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Claims

The VVS »Claim Management« module is used in the process of claim notification, entering claim request data, defining claim reserves and payment of damages, and in relation to all other data that should be registered. This module enables automatic generation or manual entry of subrogation, as well as crediting  claim payout to a policy or personal account.


This module can be linked to the product definition subsystem and in this way claim amounts can be automatically calculated and generated (e.g. for car insurance policy, together with a specification for the car repair shop). Claim notification may be made not only through the central VVS system, but also through the offline AIS system. In the latter case, transfer from the AIS to the central VVS is ensured.

Data to be collected, entered and stored for claims are specific for each product. Because of this, the VVS offers solution by the specially designed module called »Claim Definition«. And from the »Product Definition« module, one can define »product - claim type« relation for each product. This ensures correct user input in the claim notification process. When the user enters the claim into the system, the system guides him or her and validates the structure and content of input data against the chosen claim type.

The described system provides customization (validation and adaptation) of data entry for each insurance product. It also enables automatic computation  of claim payout and other amounts, automatic cancellation of the insured object, risk or of the whole contract.

The basic features of the »Claim Management« module are as follows:
•    a universal module, independent of the insurance product; product-specific differences are customized by the »Claim Type Definition« module; this principle ensures individual view and design of customized claim types by user demands;
•    definition of individual data structure enables input of arbitrary data in all phases of the claim settlement  process – e.g. car driver, witnesses, expert witness, court, judge, etc.;
•    definition and use of user defined variables for more detailed claim description and subsequent analysis; variables can be defined at the level of the claim, insured object, involved persons;
•    definition of user-specific conditions, input data validations, bookkeeping schemes, etc;
•    automatic calculation and cancellation of the insured risk or cancellation of the whole contract – e.g. car insurance (full coverage) in case of the total loss or death of the insured person in life insurance;
•    reserves, payouts, reserve corrections (on payouts) etc. are automatically booked in the accounting subsystem;
•    subrogations are automatically managed and booked in the accounting subsystem;
•    automatic calculation and booking of co-insurance and reinsurance shares in claim payout amounts;
•    the module is directly linked with VVS modules for accounting and contracts. From this module we can easily retrieve any information related to a claim, such as contract, invoice and payment information, accounts balances, reminder data, client status, other claims or contracts held by the same client etc.
•    claim analysis by products, company branch offices, etc.
•    automatic journal management - all actions involving a claim are automatically registered into "Journal" subsystem, along with the information as to who performed them and when;
•    the "Journal" subsystem can be used for end-user arbitrary notes and comments;
•    the “Notes” subsystem can be used for end-user arbitrary notes and/or internal mail related to a claim;
•    the “References” subsystem can be used if we want to link the claim with an external documents (e.g. MS Word, MS Excel, WordPad, Pagis, ...); this module provides easy referencing, storage and search of all additional documentation related to the claim;