BUSINESS CAPABILITY MAP - P&C Claims Services

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Description	EN:  P&C Claims Services group all specific capabilities related to detecting fraud, managing recoveries, handling complaints, and settling P&C insurance claims effectively. FR: La  Gestion des sinistres IARD regroupe toutes les capacités spécifiques liées à la détection des fraudes, à la gestion des recouvrements, au traitement des plaintes et au règlement efficace des réclamations d'assurance P&C.
Name (FR)	Gestion des sinistres IARD
Implementing Functions	P&C Production
Packaging Library	Insurance

TREE VIEW

•    P&C Claims Services

   P&C Claims Services group all specific capabilities related to detecting fraud, managing recoveries, handling complaints, and settling P&C insurance claims effectively.

  •    Complaints Handling & Monitoring (*)

    Involves tracking and updating claims while ensuring clear communication with the insured. The goal is to resolve claims promptly and transparently, ensuring customer satisfaction.

  •    Fraud Prevention (*)

    Aims to detect and prevent fraud by analyzing claims and verifying information. The service includes using detection tools to identify irregularities. The expected result is to reduce fraud-related losses, maintaining process integrity.

  •    P&C Claims Settlement

    Finalizes indemnity payments after claim assessment and validation of amounts owed. The service includes communication with the insured and execution of payments. The expected result is to efficiently close claims files, with prompt and contract-compliant payments.

    •   =>   Bodily Injury Compensation

      Type of P&C Claims Settlement that includes handling claims and paying compensation for bodily injuries caused by a loss. This involves coordination with insured parties and medical professionals to assess the damages. The expected outcome is fair and prompt compensation for victims.

    •   =>   Property Damage Compensation

      Type of P&C Claims Settlement that involves assessing and paying compensation following a property-related claim (fire, theft, etc.). This includes analyzing damages and determining compensation amounts. The expected result is timely payment aligned with the insured property's contractual coverage.

    •   =>   Victim Compensation (Liability Claims)

      Type of P&C Claims Settlement that involves handling liability claims by identifying responsible parties and compensating victims. This includes analyzing the facts and determining liability. The expected result is fair compensation for victims and reduced disputes for the insurer.

  •    Recovery & Subrogation (*)

    Involves recovering amounts owed from third parties responsible for claims, such as other insurers. The service includes analyzing recovery opportunities and necessary legal steps. The expected result is to recover owed funds, thus reducing the insurer's claim costs.

MAP VIEW