BUSINESS CAPABILITY MAP - Life Insurance Claims Services
| Description | EN: Life Insurance Claims Services group all specific capabilities related to fraud detection, recovery, complaints handling, and the fair settlement of life insurance claims. FR: Les Services de réclamations d'assurance-vie regroupent toutes les capacités spécifiques liées à la détection des fraudes, au recouvrement, au traitement des plaintes et au règlement équitable des réclamations d'assurance-vie. |
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| Name (FR) | Services de réclamations d'assurance-vie |
| Implementing Functions | 
Life Insurance Underwriting |
| Packaging Library | 
Insurance |
TREE VIEW
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Life Insurance Claims ServicesLife Insurance Claims Services group all specific capabilities related to fraud detection, recovery, complaints handling, and the fair settlement of life insurance claims.
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Complaints Handling & Monitoring (*)
Involves tracking and updating claims while ensuring clear communication with the insured. The goal is to resolve claims promptly and transparently, ensuring customer satisfaction.
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Fraud Prevention (*)
Aims to detect and prevent fraud by analyzing claims and verifying information. The service includes using detection tools to identify irregularities. The expected result is to reduce fraud-related losses, maintaining process integrity.
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Life Insurance Claims Settlement
Enables the finalization of indemnity payments after claim assessment and validation of amounts owed. The service includes communication with the insured and execution of payments. The expected result is to effectively close claims files with prompt and contract-compliant payments.
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Death and Disability Benefits
Involves paying death benefits and disability claims according to contractual terms. This includes verifying the required documents and executing payments. The expected result is a timely and compliant payout in accordance with the policy conditions.
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Estate and Tax Administration
Supports beneficiaries in the transfer of capital, ensuring legal and tax compliance of the payments. This includes preparing and verifying the necessary documents. The expected result is a smooth and compliant transfer process aligned with tax and legal standards.
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Policy Surrenders and Cash Values
Handles partial or full surrender requests and calculates the available amounts after any applicable penalties.
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Recovery & Subrogation (*)
Involves recovering amounts owed from third parties responsible for claims, such as other insurers. The service includes analyzing recovery opportunities and necessary legal steps. The expected result is to recover owed funds, thus reducing the insurer's claim costs.
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