Insurance Management System Case Study

Overview

Our client is one of the market leaders in the insurance industry and provides services like health and travel insurance. Their main aim is to provide insurance to the individuals who are staying or visiting abroad for academics, or expats. Our skilled developers have developed a web application that has improved the claim management process, data analysis, coordination with medical providers, finance and forex management, inquiry and feedback management, and various other processes.

Key Challenges

Our client offers tailor-made health and travel insurance to people who are temporarily staying or visiting places abroad. Here are some of the key challenges that we have addressed:

Scalable solution to analyze the policy and claim information.
A single system for all the claim management activity.
To establish Coordination between policyholders and medical service providers for claim management.
Manage all the data in one place.
Make a simple and fast process for claim verification.
Address feedback and queries of the customers - ratings, and comments.
Report generation as per the customer needs.

Expertise

Tools & Technology

Angular • Jasper Report • C# • .Net Core • Oracle

Solution

Our software developers have expertise in creating modern-age insurance applications with all the required and user-friendly features. For this application, they have used technologies like angular in frontend and .NET in the backend to make the application robust and fulfill as per requirements. This insurance management system offers different functionalities as shown below to overcome all the challenges faced by the client.

Policy Management Portal

This module is used to manage all the policies, their premiums, deductibles, and more.

It includes policy features, and government rules and regulations.
It also includes policy type (i.e. travel policy), subscribers, their mode of purchase, time duration, and broker information.

Partners Integration Orchestrator

System users can create any data exchange transactions.
They can also configure mappings and apply rules to transform data structures between the 2 entities and then integration will occur based on configuration.

Claim Management System (User Side)

This module allows users to manage their claims.

Generate the complete workflow and minute details of claims.
It enables the Submission of claims and claim Queries.
Takes into account necessary details of payment.
Users can also modify the previously entered details.
They can also track the status of their inquiry/claim.

Claim Management System (Admin Side)

This module enables the in-house team to manage the end-user’s claims.

All the data related to the insured persons are configured here.
Also, data related to service providers and their agreements, office details, and supported payment methods are configured.
Admins can initiate payment from this portal in various currencies to the policyholders or directly to the service providers.

Finance Management

This module enables managing finances, tracking the settlements, and keeping financial records.

Two types of payments can be initiated: one is Direct payment to the service providers and another is to policyholders.
Tracks and settles the single or multiple transactions of the policyholders.
Keeps record of the past financial data of the policyholders and calculates the premium accordingly.
Admins can also generate vouchers for the policyholders.

Inquiry Tracking System

This module helps in keeping track of the claims and inquiries registered by the end users.

Global Admin and sub-admins can check, and respond to all the registered claims and inquiries.
They can track the inquiries with statuses like Open/InProgress/On Hold/Close.
They can also analyze all the inquiries in graph form.

Report

This module shows the report of the policies.

Generate the detailed Report for the various policies with one click representing various graphical charts.
The report can be scheduled and delivered in various formats (i.e. Excel, Pdf, etc.)

Medical Service Providers Management

This module is used to maintain the details about medical Professionals and their licenses as per the authority.

It stores the details of the health care providers e.g. Hospitals, Laboratories with their branches, associated medical professionals (surgeons, doctors), and services that they provide.
These details help to verify the claims faster and reimburse the claim amount to the policyholders.

Emergency Calling Management System

This module manages the emergency calling system.

It enables the company to offer on-call medical and rescue services.
This helps in not laying out high hospital bills as the hospital will be directly contacted in case of emergency by the insurer.

Feedback System

This module helps in managing the feedback.

To get feedback from the customer after closing any inquiry.

Result

A well-structured and feature-rich claim management system developed by TatvaSoft offers innovative operational abilities. By taking advantage of our top-notch web application development services, the client was able to have a unique solution with the following benefits -