Claim Management
Building a Custom Web-Based Claim Management System for Insurance Providerp>
Timely Service Delivery & Incident Resolutions!!
Summary of the project
ENSoft Technologies partnered with an insurance startup in Mexico to design and develop a web-based Insurance Claim Management System. The client wanted to replace their legacy system with a seamless and automated system for better efficiency and customer satisfaction. We stepped in as a trusted third-party technology partner to transform claims lifecycle, reduce processing times, keeping regulatory standards in mind.
➔ Industry: Insurance
➔ Services: Web-App Development
➔ Client Location: Mexico
Timely Service Delivery & Incident Resolutions!!
Problems Faced by Our Client
The client approached us with a clear need to replace their claims management process, because it had the bellow problems:
● Time-Consuming Manual Processes: Their legacy system relied on manual interventions, creating bottlenecks and delays at every stage of the claim lifecycle.
● Disorganized Data Management: Claims data was scattered across multiple disconnected systems adding difficulty to track progress or extract meaningful insights.
● Customer Dissatisfaction: Policyholders had no way to monitor their claims in real-time which increased repeated inquiries.
● Compliance Risks: The absence of integrated compliance checks left the company vulnerable to regulatory penalties and audits.
● Lack of Scalability: With increasing claim volumes, the existing system faced issues to handle the load which limited the company's growth.
Solutions We Delivered to Transform Insurance Claims Management.
We developed a custom web-based system meeting the client’s unique needs. The key features and functionalities we added were:
Streamlined Claims Submission Functionality
● Designed a user-friendly portal that allowed policyholders to submit claims easily, along with supporting documents.
● Added AI-based document scanning and validation to verify data accuracy automatically.
Automated Workflow Management
● Built an intelligent workflow system that routed claims to the appropriate teams based on claim type, urgency, and complexity.
● Used rule-based validation to check claims against policy details, reducing errors and the need for manual reviews.
Real-Time Updates and Transparency
● Implemented a tracking dashboard for policyholders to monitor their claim status at every stage.
● Introduced automated notifications via email and SMS for critical updates like the claim approvals and settlements.
Timely Service Delivery & Incident Resolutions!!
Solution We Delivered to Address the Challenges
Integrated Compliance Checks
● Developed a compliance module to ensure every step of the claims process meeting the regulatory requirements.
● Implemented an audit trail system to record all actions, simplifying internal and external reviews.
Advanced Reporting and Analytics
● Added a reporting dashboard that provided actionable insights into claim trends, processing times, and performance metrics.
● Gave the management team an ability to optimize resource allocation and predict future trends effectively
Timely Service Delivery & Incident Resolutions!!
Tech Stack We Used To Build the System
● Frontend: React.js for an interactive and intuitive user interface.
● Backend: Node.js with Express.js for efficient server-side operations.
● Database: MongoDB for flexible and secure data storage.
● Cloud Services: Amazon Web Services (AWS) for scalable hosting and deployment.
● Third-Party Integrations: Twilio for communication and Stripe for integrated payment processing during claim settlements.
Quick look at Implementation Phases
★ Discovery and Planning
★ Agile Development
★ Seamless Deployment
Positive Results Our Solution Unlocked With our solution, the client was able to achieve the following results:
✔ Faster Processing Times
The claim resolution time reduced to drastic 60% allowing quicker payouts and better customer satisfaction.
✔ Operational Efficiency
Automated workflows cut manual interventions by 75%, freeing up employees to focus on complex and high-value tasks.
✔ Improved Customer Experience
The tracking portal and real-time updates reduced customer complaints by 40% and increased positive feedback ratings.
✔ Enhanced Compliance
The integrated compliance module ensured the client met all regulatory requirements, mitigating risks and simplifying audits.
✔ Scalable Infrastructure
The system now handles 2x the previous claim volume effortlessly, preparing the company for future growth.
✔ Data-Driven Decision-Making
The analytics dashboard empowered the client’s leadership to monitor KPIs and address bottlenecks proactively.
Timely Service Delivery & Incident Resolutions!!
What Client Said About Our Work?
“Team of NSoft really transformed our whole claims management with a web platform. Our claim resolution time has decreased by 60% and overall manual interventions dropped by 75%. Their integration is seamless and gives real time updates. Our customers and employees enjoy using our platform.”
