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Pain points

Paying claims in the open market

Unstructured and inconsistent data

Data sheets

Notification of loss, policy matching and verification

  • Customer making a claim on a laptop
    Customer makes a claim

    There is no specific format or process in place for customers to share information with brokers

  • A man holding a document while sat a desk with a computer
    Broker submits the claim with supporting documents

    Claim data submissions are unstructured and inconsistent, and received in multiple formats; the ECF has data gaps and unnecessary fields

  • A man on a computer with a claim and policy document above
    Claim is matched against the relevant policy

    Claim data is captured in different ways and formats making it difficult to match premium against policies

  • A woman checking things on a computer
    Policy and premium verification checks are performed

    Manual reconciliation of multiple data sources (i.e. policy information from LIDS and PoSH, and premium information from LPANs) against the claim data

Triaging, routing and assignment

  • A man receiving a notification on an iPad
    Lead underwriter and claim agreement party(ies) are notified of the claim (if required)
    Pain point not applicable to this step
  • Two people on computers with a checklist above them
    Lead underwriter and claim agreement party(ies) are assigned claims tasks

    Lead underwriter and claim agreement party must rekey data into multiple systems i.e. into their own systems and centrally into the ECF

Agreement

  • A man on the phone at a desk
    Query management and requests for additional information is undertaken (if required)

    There is no single source of truth or repository for data and documents required to support the investigation; and there is no record to support an audit trail

  • Two people shaking hands at a desk
    Lead underwriter and broker negotiate, and agree or deny the claim
    Pain point not applicable to this step

Digital processing

Settlement and claims payment

  • A woman doing technical checks on three computers
    Technical processing checks conducted to review and finalise the claim
    Pain point not applicable to this step
  • Funds being sent from one person to a computer to another person
    Funds or fees are moved
    Pain point not applicable to this step

Pain points

View the pain points the new digital solutions are addressing for paying claims in the open market.

Man scratching his head with paper flying around

Manual intervention, re-keying, and lack of automation

Woman and Man blindfolded holding puzzle pieces

Lack of visibility, transparency, and collaboration

Man going through step by step flow

Claim tasks must be completed sequentially

A man checking his watch in front of a clock

Delays in claims processing, payments, and movements of money to customers

Solutions

We’re delivering several solutions which are transforming how we’re paying claims in the open market. Learn more about these solutions, including our progress, benefits and where to find out more.  

A yellow badge with a tick

ACORD Data Standards

ACORD technical data standards will be used to populate the Core Data Record (CDR) and other key data. 
A database

Core Data Record (CDR)

A set of standardised, quality transactional data, that powers downstream processing.   
A computer with a document, a badge and a settings icon on it

Digital Processing Platform for claims (ICOS)

A digital claims processing service which can automate processes.

Related steps

Journey overview

A high-level overview of the journey including associated pain points and solutions. 

Detailed steps

A detailed view of the journey, showcasing the technology that’s involved in each step.
Previous Lack of visibility, transparency, and collaboration
Next Claim tasks must be completed sequentially
Get adoption ready

Blueprint Two will be delivered in two phases. At phase one cutover, all market firms must adopt the new digital services.