Health Insurance Policy Management Software System
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Health Insurance Policy Sales and Management System

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Concept

The world has become an interesting place. Initially products used to be the deal clinchers for companies. However today, with the converging boundaries of global market space, efficient delivery of services has become the USP. The spotlights have focused on service delivery while efficiency is the key word now. Insurance is no exception to this. However, redundancy and duplication of processes involved in insurance sector can mar the ultimate delivery experience.

Client

Exclusive Healthcare SA is a France-based company providing health insurance to the English speaking expats of the country. The company specializes in offering top-up health insurance to these people in policies drafted in English language. The founders of the company are highly experienced in working with the healthcare industry of the country. Over the years, they came in contact with quite a large number of families that were moving to France and required health insurance. Being operative in the industry for a good number of years, they were aware of the practical problems of providing these families health insurance.

Pain Points

For past few years, the company’s agents initiated critical daily tasks by contacting company representatives at the insurer’s major office. This led to duplication of effort which was becoming increasingly inefficient and burdensome with the rise in the sales volume. They realized that integrating and streamlining policy application and documentation processes would make operations less straining and reduce administrative overheads.

They envisioned a solution that would provide their agents direct, real-time access to legacy applications to drive sale and support of the policies and save on time and cost. They intended to remove the duplication of processes that was happening. “With everyone involved in preparing, printing, mailing, storing, and retrieving policy documents and always in several sets of duplicates, it’s easy to see how costly and time consuming the process is”, supplied the company’s Chief Executive Officer.

Approach

The project was characterized by interplay between different variables. To garner a comprehensive understanding of top-up health insurance, we applied a process known as thick description, that involved an in-depth description of the entity, the circumstances under which it is used, the characteristics of people involved and the community in which it is located. Since the client was an insurance service provider, thick description also involved interpreting the demographic and descriptive data provided like articles, product line, purchasing Wealthcare from HiFX etc.

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The Solution

After much deliberation we delivered a browser-based transaction application that established a unified, service-oriented process to quote and issue insurance policies. This web-based quoting engine is designed to maximize flexibility and render ease of integration. It is also a robust marketing tool that is equipped with dynamic and user friendly interface.

For each policy, the solution creates a PDF containing insurance details, which is automatically attached to the policy with descriptions and dates. This delivers 75 percent saving in time and effort to the management, underwriters, claimants as well as external users.

The solution, in a sense, replaces the age old system of maintaining paper based files. Some of the fundamental features of the solution are as follows:


Web-enabled Data Entry

  • The solution provides a detailed breakdown of premium summary.
  • It provides an automatic reflection of characteristics predefined by the product developer along with configuration such as coverage, rates, forms etc.
  • The solution embodies an ability to edit and save multiple quote iterations.
  • It allows easy transition from quick quote and/or full quote to policy issued.
  • The solution enables document imaging.

In-force Automation

In-force Automation streamlines the processes associated with management of policies. It automates incomplete processes like pending registration of a policy whose payment has been completed. This removed the involvement of human factor and enhanced accuracy. In-force automation completes the following processes:

  • Cancellation/reinstatement of policy
  • Policy correction
  • Endorsement
  • Renewals and non-renewals of policies
  • Detailed policy transaction history including “point-in-time” details
  • Diary, notes and renewal information windows
  • Export data in CSV format
  • Reports
  • Underwriting of health insurance policies
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Benefits of the Solution

The Policy Management System developed by Radix renders following benefits:
  • The solution has allowed the client to handle his core business online and the robust architecture has improved the productivity and lowered the costs.
  • The solution has consolidated various systems into a single homogenous entity improving manageability, reducing maintenance cost and ensuring lesser downtime.
  • The solution has established a single database for all the data residing in contrasting systems and the access to this data has been enhanced rendering higher customer service levels and reduced customer query response time.
  • The solution is a pan-France application and has standardized the administration process for the client all across the country.
  • It has automated the manual tasks thereby delivering significant efficiency benefits in operations.
  • The solution has delivered transparent and seamless flow of data between databases belonging to two separate modules.

Highlights of the Solution

  • Document Imaging i.e. automatic digital archive of every document in PDF format.
  • Management of full lifecycle of insurance policies.
  • Advanced MIS System for Administrators.
  • Automated Insurance Claims Processing.

Client Feedback

“You guys have provided us the service within expected timelines and have met my budget. I appreciate your commitment to work and will be in touch with you soon for more work. Thanks Radix.”

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