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Pain points

Paying claims in the open market

Lack of visibility, transparency, and collaboration 

Woman and Man blindfolded holding puzzle pieces

Notification of loss, policy matching and verification

  • Customer making a claim on a laptop
    Customer makes a claim

    Only brokers can start the claim process and monitor the progress of the claim

  • A man holding a document while sat a desk with a computer
    Broker submits the claim with supporting documents
    Pain point not applicable to this step
  • A man on a computer with a claim and policy document above
    Claim is matched against the relevant policy
    Pain point not applicable to this step
  • A woman checking things on a computer
    Policy and premium verification checks are performed
    Pain point not applicable to this step

Triaging, routing and assignment

  • A man receiving a notification on an iPad
    Lead underwriter and claim agreement party(ies) are notified of the claim (if required)

    Lead underwriter manually selects the claim agreement party; there is no visibility of who is on risk until the lead underwriter confirms this

  • Two people on computers with a checklist above them
    Lead underwriter and claim agreement party(ies) are assigned claims tasks

    Lack of transparency and visibility on the progress of the claim for the customer; broker must provide ad hoc updates and only to the lead underwriter

Agreement

  • A man on the phone at a desk
    Query management and requests for additional information is undertaken (if required)

    Insurers, customers and experts must direct queries via the broker; communication is through email, telephone or in person discussions making it difficult to track

  • Two people shaking hands at a desk
    Lead underwriter and broker negotiate, and agree or deny the claim
    Pain point not applicable to this step

Digital processing

Settlement and claims payment

  • A woman doing technical checks on three computers
    Technical processing checks conducted to review and finalise the claim
    Pain point not applicable to this step
  • Funds being sent from one person to a computer to another person
    Funds or fees are moved

    Inability for the customer, insurer and broker to track the progress of the claim settlement and payment

Pain points

View the pain points the new digital solutions are addressing for paying claims in the open market.

Man scratching his head with paper flying around

Manual intervention, re-keying, and lack of automation

Data sheets

Unstructured and inconsistent data

Man going through step by step flow

Claim tasks must be completed sequentially

A man checking his watch in front of a clock

Delays in claims processing, payments, and movements of money to customers

Solutions

We’re delivering several solutions which are transforming how we’re paying claims in the open market. Learn more about these solutions, including our progress, benefits and where to find out more.  

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ACORD Data Standards

ACORD technical data standards will be used to populate the Core Data Record (CDR) and other key data. 
A database

Core Data Record (CDR)

A set of standardised, quality transactional data, that empowers downstream processing.
A computer with a document, a badge and a settings icon on it

Digital Processing Platform for claims (ICOS)

A digital claims processing service which can automate processes.

Related steps

Journey overview

A high-level overview of the journey including associated pain points and solutions. 

Detailed steps

A detailed view of the journey, showcasing the technology that’s involved in each step.
Previous Manual intervention, re-keying, and lack of automation
Next Unstructured and inconsistent data
Get adoption ready

Blueprint Two will be delivered in two phases. At phase one cutover, all market firms must adopt the new digital services.