ENTERPRISE FUNCTION - Life Insurance Underwriting

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Description	EN: The  Life Insurance Underwriting function oversees the administration and claims management of life insurance policies. It supports long-term financial protection by ensuring accurate policy servicing, risk-aligned underwriting, and timely claims settlement in line with customer and regulatory expectations. FR: La fonction  Production/exploitation assurance vie supervise l'administration et la gestion des sinistres des polices d'assurance vie. Elle contribue à la protection financière à long terme en garantissant un service de gestion des polices précis, une souscription adaptée aux risques et un règlement rapide des sinistres, conformément aux attentes des clients et aux réglementations.
Name (FR)	Production/exploitation assurance vie
Related Capability Maps	Life Insurance Policy Services    Life Insurance Claims Services
Packaging Library	Insurance

FULFILLED CAPABILITIES

•    Life Insurance Claims Services

   Life Insurance Claims Services group all specific capabilities related to fraud detection, recovery, complaints handling, and the fair settlement of life insurance claims.

  •    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.

  •    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.

  •    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.

    •    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.

    •    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.

    •    Policy Surrenders and Cash Values

      Handles partial or full surrender requests and calculates the available amounts after any applicable penalties.

  •    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.

•    Life Insurance Policy Services

   Life Insurance Policy Services group all specific capabilities related to the administration and monitoring of life insurance policies and the management of insured portfolios.

  •    Insured Portfolio Management (*)

    Analyze, monitor, and optimize insured portfolios to ensure a balance between profitability and risk exposure.

    •    Insurance Product Profitability

      Assess the financial performance of insurance products by analyzing loss ratios and technical margins.

    •    Monitoring of Solvency Reserves

      Involves monitoring and adjusting technical reserves to ensure the insurer’s ability to meet future obligations in compliance with regulatory requirements.

  •    Life Insurance Policy Administration & Monitoring

    Oversee and coordinate all actions related to the lifecycle of insurance contracts, from implementation to renewal, ensuring regulatory compliance, policyholder satisfaction, and continuous alignment between coverage, risks, and client expectations.

    •    Contractual Rights Administration (*)

      Encompasses all operational activities aimed at managing, monitoring, and updating the rights and obligations of stakeholders (insurer, policyholder, beneficiaries) throughout the life of the contract.

    •    Investment Fund Administration & Monitoring

      Manages life insurance policy assets through flexible multi-support arbitrages, continuously monitors each fund's performance, clearly communicates on asset valuation and fees, while maintaining the optimal balance between euro funds and unit-linked investments in line with the policyholder’s strategy.

MAP VIEW