Claims Management

Check and process claims, make decisions 

Claims Management system
Automate insurance claim processes

Claims management in insurance has great potential for automation. Two factors are important: fast communication with the client to provide support before the claims process is opened and the processing of the claim. The insurance software from ACTICO helps companies automate internal processes and the interaction with the affected parties to a great extent. The ACTICO Rules software makes automated decisions on the basis of business rules. This allows a high percentage of claims to be processed automatically. 

Making filing easy

Clients expect their insurer to respond to their claim almost in real time. Automating claims settlement makes it possible to fulfill this expectation. 

Checking claims 

Automated processes support insurers in assessing the amount and the obligation to compensate (e.g. by checking whether the premium covers the reported damage).

Reducing costs

Automated claims management reduces costs, since claims must be processed by the claims manager only in exceptional cases.    


Approach
Automation from initial claim through claims processing

Checking the claim

As soon as a customer reports a claim, the claims manager estimates the cause, scope, complexity, and amount of damage and assesses the obligation to compensate. The interface to the client must already be working well when the damage is being assessed, since the client no longer sees himself merely as a premium payer, but as a claimant, and expects good service.

Claims managers work closely with underwriters and relationship managers. This cooperation allows insurers to improve their risk assessments and optimize claims prevention.

Automating claims processing

Manual claims settlement takes time. That is why insurers automate claims processing and assessment as much as possible. The ACTICO Rules insurance software supports claims settlement by automating the following processes: 

  1. Damage assessment 

  2. Checking whether the damage is covered by the premium

  3. Ensuring that there is no insurance fraud

  4. Checking the damage amount and replacement value

  5. Controlling other service provider

  6. Storing directories and rules for reducing bills and automating payment

Creating decision rules

Automation in claims settlement is achieved with business rules. As soon as a claim is reported, ACTICO Rules come into effect. They make a decision based on insurance premiums and internal requirements. Claims managers, underwriters, and relationship managers can focus on exceptional cases that cannot be decided automatically. ACTICO Rules consists of a graphical interface. This makes decision rules entirely transparent and readable by the specialist department and by IT. 


Products

Claim management software

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Regeltechnologie zur Automatisierung und Flexibilisierung von Leistungsprozessen
ACTICO Rules
Automate claims processes with high flexibility
Insurers are under pressure to make reliable decisions even when making adjustments to meet short-term requirements. With ACTICO Rules, insurance companies automate their decision-making and audit processes in a highly flexible way.
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Software for claims checking
ACTICO Platform
Efficient and flexible insurance processes
ACTICO Platform is a highly flexible software technology for automating and optimizing operational decisions. Insurance companies use our Decision Management Suite to digitize their decision-centric business processes such as claims management, underwriting, fraud detection and many more. With ACTICO Platform, they can achieve maximum efficiency and agility.
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Software for Intelligent Decision Automation
ACTICO Machine Learning for insurance companies
Methods for better risk decisions

Insurance companies can use their clients’ data to automatically create risk models for underwriting and claims management. Machine learning provides methods that make better risk decisions and complement rule-based models.