Claims Processing

A complete and paperless workflow solution for insurance organizations

Insurance providers face a number of challenges. Not only do they have to contend with increasing labor costs, risk mitigation, fraud detection, and stringent regulatory compliance, but the inefficiencies that stem from traditional paper-based processes often reduce transparency and unnecessarily raise the risk of human error. To make matters worse, existing automated systems typically operate in segregated silos, making crucial claimant information difficult to locate or access.

 

Solution

Ensemble’s claims processing solution addresses these issues by providing a comprehensive environment for capturing, transmitting, processing, and storing data related to insurance claims, applications, and other activities. Built on Adobe® LiveCycle® and Adobe® Flex®, our solution tightly integrates with existing business rules and IT infrastructure, and ties multiple backend systems together through rich frontend interfaces. From claimants submitting forms online to claims adjusters collaborating with insurance brokers in real time, our solution effectively and efficiently streamlines the insurance process, start to finish.

The Customer

By tapping into the form guide capabilities of ADEP and the presentation capabilities of the ubiquitous Adobe® Reader®, our solution provides claimants with a dynamic and intuitive method of submitting forms associated with a claim or application online. A rich Internet application (RIA) and interactive forms with built-in intelligence guide customers through every step of form completion.

The Underwriter

Once submitted, the data from the forms is automatically captured and routed to the insurance company for instant and secure processing. This automatic routing expedites information processing entirely via electronic means, eliminating the need for manual, paper-based processes, reducing operational costs and response times, and allowing claims managers to gain greater control over the processing environment.

The Adjuster

The collaboration component of our solution fosters personalized service by connecting disparate backend systems and data sources, and aggregating customer information in a single workspace that is accessible via a tablet device. Through the rich user interface, claims adjusters can collaborate with insurance underwriters in real-time via text or video chat, view existing photos and videos of a claim, or take new photos and videos and save them directly to the claim file.
Features
  • Provides superior, personalized service to a diverse customer base
  • Facilitates data entry and flow between claimant and claims employees
  • Automatically converts claims to a standardized PDF format
  • Aggregates all claim information together in a single PDF document
  • Allows for PDF file previews prior to file download
  • Ensures security by authenticating users when accessing documents
  • Achieves cost savings and reduces error rates by automating existing manual-based processes
  • Eliminates costly paper-based claims while maintaining information integrity and security
  • Streamlines document exchange, review and approval
  • Provides agents with faster access to accurate, comprehensive customer histories
  • Delivers an intuitive user experience, enhanced by rich media
  • Allows agents and brokers to collaborate with one another about the details of a case in real-time
  • Grants field agents access to pertinent customer information and rich media through their tablet device
Web Design
  • Adobe Flex
  • Adobe LiveCycle

  • Claims Processing Dashboard
  • Claims Processing Dashboard
  • Claims Processing Dashboard