Claim Management

Claim Management

The CMS (Contract Management System) includes a comprehensive claim management feature that ensures efficient processing and authorization of claims. All claim statuses, claim values, sum insured, and document hashes are stored on-chain, providing transparency and immutability. Sensitive data, however, is stored off-chain for enhanced security.

When it comes to claim validation and approval, there are two possible scenarios. Firstly, the system can automate the claim validation process, utilizing predefined rules and algorithms to verify the claim against the specified criteria. This automation streamlines the claim processing, allowing for quick and accurate validation.

Alternatively, a company supervisor, such as a branch supervisor, can be authorized within the CMS to manually review and approve claims. This human validation process ensures an additional layer of scrutiny and allows for the exercise of discretion in complex or exceptional cases.

To maintain control and oversight, only authorized company or branch supervisors have the authority to approve claims within the CMS. This ensures that claims undergo proper evaluation and validation by qualified individuals, guaranteeing adherence to company policies and procedures.

By integrating claim management into the CMS, companies can streamline and automate claim processing while maintaining the necessary oversight and authorization from qualified supervisors. This comprehensive approach optimizes the efficiency and accuracy of the claim management process, providing a robust and secure platform for handling and authorizing claims.

Claim: Detail

In the claim management process, supervisors within the CMS have the capability to access and review the details of claim requests submitted by customers. This feature enables supervisors to gather essential information and perform a primary estimation of the damage reported by the customer.

Supervisors can access the claim details, which may include relevant information such as the nature of the claim, supporting documentation, incident descriptions, and any additional evidence provided by the customer. This comprehensive view empowers supervisors to evaluate the claim and make an initial assessment of the reported damage.

By having access to the claim details, supervisors can effectively analyze the information provided by the customer and initiate the necessary actions for processing the claim. This primary estimation of the damage helps supervisors determine the next steps in the claim resolution process, such as requesting further documentation or assigning a field inspector for a more detailed assessment.

The ability for supervisors to review claim details within the CMS ensures a thorough understanding of each claim, facilitating efficient decision-making and ensuring that claims are handled appropriately from the initial stages. This feature enables supervisors to provide accurate and timely responses to customers, enhancing the overall customer experience and streamlining the claim management process.

Claim: Product

In the claim management process, product information plays a crucial role in assessing whether repair or replacement is necessary. The product details provided by the customer are utilized to evaluate and determine the appropriate course of action.

When reviewing a claim, the product information is used to assess the feasibility of repair or replacement. The CMS utilizes the details such as the brand and model of the product to identify and consider options for repair or replacement. The goal is to provide customers with new, similar items of the same brand and model, or products with comparable qualities.

By leveraging the product information, the CMS ensures that customers receive appropriate solutions that align with the original product's specifications and quality. Whether it involves repairing the item to its original condition or providing a suitable replacement, the product details enable the claim management process to deliver an outcome that meets the customer's expectations.

The utilization of product information within the claim management process enhances accuracy, efficiency, and customer satisfaction. By considering the specific brand, model, and comparable qualities, the CMS aims to resolve claims effectively and provide customers with satisfactory resolutions for their products.

DLT Manangement: Claim Data Storage

The DLT (Distributed Ledger Technology) section within the CMS ensures secure and transparent storage of claims information, enhancing the integrity of the claim process. By leveraging DLT Management, data is recorded immutably, providing a trustworthy and accurate record of each claim.

Claims information, including associated documentation, is stored on the distributed ledger, ensuring tamper-proof and transparent data management. The use of DLT guarantees data integrity, preventing unauthorized alterations and ensuring the reliability of the recorded information. Additionally, checksums are applied to claim documents, further enhancing data security and enabling verification of document integrity.

Through the adoption of DLT Management, the CMS establishes a robust and transparent system for storing and retrieving claims data. This enhances the security and transparency of the claim process, instilling confidence in stakeholders and facilitating efficient claim resolution.