SISnet Claims functional parts scheme

Graph showing SISnet Claims product, presented as a set of polygonal shapes, which represent each of the major areas (Core, Claims, Third parties and Administration) that compose it. These polygonal shapes show independent functions for each area, and intersect each other to present the common features between these areas. Moreover, several transverse features to the entire product are presented independently of the polygonal shapes.

List of functionalities:

• Core

  • Engine
  • Task diary BPM
  • Clients CRM
  • Document management
  • Content management
  • Datawarehouse

• Claims

  • Claim opening:
    • Opening refusal
    • Agent assignment
    • File assignment
    • Initial reserves
    • Other openings
  • Claim processing:
    • Claim diary
    • Claim agenda
    • Processing blocks
    • Correspondence
    • Documentation
    • Rejections
    • Annotations
  • Claim Closure
  • Claim Reopening
  • Events:
    • Catastrophic
    • Linked claims

• Third parties

  • Third parties management
  • Third parties portal
  • Order management:
    • Order generation
    • Order acceptance
    • Order resolution
    • Order closure

• Administration

  • Payment circuit
  • Authorization
  • Confirmation
  • Accounting interfases
  • Reserves, payments and recoveries:
    • Initial reserves
    • Reserve modification
    • Recovery expectations

• Functionalities regarding Core and Claims

  • Excess of loss reinsurance
  • Provisions

• Functionalities regarding Core, Partners and Administration

  • Self-billing
  • Provisions
  • Multiple payments