Oracle Insurance Claims Solution

Oracle Insurance claims solution provides rules-based, end-to-end claims processing that enables insurers to improve quality and efficiency of claims handling, reduce claims and IT costs, and improve visibility and transparency into the claims organization.

Oracle Insurance claims solution manages the entire claims process, from first notice of loss (FNOL) to settlement. Insurers can capture all necessary data, manage all the constituencies involved with a claim, and ensure that all adjustment activities, such as reserving and payments, are assigned and completed.

It also offers self-service Web portals where customers and agents can check the status of their claims online. The end result is improved insight and increased customer satisfaction.

Customer snapshot: After implementing Oracle Insurance claims solution, a leading insurer increased claims handling efficiencies by up to 25 percent. The company also achieved a single view of the customer, allowing employees to take informed action during a claims interaction.

Oracle Insurance claims solution provides end-to-end claims handling capabilities, automating much of the claims process and improving resolution times. Unique, built-in training tools and step-by-step instruction guides let adjusters learn procedures quickly and resolve claims efficiently. Oracle Insurance claims solution also provides built-in analytics and other tools to help adjusters easily spot fraud, abuse, subrogation, and salvage opportunities.

Because the Haley Business Rules Engine is embedded in Oracle Insurance claims solution, business analysts can rapidly configure the system, using natural language, to ensure that best practices are followed across the claims organization—with little or no IT intervention.

Customer snapshot: Since deploying Oracle Insurance claims solution, an insurance carrier has saved US $4 million annually—and achieved a 1 percent reduction in loss ratio.

Oracle Insurance claims solution provides solutions for all constituents in the claims ecosystem, enabling fast and easy access to "single source of truth" claims information, claims activity plans, and claim adjusting performance. Built on Oracle's leading Siebel CRM system, Oracle Insurance claims solution gives CSRs and adjusters a complete view of the customer. In addition, Oracle Insurance claims solution provides unparalleled analytics and business intelligence. Managers and executives can easily obtain the information they need to measure the efficiency and performance of the claims department.

Claims systems must integrate effectively with numerous other systems to achieve efficient claims handling. Oracle Insurance claims solution easily integrates with other IT systems, including policy administration and financials, to pull information from across the organization.

Customer snapshot: A wholesale insurer serving other financial institutions integrated Oracle Insurance claims solution with its payment and policy systems, to gain a complete view of its varied customers (financial institutions, general agents, mortgage bankers, lenders and their customers). Leveraging the built-in analytics and reporting in Oracle Insurance claims solution, the company has made mission-critical data available to all levels of users in an ad-hoc, real-time fashion, and achieved a single view of the customer.

• End-to-end automation — Manages claims handling from first notice of loss to settlement with built-in staff productivity and training tools to guide users through the claims process
• Powerful Haley Business Rules — Enables business analysts to rapidly and easily change claims workflow as business needs change
• Leading analytics and business intelligence — Includes dashboards, analytics, and 140+ KPIs that make it easy to spot potential fraud, measure claims department performance, and identify cost-savings
• Leading integration capabilities — Integrates through Web Services, SOA, and other integration methods such as Oracle Application Integration Architecture (AIA) with leading financial systems, such as Oracle's PeopleSoft and Oracle E-Business Suite, to improve funds management and financial accuracy—and reduce the risk associated with integration.
• CRM capabilities on the industry-leading Siebel platform — Gives call-center agents a complete view of the customer, helping them provide better, more consistent customer service
• Web portals for self-service and improved collaboration — Provides self-service options for agents, claimants, and service providers, letting them monitor the status of a claim online
• Unmatched scalability — Provides a true, enterprisewide claims handling system