Claims Management System

Claims Management System

Technologies & Tools:

PHP: PHP 5.6, PhpStorm 2016.2, Symfony 2.7+, DoctrineORM 2.2+, Extjs 6.0+

.NET: WIA (Windows Image Acquisition), TWAIN

Server Configuration: RedHat 6, Nginx 1.8, MySQL server 5.6, Elasticsearch – 2.3.5, Openoffice – 4.4.2, Java 8

Customer

The customer is a European company that specializes in integration of technology, solutions and services for intelligent transportation systems.

Challenge

The customer had a claim processing procedure that involved complicated algorithms and required a great amount of manual work performed by employees. The challenge was to build a web-based platform which would optimize business processes and offer a number of additional advantages, such as:

  • Reduced time required to provide a response;
  • Improved response quality with decreased human factor risks;
  • Simplified claims filing process;
  • Reduced number of staff required to work with claims by automating decision-making process.

The system was supposed to include claims registration and claims processing functionality with extended admin dashboard to allow creating and managing automatic claim processing workflows.

Moreover, the system had to allow the customer’s employees to perform the following activities:

  • Managing claims processing workflows;
  • Generating automatic claim decisions in printable format;
  • Attaching documents to claims from web UI via implemented scanning tool (single and multiple page scanning capability);
  • Search for registered claims with different statuses;
  • Generating various KPI reports.

Since the customer’ infrastructure was very outdated, the system had to be optimized for stable work on low-performing PCs with older versions of Internet Explorer (IE 8 +).

SOLUTION

create-new-claim

OCSICO, as an experienced software development company skilled in the fleet management solutions field, has been chosen to build the solution. The new system was developed in three phases that are further described below.

1. User experience analysis and design.

  • Completed by UI designer and business analyst working hand on hand with the customer’s team. Clean interface was developed and system requirements document was prepared.
  • Lead technical specialists created technical design and processing algorithms, employing required libraries and technologies.

2. Development of the system.

Database development. Development team started with database development, user roles system, data access and processing workflow. The main challenge was the development of manageable workflows with user-friendly interfaces. OCSICO implemented a custom solution that allowed administrators to easily manage rules and algorithms within graphical interfaces, along with drag and drop capability.

Scanning solution. Scanning application was the next functionality to develop. One of the requirements of our customer was to run the scanning process by utilizing web UI with automatic uploading and attachment of scanned documents to claims without using the browsing option. It was implemented by developing a desktop .NET application that would be installed on operators’ PCs. WIA (Windows Image Acquisition) and TWAIN were used for this purpose. Application’s installation and auto update solution was also developed.

dev-of-sys

Web application. Web application development then started. UI and business logic for claims registration and processing were developed. The main challenge during this stage was to optimize web application for older browser versions (Internet Explorer 8+) and make it stable on low-performing PCs. Web application was freezing and its overall performance was unstable under IE 8 and 9. OCSICO solved these issues by displaying web forms in simple HTML using current back-end API methods, simple views and minification of JavaScript and CSS files.

Claims search function was developed using ElasticSearch. The service featured fast auto-complete look-up functionality for finding claims, including searching the archive. Advanced search by various parameters was implemented as well.

OCSICO development team has also created a mechanism for finding and importing claim-related information from external customer’s systems.

Ability to check whether a registered claim has a double record and ability to manage different selections were also implemented.

The developed system allowed exchanging of additional claim-related information between various company’s departments. All additional info request tickets were processed within the system.

Claim processing included step-by-step claim decision making (done automatically by the system with a possibility to add comments and make adjustments by appropriate users). It was also possible to return a claim back to the originator and request specific adjustments.

During claim processing, each claim was assigned to appropriate employee according to user role, responsibility and department within the company.

Possibility to automatically combine same decisions for sub-claims into a single response was also developed. Once the final decision was generated and approved, it could be easily printed, if needed.

Since multiple departments were involved in the process, the system had to feature different permissions and dashboards. Each department member was only able to review the information appropriate for his role in the company.

Finally, a back-end web dashboard was created for users with admin privileges. Administrators were able to manage users/roles/permissions, setup e-mail notifications with rules and tags, set and edit claims classifications, manage templates for answer generation, manage departments and their assigned user roles. They were also able to tune decision-making algorithms by utilizing graphical interfaces with drag and drop option. Various reporting functionality with built-in filters and an export feature were developed for admin and regular users.

3. System stabilization and user guides creation.

  • OCSICO quality assurance crew worked together with the customer’s team on functional, integration, compatibility and security testing.
  • Finally, the customer’s staff training was conducted by OCSICO team.

RESULT

OCSICO has developed a claim management system that integrated user’s web-interface, administrative functionality, search service and a scanning application. The developed solution was successfully delivered and implemented.

As a result, the customer was now able to utilize all of the software’s functionality without any lag, and all of the business processes were greatly optimized. The number of staff required to work with claims has been optimized and the entire claims filing procedure has become a simple, efficient and high-quality process.

Please submit a short project request, and our account managers will get back to you within 24 hours to discuss our future cooperation.
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