ENTERPRISE FUNCTION - P&C Production
| Description | EN: The P&C Production governs the lifecycle of property & casualty insurance delivery, from policy issuance to claims closure. It integrates policy management and claims operations to maintain service quality, optimize loss ratios, and ensure regulatory and customer standards. FR: La fonction Production/exploiration IARD gère le cycle de vie des prestations d'assurance dommages, de l'émission des polices à la clôture des sinistres. Elle intègre la gestion des polices et les opérations de sinistres afin de maintenir la qualité de service, d'optimiser les ratios de sinistralité et de garantir le respect des normes réglementaires et des normes clients. |
|---|---|
| Name (FR) | Production/exploiration IARD |
| Related Capability Maps | 
P&C Policy Services
P&C Claims Services |
| Packaging Library | 
Insurance |
FULFILLED CAPABILITIES
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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P&C Policy Services P&C Policy Services group all specific capabilities related to administering property and casualty insurance policies, managing insured portfolios, and mitigating catastrophic risk.
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Catastrophic Risk Management
Identify and manage risks related to natural or industrial disasters (fires, floods, earthquakes) to minimize losses.
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Insured Portfolio Management (*)
Analyze, monitor, and optimize insured portfolios to ensure a balance between profitability and risk exposure.
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Insurance Product Profitability
Assess the financial performance of insurance products by analyzing loss ratios and technical margins.
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Monitoring of Solvency Reserves
Involves monitoring and adjusting technical reserves to ensure the insurer’s ability to meet future obligations in compliance with regulatory requirements.
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P&C Policy Administration & Monitoring
Oversee and coordinate all actions related to the lifecycle of insurance contracts, from implementation to renewal, ensuring regulatory compliance, policyholder satisfaction, and continuous alignment between coverage, risks, and client expectations.
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Contractual Rights Administration (*)
Encompasses all operational activities aimed at managing, monitoring, and updating the rights and obligations of stakeholders (insurer, policyholder, beneficiaries) throughout the life of the contract.
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Insurance Asset Monitoring
Ensures dynamic management of covered assets by maintaining an up-to-date inventory of insured properties (homes, professional equipment, inventory, etc.) and coordinating regular assessments with experts. Ensures a constant match between the asset characteristics, their real value (replacement/market value), and the subscribed contractual coverage.
MAP VIEW
P&C Production
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.
P&C Policy Services P&C Policy Services group all specific capabilities related to administering property and casualty insurance policies, managing insured portfolios, and mitigating catastrophic risk.
-
Catastrophic Risk Management
Identify and manage risks related to natural or industrial disasters (fires, floods, earthquakes) to minimize losses.
-
Insured Portfolio Management (*)
Analyze, monitor, and optimize insured portfolios to ensure a balance between profitability and risk exposure.
-
Insurance Product Profitability
Assess the financial performance of insurance products by analyzing loss ratios and technical margins.
-
Monitoring of Solvency Reserves
Involves monitoring and adjusting technical reserves to ensure the insurer’s ability to meet future obligations in compliance with regulatory requirements.
-
-
P&C Policy Administration & Monitoring
Oversee and coordinate all actions related to the lifecycle of insurance contracts, from implementation to renewal, ensuring regulatory compliance, policyholder satisfaction, and continuous alignment between coverage, risks, and client expectations.
-
Contractual Rights Administration (*)
Encompasses all operational activities aimed at managing, monitoring, and updating the rights and obligations of stakeholders (insurer, policyholder, beneficiaries) throughout the life of the contract.
-
Insurance Asset Monitoring
Ensures dynamic management of covered assets by maintaining an up-to-date inventory of insured properties (homes, professional equipment, inventory, etc.) and coordinating regular assessments with experts. Ensures a constant match between the asset characteristics, their real value (replacement/market value), and the subscribed contractual coverage.
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