A solution for processing claim declarations
Summary: Vivium, a part of the P&V Group, ranks among Belgium's top three insurance providers, offering insurance packages through more than 1,000 independent brokers. These brokers serve as intermediaries between insurance firms and end consumers. Our solution incorporates a Decision Table that standardizes and interprets claims from various brokers, facilitating automated processing and minimizing manual work.
Client Challenge: Brokers faced difficulties in fully digitizing the claims submission process. While they could enter general information online, the following steps demanded considerable manual effort from Vivium staff. The lack of a uniform method for interpreting each broker's specific standards and message codes added to the complexity, leading to delays and inefficiencies.
The Solution: The new system enables Vivium to accept and interpret all broker data, allowing for seamless processing without the need for adjustments to internal applications or procedures. Brokers can now interact directly with Vivium’s insurance systems. To tackle the issue of different brokers' codes, a Decision Table was introduced. Upon claim submission, this table chooses from over 30 main scenarios and 500 variations, guiding the back office on claim processing, even if some information is still pending. Additional default fields and automated API integrations enhance the workflow, reducing the necessity for broker manual input. The Decision Table also empowers the client to independently create and manage new scenarios.