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Insurance Claim
Management
Solution

The insurance claim management solution is an application solution which enables the easy and accurate estimation of claim amount by automating complicated claim processes through the management of insurance master data.

Insurance Claim Management Solution Insurance Claim Management Solution Insurance Claim Management Solution Insurance Claim Management Solution

InnoClaimInsurance Claim
Management Solution

InnoClaim is a rule-based insurance claim solution which offers all features needed to handle the claim amount payment process. It ensures the integrity and consistency of task results by integrating all master data and rules used in handling payout estimation processes such as management of payment conditions, management of causes of payment and results management. In addition, it guarantees great performances and stability based on a proven powerful rule engine through multiple clients inside and outside the country.

InnoClaim InnoClaim InnoClaim

Benefits

InnoClaim estimates claim amount in a quick and accurate fashion and at the same time improves work convenience by automating the claim amount payment process.

Benefits Benefits

Features

InnoClaim supports the integrated management of claim amount estimation tasks from coverage unit management to coverage type, payment criteria and payment history.

  • 사고 보장 단위 관리
    Coverage Unit Management

    Manages payment units for the payment of claim amount

  • 사고 보장 유형 관리
    Coverage Type Management

    Manages a coverage type for the payment of claim amount

  • 사고자 관리
    The Insured Management

    Manages the insured for the payment of claim amount Manages additional conditions (e.g., age limit (highest, lowest), etc.) for the payment of claim amount (automatic estimation)

  • 사고 원인 관리
    Management of Causes of Accident

    Manages the causes of accident for the payment of claim amount by type of disease Registers and manages the causes of accident for the payment of claim amount by coverage unit

  • KCD(ICD)관리
    KCD(ICD) Management

    Registers and manages Korean Standard Classification of Disease (KCD) Easy application at KCD revision

  • 산출식 및 산출 기준정보 관리
    Management of Estimation Formula and Master Data for Estimation

    Manages the payout estimation formula in an integrated manner, separated from the system (InnoRules linkage management) Manages master data for payout estimation (e.g., fixed sums, limit, payment rate, etc.), separated from the system (InnoProduct linkage management)

  • KCD(ICD)관리
    History Management

    Records and manages coverage data revision history internally Searches coverage data transfer history

Functional Architecture

API Product Coverage ReimbursementCoveragePool Master DataManagement(Claim) Task RuleManagement (Rule) InnoRules (DDM) SolutionManagement InnoClaim InnoProduct(DPM) Reimbursement ReimbursementCoveragePool Legacy
Reimbursement
Easily extracts and manages reimbursement coverage information pooled through DPM linkage
Master Data Management
Supports the integrated management of claim amount from coverage unit management to coverage type, payment criteria and payment history

Conditions for the insured Causes of accident Results KCD Estimation formula

Task Rules Management
Supports scalable and flexible task rules management through DDM linkage

Rule template Rule development Rule simulation Rule test

Solution Management
Offers diverse convenience features needed for system operation

User management Log management Approval management Transfer management

Application

InnoClaim supports the integrated management of claim amount estimation tasks from coverage unit management to coverage type, payment criteria and payment history.

InnoClaim Legacy Coverage Trigger Management Rule Management Coverage TriggerFactor Analysis Payment Review Estimation InformationInput Submission Collaboration Development of PayoutEstimation Rules · Reimbursementcoverage extraction rules· Claim amountestimation rules History DB Contract DB Accident DB · ComputerReview Rules Insurance Terms AutomaticLoading ClaimBuilder Rule Builder Coverage Trigger Coverage Trigger Designand Development

Cases

Find out why digital innovation is taking place across various industries,
and why many market-leading companies choose INNORULES as their digital innovation partner.