Claims Management
Overview
Documentation
Claims
Claims Management demonstrates how Mendix can be used to improve customer engagement and process efficiency. The B2C responsive web app helps guide customers through a claim process for vehicles or luxury goods.
The Claims app and quote and buy app are linked, via Data Hub, allowing you to claim on the goods and vehicles covered during the Quote and Buy Journey. It also demonstrates a multi-stage workflow, speech-to-text and a chatbot supported with AWS Lex.
How to setup
The application is available both as a demo environment and as a starter app. You can find the demo environment here: https://mendixinsuranceclaimsportal.mendixcloud.com
To create your own version, the Claims application is available via the create new app flow on the Marketplace. The Model is built using Mendix 9 and we will try to ensure it's on the latest version of the product.
This application is dependant upon an instance of Quote & Buy for it’s information. By default new applications will connect to the acceptance demo of Quote & Buy hosted by Mendix. Instructions are included in the onboarding process for how to change this to your own instance.
To use speech-to-text and the chatbot functionality an AWS account will be required. Details for how to setup this functionality is also in the on boarding process.
Feel free to customize this application to suit your needs. The following steps will help you provision the Claims app.
- Find the app via the create new app flow
- Edit in Studio or Studio Pro
- Follow the onboarding process on first run to setup sample data and API key
Roles
The application has seven roles:
- Anonymous
This is the role used by customers to make a claim. They are not required to log in, for expediency in case of an emergency, and can find a policy created on Quote & Buy via reference or e-mail and zip code.
- Claims Investigator
The claims investigator is the first point on both valuable and vehicle claims and is responsible for assessing the validity of a request.
- Damage Appraiser
In the case of a vehicle claim a damage appraiser can review the damage reported on the claim, estimate the cost of repairs and labour, and classify the damage type. They can also add notes to the claim.
- Claims Negotiator
The role of the negotiator is to establish which party is at fault and to determine the value of the payout.
- Finance Officer
The final step in the workflow, in the case of an at fault payout, is the finance officer who is responsible for indicating when the payment has been completed.
- Administrator
The final role is the administrator who has an overview of all the information in the system and access to configuration options
Customer journey
The steps involved in the main process are in the ClaimsHub Module -> Claims.
Find your policy
To begin a claim a customer first needs to find a policy within the supporting system. This can be done via the policy reference or the email address and zip code associated with a policy.
After this the claims process diverges to support vehicles and valuables.
Vehicles
Step 1: Incident information
Basic information about the claim such as the type of claim, and when and where it happened.
The location can be provided via geolocation for an incident which has just occurred, and this will establish the long/lat of the customer’s current position.
Step 1b: Other parties
If the customer says other parties were involved in step 1 then the details of those parties are gathered here.
Step 2: Damages information
In the case of a damage or fire claim at this point a customer can indicate where on the vehicle damages have occurred and uploading supporting images and notes.
Step 3: Additional information
A description of the incident
Valuables
Step 1: Incident information
Basic information about the claim such as the type of claim, and when and where it happened.
Step 2: Assets
The customer can now select which items on the policy are involved with claim and any additional information in the case of damages.
Step 3: Anything else
A supporting statement for the claim.
Summary and confirmation
The customer is shown a summary of all the information before the claim is submitted to the workflow process and they are provided with a claims reference.
Chatbot
The chat bot, once configured, is accessible from the bottom right of the home screen. On the demo site it will reply to the question, “What is the status of my claim?”. The customer is then prompted for their claim number and, once a response matching the pattern is received, it will send a flag to the system to respond to the custom with the status of the relevant claim.
Claim handler dashboard
The claim handler dashboard provides a bespoke view of the tasks available to all claim handler roles. This allows claims handlers to assign available steps to themselves and carry out their part of the workflow process.
Admin dashboard
The admin dashboard shows an overview of the current claims in the system including those which are in progress and a chart displaying the average claim handling time. A administrator can also see any high value claims approvals they are currently working on.
Workflow
There are two workflows in the claims system; one for valuables and one for vehicles. These can be found in ClaimsHub -> Workflow -> Valuables/Vehicles. The appropriate workflow is triggered when a claim is submitted.
The domain model
The domain model hinges on the Data Hub and pulling data from the Quote & Buy system. As such, most of the entities relate to the OData exposed from there. The new entities in Claims are related to the workflow process and are split between Vehicle claims and Valuable claims. All of the key entities are within the ClaimsHub modul.