The Claim component leverages technology and standards to maximize flexibility and reduce integration time. The J2EE environment and relational databases are at the core of the technologies being used.

The Claim component handles the unique and resource intensive nature of Long Term Care, Short Term Disability and Long Term Disability products.

Adding New Claims

The Claim component supports several ways to add new claims to the system. The New Claim Wizard guides the user through the steps necessary to add a new claim to the system. Or, for the expert user, the standard claim add transaction allows them to go straight to the data that they know they need to input.

The system supports the importing of policy data from the policy administration system to minimize the keying of redundant data. Claim maintenance functions speed the examiner through the process of adjudicating the claim. Disposition of the claim can lead to repetitive payment streams, that are tracked and made available for historical viewing.

Automation & Rules

Automation and rules technologies alleviate many of the labor-intensive processes found in the typical claim processing environment.

• Determination of the claimant's eligibility
• Calculation of benefit amounts
• Production of the explanation of benefits
• Payment transactions
• Follow-ups