Organize claim submissionsFocus attention on missing evidenceClarify acceptance status
THE INDUSTRY CHALLENGE
Claims need context, not another disconnected attachment.
Policy applications and claims draw on declarations, identity records and supporting documents supplied at different times. Claims handlers need to understand which records relate to the event under review.
The proposed workflow organizes submission and review without treating extraction as a coverage decision. Policy terms, fraud escalation and settlement authority stay with the insurer.
Incomplete policyholder declarations
Claims evidence separated from the event
Unclear policy acceptance and review history
Illustrative workflow. No live customer integration is implied.
PRACTICAL USE CASES
Where the document journey matters.
Insurance / 01
Policyholder onboarding
Collect records
Authorized review
Retain context
Policyholder onboarding
Challenge Identity and declarations may arrive through several channels.
Proposed workflow Capture supported identity documents and prepare the policy checklist.
Expected benefit Identify missing readings before underwriting review.
This illustrates the intended portfolio journey. Only supported ID Secure capture is available for evaluation today; the connected stages require agreed development and validation.
Proposed handover. Records stay connected to their review context.
01
Receive the policy or claim request
Proposed workflow
02
Collect supporting records
Evaluation: supported document capture
03
Review declarations and evidence
Proposed workflow
04
Authorize the insurance outcome
Proposed workflow
05
Retain the relevant context
Proposed workflow
THE BUSINESS VALUE
Outcomes worth designing for.
01
Organize claim submissions
Identify missing readings before underwriting review.
02
Focus attention on missing evidence
Keep the evidence associated with the claim event.
03
Clarify acceptance status
Make completion and outstanding actions easier to follow.
04
Prepare reviewable claim records
Support consistent retrieval for an authorized reviewer.
Qualitative objectives for evaluation, not measured performance claims.
PROPOSED INDUSTRY SCENARIOS
Picture the work in context.
Proposed scenario
Supporting invoice review
A claims handler compares an extracted invoice reference with the submitted record before continuing review.
Proposed scenario
Policy acceptance follow-up
An operations team locates the final policy agreement and outstanding participant response.
DEPLOYMENT, SECURITY AND GOVERNANCE
Agree the operating boundaries first.
Design the insurance workflow around its records, users and responsibilities.
Confirm Cloud, On-premise or Hybrid support by product. Agree data location and operational responsibilities; the entire portfolio is not already available in every mode.
Roles and approvals
Define who may submit, review, approve and retrieve insurance records. Keep acceptance decisions with authorized personnel.
Evidence and retention
Agree the records needed for enquiry or audit, review periods, legal holds where required, and disposal responsibilities.
Integration and validation
Define system boundaries, reference matching, authentication and failure handling. Confirm local regulatory and customer approvals before rollout.
COMMON QUESTIONS
Plan with the right expectations.
Will document extraction determine coverage?
No. Coverage depends on policy terms and the insurer’s authorized assessment. Extracted readings require review.
Does the proposal detect insurance fraud?
It does not establish a qualified insurance fraud decision. Agree supported checks and evaluate any proposed detector separately.
Can different claim types have different checklists?
Yes. Define evidence requirements for each claim type and preserve the reason when an exception is approved.
Can we retain records after settlement?
Retention and disposal depend on record purpose, insurer policy and applicable requirements. Agree those controls before rollout.
YOUR NEXT STEP
Design a digital trust journey around your business.
Discuss your insurance document volumes, approval responsibilities and deployment preferences with CEBS.
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