite as a platform will always be

regulatory compliant in the

geographies it is used.

New regulatory requirements can

also be configured in the IBSuite

solution for insurers as they arise.

Manage Users and Security

IBSuite is “Security by Design”. All

data at rest and in transit is

duly encrypted with strong

encryption. All access to IBSuite is

facilitated through secure APIs and

segregation of duty is fully

maintained along with

transactional security and

input/output validations.

Access to functions and data is fully

managed in IBSuite with robust

user, role and access management

capabilities. It is even possible to

define an organizational structure

and manage access to

specific customers, policies and

claims based on the organizational

structure.

Changes to any data in IBSuite is

logged at field level. These low-level

logs are only available to authorized

users.


Handling Claims on Policies

External to IBSuite All IBSuite functionality is available

through APIs, making integration to

an external Policy Administration

Systems (PAS) simple. IBSuite

Claims module leverages this

capability to integrate into an

existing insurer’s architecture and

completely transforming the claims

processing capabilities without a

complete core system replacement.

In order to provide the best user

experience, IBSuite Claims

seamlessly interacts with the

existing PAS:

Collecting External Data

Information from external policies

can easily be saved to a reference

policy in IBSuite, without the need

for full policy administration, as well

as client and other external data.

Automatically Generating Policies

Reference Policies can be

automatically generated in IBSuite

at the time of FNOL and populated

with relevant information from the

external system.

Supporting Product Configuration

IBSuite’s product configuration

engine allows for configuring new

fields, so any external data can be

mapped to reference policies. The

claims related Product

Configuration can also include

'Causes of Loss', 'Standard

Reserves' etc.

Supporting Automation

It is possible to automate the steps throughout the Claims process, leading to fully automated processes.


Automation, IoT and AI IBSuite supports configuring any desired workflow from fully automated to fully manual processes, with tasks and approvals assigned to user groups as needed. All the processes in the claims flow can be automated, meaning that processes such as updating bonus or cancelling policies in case of claims can be fully seamless.

Claim process automation

IBSuite can interact with external

parties using automatic rules,

meaning that requests for

documentation, video inspections,

or automatic fraud checking can be

controlled by the system,

regardless of the way the FNOL

was registered. Furthermore, for

cases such as income protection

claims, IBSuite can automatically

request documentation for

recurring payments. IBSuite can

also automate incoming events. For

example, incoming email invoices

can be scanned by our smart reader

and converted into outgoing

payments without the need for

human interaction.

IoT and Parametric Claims

IBSuite supports IoT and

parametric claims processes.

Claims FNOL can be triggered by

IoT devices or events reported on

data services without the customer

needing to act. Examples of these

include flight or climate data

services, car telematic devices, and

a range of smart home IoT devices.

Artificial Intelligence

It is possible to integrate Artificial

Intelligence services for fraud

scoring, smart orientation, and

many other processes during the

claim’s lifecycle. Automatically

routing claims to appropriate areas,

such as internal investigations, or

straight through processing based

on AI rules or augmenting the

agents’ response ability are possible

with AI and we currently have

integrations with different AI

partners and services to support

this.


Native Cloud and True SaaS IBSuite is designed as an always-on

true native cloud solution. The

underlying technology is constantly

kept up-to-date, improved,

upgraded, exchanged and

enhanced. All, to ensure that

IBSuite runs on new, proven

technology with no dependencies

for the customers to manage - and

no technical debt. Everything is API

based and the underlying

implementation is encapsulated by

APIs and processes that the

customers access. There are no

dependencies to hardware or

software providers for the

customer to manage.

True Cloud Native

IBSuite is fully underpinned by

Amazon Web Services (AWS), thus

supported by the most resilient,

secure, robust, high-performing,

durable and highly scalable

infrastructure available at any given

point in time.

Regular Seamless Upgrades

IBSuite is always evolving, with

monthly seamless upgrades you will

never miss out on a new feature or

an enhancement to the platform.

Neither will you have to go through

a lengthy and painful upgrade

project again. IBA both ensures and

enforces full secure backwards

compatibility in every release.


Service Model IBSuite is provided as a true cloud, SaaS platform, meaning our clients do not

have to spend their time and resources managing any of the infrastructure

hardware, software, or system development. It is always available, always

secure and updated.

Some of the benefits of our service model include:

✓ Unlimited number of users

✓ Unlimited storage

✓ Unlimited API calls

✓ SaaS Platform updates and

upgrades (full management

and maintenance)

✓ Backup and Disaster Recovery

✓ Service commitment (SLAs)

✓ 24/7 Support, Helpdesk,

Unlimited support requests

✓ Compliance & Security Audits

(external penetration test,

yearly ISAE-3402 and ISAE-

3000 audits)


Summary IBSuite allows insurers to transform their complete operation or critical components like Claims Management. It is a digital, cloud-native, SaaS platform with a powerful integration layer that would allow your company to differentiate its offering by orchestrating an ecosystem of service partners, facilitating rapid deployment and integrating the most relevant technologies, including IoT, AI whether they are available now or in the future. ✓ All-in-one: An insurance

company can run all its business on IBSuite – or parts of it like Claims Management

✓ Customer-Centric: Any user experience can be enabled at the core through APIs / REST services

✓ Ecosystem Play: Products and services can be created by connecting with third parties in a flexible way, unlocking innovation

✓ Accelerated Time to Value: Products can be launched within weeks

✓ Low Cost of Ownership: Reduced IT costs, aligned with Insurers’ success in the market

✓ Fully Compliant: Security,

compliance, GDPR, it’s all included at any time, in any geography!

✓ Cloud Native: Powered by Amazon (AWS) and designed as true cloud

✓ Global: IBSuite is multi-country, multi-language, multi-currency

✓ Continuous Innovation: IBSuite is currently upgraded on a monthly basis

✓ Standards and Best Practices: All customers are using the same version of IBSuite and benefit from continuous R&D

✓ Differentiation and Innovation: IBSuite allows for unique customer configuration and differentiation.

Documents

Transforming Claims Management with IBSuite