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MetaMorphoSys Claims Platform

oleh METAMORPHOSYS TECHNOLOGIES PRIVATE LIMITED

Unified Claims Platform for Life and Health Insurance Covering Retail and Group Products

MetaMorphoSys Claims Platform is a client centric end to end claims management solution which manages the entire process from claims intimation to payment for both life and health claims. It handles both individual and group claims with integration to policy admins like Life Asia, Group Asia, Ingenium, eBao and other integrations like OCR, CRM , Payments Gateways, Single Sign-on etc for a seamless unified experience to claims users. With Over 200+ Man Years of Expertise, 18 Engagement's Executed and over 500+ Insurance Products Configured, the MetaMorphoSys Value Proposition focusses on an outcome-based implementation approach.
The platform is completely cloud-based supporting micro services architecture which has APIs for various Claims functions, Dashboard Analytics, STP processing, ML based fraud identification and real-time integrations for customer verification & KYC.
Key Features & Functionality of the Claims platform are:
- Claims Configurator & Benefit Calculator
- Claims Intimation
- Pre-Authorization & Claim Registration
- STP Engine for Auto Adjudication
- Claim Workbench for Manual Adjudication
- 360 view of Customer
- Claim Payments
- Claims Investigation
- Claims Reports & Dashboard
- Claims Communicator
- Fraud Analytics
Product Lines Supported in our Claims Platform: Life Insurance: Whole Life, Endowment, Universal Life, Unit Linked, Term Plans, Critical Illness, Term Riders, Accidental Disability, Waiver of Premium, Maturity and Total Permanent Disability Health Insurance: Indemnity (Inpatient Hospitalisation / Re-imbursement, Individual Floater, Corporate Floater, Critical Illness, Personal Accident, ,Outpatients (OPD),Dental, Micro Insurance, Travel Health and Hospital Daily Cash anent Disability.
The platform is architected as a completely micro services-based API platform with a claim's workbench designed to cater to the challenges of the claim users, adjudicators and investigators. Some of the key benefits of the platform are:
- STP engine for auto adjudication of claims
- Unified claims engine for individual and group claims
- Improved Consistency, Control and Accuracy
- Improved Productivity and Efficiency of Claims Team
- Empower Channels and Agents to effectively Register Claims
- Reduce Loss Ratio
- Improve TAT and Reduce Cost
- Improved Customer Experience (Customer Centric Approach)

Sekilas

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