Claims management

The term damage management refers to the organized handling of damage , especially in the case of insurance companies , rental cars , leasing companies or forwarding agents .

species

A distinction is made between two types:

• Claims management as a corporate control task ; In insurance companies, this term is often chosen for the organizational unit (department, team) that defines the work processes of the claims department.
• Claims processing in individual cases. The insurance industry understands claims processing as all activities that are related to the processing and settlement of claims (claims settlement). Claims management is one of the operational performance processes and is an important part of insurance production. It encompasses all business processes from recording the claim to determining the status quo to payment or compensation in kind.

The process of claims management

The claims management process varies depending on the division and company. However, some basic editing steps can be generalized:

Claims management process

1. Damage system
   • Exclusion of double systems
   • Record the claim report
   • Creation of a damage file
   • Examination of insurance coverage
2. Claims handling
   • Collection of statements from policyholders , injured parties, witnesses, etc.
   • If necessary, obtaining reports from experts, doctors, etc.
   • Fraud investigation
   • Assessment of the damage by the clerk
3. Claims settlement / disbursement
   • Informing the insured about the result of the assessment
   • Instructions for payment or compensation in kind
   • regress

IT systems

Many insurance companies still use proprietary software systems that have evolved over the years in claims management, which cannot be processed “from a single source”. Newer software solutions use the possibilities of modern internet technologies. Web-based systems enable everyone involved in claims processing, such as B. call center agents, field workers, claims handlers and appraisers to work with the same software platform.

Innovative software systems work dynamically, object-oriented (= dynamic, object-oriented claims management), i.e. H. the systems network logically related processes to form dynamic objects: processing steps within a claim and from different cases of damage that intersect at a certain point in time are combined to form a processing cluster. The claims handler always receives new processing bundles of the same type / characteristics via the system: In this way, such systems simplify and accelerate processing, prevent duplication of work and thereby reduce the costs that arise.

literature

• Roman Dickmann: Active claims management: Specification of the harm reduction obligations of the injured party by the motor liability insurer . 3. Edition. BoD, Norderstedt 2012, ISBN 3-8448-1582-1 .
• Detlef Speer: Active claims management in motor vehicle insurance . 1st edition. Verlag Versicherungswirtschaft, Karlsruhe 2001, ISBN 3-88487-946-4 .
• Melanie Lünzer: Active claims management in motor vehicle insurance . 1st edition. AV Akademikerverlag, Saarbrücken 2012, ISBN 978-3-639-39184-8 .