- Overview of Oracle Insurance Claim Management
- Overview of Oracle Insurance Claim Management
- Oracle Insurance Claim Management (ICM) Process Accelerator is a process solution, based on the adaptive case management framework, which enables organizations to create and process insurance claims. Oracle ICM provides dashboards to view process analytics and claim summary reports. Administrators can modify the business rules and the drop-down lists.
- Oracle ICM is a role-based solution; your role determines the activities you can perform. Oracle ICM delivers the following roles:
- The customer service representative creates a claim and dispatches emergency services, if needed.
- The case manager is the primary claim owner responsible for validating the claim, assigning a field adjuster if needed, and negotiating a settlement.
- The field adjuster assesses damage and provides estimates, if needed.
- The fraud investigator investigates fraudulent claims.
- Because Oracle ICM is based on the adaptive case management framework, there is no single BPM process model to dictate claim processing. Claims are processed based on the activities performed by each role, and the defined business rules. Activities are performed on an adhoc basis depending on the circumstances of a claim. Some activities are repeatable due to the adaptive case management framework; while others are performed once. The Claim Status table provides the details for each status, the case activity, the role, when the activity changes to the next phase, and if the activity is repeatable.
- Claim Status