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FINEOS Claims for LIFE

Life claims are unique to the insurance industry in that they are the culmination of the relationship between the insured and the insurer. Life claims represent a traumatic event for the family of the insured so it is vital that they are handled as speedily and tactfully as possible. The insurer is judged on their efficiency and sensitivity in handling the life insurance claim. Mistakes, delays, unnecessary intrusion or mishandled queries will impact the claim experience negatively and will alter their perception of the insurer permanently.

Improved Customer Service

FINEOS Claims for Life manages customer relationships through direct, real-time access to information which in turn enables a swift turnaround time on life claims. Through using FINEOS Claims, carriers can offer faster claim resolution and superior overall customer service. The solution acts as the central hub for the life claims handling process and ties in beneficiaries, intermediaries and third parties as well as interfacing directly with numerous document, reporting and legacy systems. The system has the ability to configure scripted processes and ensure that all claims are dealt with efficiently and consistently. FINEOS Claims enables insurers to respond quickly to the divergent needs of their customers, for example the system supports the splitting of payments between multiple beneficiaries.

Engineered for Flexibility

FINEOS Claims is very flexible and highly configurable. Flexible business rules allow you to change the way life plans are defined and payments are made, allowing for cafeteria-style selection and maintenance. Changes can be made quickly and easily at the business level, removing the need for complex code development or cumbersome testing requirements. In addition, FINEOS Claims can be deployed quickly and is highly scalable across many users and multiple sites.

Streamlining the Claims Process

FINEOS Claims orchestrates the bulk of the manual processes tied up with life claims. The system can help to reduce time spent doing routine administrative tasks and enables you to link to additional information such as death certificate verifications, and view other necessary information as required. FINEOS Claims filters this information into an electronic claim file system via intelligently-generated electronic forms. It provides claims staff with appropriate and accurate real-time access to claim information involving third parties, including beneficiaries, employers and physicians. In addition, the system can be configured to alert users of the need to investigate potential non-disclosure cases. The FINEOS Claims workflow automation features have the ability to configure automated follow-ups and generate checklists, making sure that every claim is handled efficiently, consistently and within business and regulatory time constraints.

Comprehensive Documentation and Auditing

FINEOS Claims provides comprehensive document and activity auditing capabilities, including the automatic generation of all necessary forms and correspondence. This enables you to provide evidence that all regulatory requirements have been met in the handling of claims. Claims status and process trails are tracked and reported to ensure compliance with internal and regulatory guidelines and standards.

FINEOS Claims for Life goes beyond traditional claims processing to deliver all aspects of a total claims solution:

• Fully automated claims and case management
• Integrated customer management
• Comprehensive financial management
• Optimal provider management
• A flexible, modern, rules-driven technology platform