Altus Insurance whitepaper spreads - Flipbook - Page 12
Your journey planner for good
claims management (cont.)
Claims value chain
By taking a methodical, architecture-led approach
to visualising an organisation, Altus Consulting
has built its understanding of claims processes at
a logical level, based on the underlying flows of
data between an insurer and the external entities it
interacts with.
Record Claims
Includes First
Noti昀椀cation of
Loss (FNOL);
recording claim
details, initial
estimates and
classi昀椀cation and
assignment claim.
1
The resulting view below covers high level claims
processes and the sub-processes involved in
claims management, from end to end.
Settle Claims
Identifying
and managing
the pursuit of
recoveries, under
contribution
(dual cover) and
subrogation
(liable third
party). Salvage
may form part of
this process.
2
Investigate Claims
Collating evidence
and assessing
coverage, liability
and quantum
(value).
3
Manage Fraud
Handling the
outcomes of
claims, including
repudiations,
resolving cover
/ quantum
disputes, claim
closure activities
and reporting.
4
Handle Recoveries
Indemnifying
the customer,
through repairs,
replacement,
reinstatement or
cash settlement.
5
Optimised
claims process
with good
customer
outcomes
6
Resolve Claims
Assessing fraud
risk, detecting
and managing
fraud, reporting
on fraud,
and ongoing
maintenance of
fraud controls.
Figure 4: Claims value chain
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