Maximize Your Claims Management Potential

Claims for L&AH offers flexible, simplified, and straight-through processing (STP) first automation capabilities, allowing insurers to streamline the entire claims lifecycle for a wide range of insurance products. Experience advanced claims management features, including end-to-end processing, appeals management, and a comprehensive 360-degree dashboard. Our platform helps deliver exceptional customer experiences through digitally-enabled claims handling and empower claims adjusters to meet the evolving expectations of policyholders.

FLEXIBLE, SIMPLIFIED CLAIMS

Automate and streamline the entire claims process, including eligibility checks, benefit applicability, claims summary, and post-submission claim form editing for a wide range of insurance products such as dental, life, vision, accident, long-term care, disability, critical illness, hospitalization, and more. Benefit from a flexible, simplified, STP-first, and automated claims operating environment that offers extensive calculation and payout options for benefit amounts, payment schedules, adjustments, overpayments, delayed claim interest, and OFAC checks.

LEVERAGE ADVANCED CLAIMS MANAGEMENT

Utilize end-to-end claims management, from intake to settlement and payment. Manage appeals, reopen claims, hold/release claims, void claims, resubmit claims, and archive claims efficiently with single-point-of-change functionality. Access a comprehensive 360-degree dashboard for each claim, allowing a unique cross-LOB claim view, effective discrepancy management to align claim data with policy, and an event center to monitor claims timelines and action plans.

DELIVER EXCEPTIONAL CUSTOMER EXPERIENCES

Provide customers with end-to-end, digitally enabled claims handling that meets their expectations and future demands. Enable case-driven straight-through processing, exception workflow, and support for various engagement channels. Empower claims adjusters with a highly configurable and business rules-driven platform to meet the demanding expectations of customers.

Exceptional Claims Management from Intake to Settlement

Deliver responsiveness, customer value, and business process improvements.

Manage intake, settlement, payment, appeals, reopen, hold/release, void, resubmit, and archiving processes.
Integrate systems to enhance the flow of information across departments.
Store everything electronically on one central platform, eliminating paper files.
Provide support for Short-Term Disability (STD), Long-Term Disability (LTD), Life (Whole, Term, and Universal), Accidental Death and Dismemberment (AD&D), Life Waiver of Premium Critical Illness, Hospital Indemnity, Accident, and Cancer.

Case-Driven Management with Straight Through Processing

Automate and streamline case management through always-on processing.

Utilize a flexible, simplified, STP-first, and automated claims operating environment.
Automate and streamline claims from eligibility check, benefit applicability, and claims summary to post-submission.
Configure workflows and tasks to ensure your team focuses on complex decision-making rather than manual administrative duties.
Gain better insights to make data-driven decisions.

Case-Driven Management with Straight Through Processing

Automate and streamline case management through always-on processing.

Utilize a flexible, simplified, STP-first, and automated claims operating environment.
Automate and streamline claims from eligibility check, benefit applicability, and claims summary to post-submission.
Configure workflows and tasks to ensure your team focuses on complex decision-making rather than manual administrative duties.
Gain better insights to make data-driven decisions.

Better Claims Outcomes

Utilize built-in, rules-based best practices, workflows, and third-party integrations.

Assign the right claims to the right people at the right time to improve claim outcomes.
Improve the accuracy and timeliness of claim decisions.
Manage discrepancies, monitor timelines, and create action plans.
Monitor claims timelines and action plans through the event center.

Majesco Billing for L&AH

by Majesco Software and Solutions India Private Limited