Solutions

Digital Processing Platform for claims (ICOS)

A digital claims processing service which can automate processes

Develop – In progress

What is the Digital Processing Platform for claims (ICOS)?

The Digital Processing Platform for claims, previously referred to as ICOS (International Claims Orchestration Service), is the core digital solution which enables automated validation of claim submissions against policy information, leveraging the Core Data Record (CDR).

A computer with a document, a badge and a settings icon on it

Benefits

Accurate and faster claims settlement processes

Enables faster claims settlement with a reduction in errors, duplication and queries.

Real-time digital orchestration service

Automates the claims process and supports integration with broker and insurer systems.

Improved operational efficiency

Removes standing legacy issues, with flexibility for future improvements to the platform.

Standardised and structured data

Increases automation of workflow by using a single source of structured data.

User journey

The Digital Processing Platform is used in both the open market claims and delegated authority claims journey. 

Open market claims 

Notification of loss, policy matching and verification 

  • A man making a claim on his laptop
    Customer makes a claim
    ICOS not applicable to this step
  • A man holding a document while sat a desk with a computer
    Broker submits the claim with supporting document

    Broker will be able to submit a FNOL via an ECOT message sent through an API from their broker system or directly via a portal, enabling faster submission and standardised data capture

  • A man on a computer with a claim and policy document above
    Claim is matched against the relevant policy
    ICOS not applicable to this step
  • A woman checking things on a computer
    Policy and premium verification checks are performed
    ICOS not applicable to this step

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)

    The lead underwriter and claim agreement party will be immediately notified once the FNOL is submitted, and the policy is matched and verified

  • Two people on computers with a checklist above them
    Lead underwriter and claim agreement party(ies) are assigned claims tasks

    Future potential for claims triaging to be automated through a rules engine – enabling automatic assignment of claims, automation of simple tasks, and the ability to action parallel activities

Agreement

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

    Broker and relevant insurers will have the ability to view queries and interact directly through a portal or via an API to their respective systems; enabling greater transparency, faster response times and query resolution, faster payments to customers

  • Two people shaking hands at a desk
    Lead underwriter and broker negotiate, and agree or deny the claim

    Claims will be negotiated and agreed centrally through the Digital Processing Platform (ICOS). All parties will engage via the Digital Processing Platform (ICOS) either directly through a portal, or via ECOT messaging through APIs from their respective systems; enabling enhanced audit trails and improved transparency

Digital processing

Settlement and claims payment 

  • A woman doing technical checks on three computers
    Technical processing checks conducted to review and finalise the claim

    The lead underwriter and claim agreement party will be immediately notified once the FNOL is submitted, and the policy is matched and verified

  • Funds being sent from one person to a computer to another person
    Funds or fees are moved
    ICOS not applicable to this step

Delegated authority claims 

First notification of loss (FNOL)

  • Customer making a claim on a laptop
    Customer makes a claim to the delegated claims administrator
    ICOS not applicable to this step
  • Money being sent from one person to another
    Delegated claims administrator approves the claim and initiates the payment, if within approval limits
    ICOS not applicable to this step

Delegated claims administrator reporting 

  • Man looking at payments on laptop screen
    Delegated claims administrator adds a record of the claim payments made within the month as part of the bordereaux
    ICOS not applicable to this step

Bordereaux processing

Agreement

  • A man at a desk on a computer
    A bordereaux approval transaction is created for agreement
    ICOS not applicable to this step
  • A woman at a desk on a computer with an eye, question mark, and tick icons above her
    Insurer reviews the transaction, will raise any queries, and then agrees it

    Insurers agree the transaction in the Digital Processing Platform (ICOS) via APIs or within the platform itself via a new portal

Bordereaux processing

Digital processing and replenishment of funds

  • A woman doing technical checks on three computers
    Technical checks are completed for accounting purposes

    All submissions can be accessed through the Digital Processing Platform (ICOS) reducing rekeying into numerous systems and providing visibility in one central platform to perform checks

  • Transfer of money between two people on computers
    Fund transaction is created, funds are replenished if required and the monies are moved accordingly

    The Digital Processing Platform (ICOS) enables better tracking of financials as the ledger record can be tracked and there is a record of all payments

Reconciliation 

  • Woman looking at laptop screen
    Insurer reconciles incoming accounting transactions

    Reconciliation in the Digital Processing Platform (ICOS) will enable greater control of funds, better visibility of financial positions and lead to reduced queries

Progress update 

What's been delivered
  • Velonetic’s new global premiums and claims processing service (sequence two) is live and in-service, utilising this service lays the foundation for the build of the new London market and delegated authority premiums and claims processing services (sequence three and sequence four) 

  • The Application Programming Interface (API) schedule has been updated to reflect the availability of London market contract specifications from Q1 2023 to Q1 2024

What we’re working on right now
  • Building the new London market premiums and claims processing service (sequence three) and the new delegated authority premiums and claims processing service (sequence four) as part of the cutover to phase one digital processing services in July 2024 

  • Defining the Digital Processing Services Agreement (DPSA) framework with market participants and customers, including service definitions and pricing approach 

  • Working closely with vendors, (including accredited placing platforms) to raise awareness of technical changes needed, and ensure timelines are aligned for the cutover to new digital processing services in July 2024  

  • Defining and agreeing the deployment approach, and contracting for the delivery of market testing, to support the ability for firms to adopt a full digital approach using the Digital Gateway (sequence five) from April 2025

Find out more about the sequence build of the core digital solution