OverviewData WarehousePolicy AdministrationClaims AdministrationInsurance AccountingMember Portal

Risk360°/Claim Administration automates administration of claims throughout their lifecycle. Unlike most claim administration systems, Risk360°/Claim Administration is tightly integrated with Risk360°/Policy Administration which eliminates duplicate effort and reduces mistakes.

Key functions:

  • Automatic verification of coverage on either an occurrence or claims-made basis.
  • Creating a direct attachment to the policy which eliminates duplicate data entry and errors.
  • Automatically determine the applicable deductible based upon the nature of loss.
  • Prevents payments in excess of annual aggregate, per-occurrence, per-claimant or per- item limits where applicable.
  • Complete financial audit trail.
  • Diary and Notes to track development of the claim, so that answers can be provided without contacting an adjuster or retrieving a paper file.
  • Track details of claims in litigation including counsel assignments, dates, witnesses etc.
  • Financial controls including case reserves based on adjuster level of authority and separation of authority between requesting payments and issuing checks.
  • Supports all Property and Casualty coverages.

Risk360°/Claim Administration uses the Customization Through ConfigurationTM to conform to the information needs of each pool in areas such as:

  • Reserve types to use for each coverage.
  • Payment codes to use for each reserve type for each coverage.
  • Deductible invoicing vs. withholding the deductible.
  • Data elements to capture for each incident.
  • Data elements to capture for each coverage.
  • Codes to use for describing cause of loss and nature of loss.

Key Benefits

  • A safety net protecting against costly mistakes exists due to the tight integration with Risk360°/Policy Administration.
  • A low lifetime cost of ownership, thanks to Customization Through ConfigurationTM.

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