Overview

The Core Policy Admin module provides administration services to an insurer's business operation. This is the business area that is responsible for the heavy lifting aspect of the insurance business. Once new business processing is complete, there is huge scope for the alteration of policies in issue to fulfill the obligations of flexibility, and morphing of a policy and its benefits so that it stays relevant to the policyholder’s circumstances.

The module encompasses the registration of permitted policy alterations, such as an upgrade to core healthcare benefits, whilst automatically identifying and communicating the requirements and evidence necessary to recalculate and complete the alteration. Evidence and document requirements gathering is orchestrated by FintechOS and assisted by Automation Processors.

Business experts directly involved in the process can use Core Policy Admin module to refine and deploy digital journeys so that they cover the requirements of legacy, current and planned products in an order that meets the identified priorities of their business.

The Core Policy Admin module covers the following typical events:

  • Mid term adjustments;

  • Benefit additions or increases;

  • Removal or reduction of benefits;

  • Addition/removal of insured persons or objects;

  • Automatic premium/benefit escalations;

  • Premium collection alterations leveraging FintechOS Premium Billing;

  • Notifications to agents, brokers or other professional intermediaries responsible for servicing the policyholders portfolio if applicable;

  • Collation and calculation of all policy benefits and reserves relevant to the alteration event

  • Initial automatic definition and request for Alteration requirements and evidence specific to the Case

  • Ongoing management of the alteration, enabling the definition and request of further requirements and evidence as it evolves and progresses;

  • Orchestrating the involvement of:

    • Third parties – Re-insurers, service providers, medical agencies;

    • Other systems of the insurer within the business architecture, such as calculation engines, expert underwriting, re-insurance solutions, fraud and finance;

    • Users, senior underwriters, senior managers and others as required by the specific case;

  • Recording and storage of the evidence received and of the decisions made during the process;

  • All communications and status changes during the process;

  • Generation of downstream activities such as ongoing premium payment schedules, generation of new commissions and fees.

This guide concentrates on use of Innovation Studio in the configuration of a digital journey, that will incorporate FintechOS Automation Processors and highlight the opportunities which exist to greatly improve efficiency, Policy Administration automation, audit and management capabilities and speed time to completion of administrative tasks.

The Core Policy Admin module helps insurers address many pain points associated with claims management, including:

  • Automation of repetitive and otherwise time-consuming process decisions;

  • Introduction of Straight Through Processing (STP) to address the bulk of Policy Administration tasks;

  • Elimination of previously manual processing steps, reducing human error but also freeing up highly paid specialist staff to concentrate more complex cases;

  • Automatic identification and elimination of requests that do not fall within a product versions terms and conditions;

  • Leverages FintechOS Automation Processors to greatly improve requirements and evidence gathering and communications.

The key features of the Core Policy Admin module are listed below:

  • It enables a central point from which to initiate policy administration tasks that impact on multiple policies;

  • It allows the automatic identification of business requirements pertaining to the changes requested.

  • It allows the automatic initiation and completion of regular scheduled policy alterations, e.g. annual premium and benefit escalations;

  • It offers high levels of automation but with the capability to determine where intervention of experts is required;

  • Reverts to manual processing only where necessary for more complex or specialist cases.

The key benefits of the Core Policy Admin module are presented below:

  • Enables the orchestration and timely involvement of multiple parties, processes and systems:

    • Underwriters, service providers, medical agencies;

    • Re-insurers;

    • External systems, such as Insurance Blacklists, MIB;

    • Other systems of the insurer within the business architecture, such as calculation engines, re-insurance solutions, fraud identification and finance;

    • Users, expert administration teams, underwriters as required by the specific case.

  • Provides a fully auditable end to end administrative process view with no blind spots covering:

    • All participants in the process;

    • Performance of third parties and service;

    • SLA’s;

    • Response times for communications to claimants for regulatory reporting.

  • Automation of high volume, scheduled or simpler alteration types;

  • Introduction of a robust policy administration management process, ongoing improvement of performance, and reduction of costs;

  • Regulatory compliance.

HINT  Integrate Core Policy Admin with more Lighthouse solutions for insurance in order to make the best of process automation for your company, portfolios, products and clients!