Payment of claim is the ultimate objective of life insurance and the policyholder has waited for it for a quite long time and in some cases for the entire life time literally for the payment. It is the final obligation fo the insurer in terms of the insurance contract, as the policyholder has already carried out his obligation of paying the premium regularly as per the conditions mentioned in the schedule of the policy document. The policy document also mentions in the schedule the event or events on the happening of which the insurer shall be paying a predetermined amount of money.

Shortcoming of the Present procedure

When a claim is made to an insurance company for damage to property, for example, typically an insurance adjustor evaluates the damage and makes an offer of a monetary compensation based upon the owner’s policy and an estimate of cost to repair or replace the damaged item. If the claimant is not satisfied with the insurance company’s offer, the only recourse available is to bring an action against the insurance company, which can lead to mediation, arbitration or full scale litigation. To a greater or lesser degree, all of these options are costly, since they all involve paying fess to highly trained professionals (mediators, arbitrators, lawyers, etc.)

SS-EQUITY (Insurance Claims) Automated Feature

SS-EQUITY (Insurance Claims) has come forward with a desire to provide a system that can negotiate or even mediate a disputed claim between the claimant or the owner of the policy and the insurance company in a more timely, efficient, and cost-effective manner.

Commitment

The system takes into account the open offers and the confidential adjustment criteria and, if possible to the predetermined rule set calculates and displays a settlement amount.

Features

Automated feature permitting a software package to act as the mediator based upon a predetermined rule set. Open offers are made by both sides, but kept secret from the opposing party are criteria by which the offer can be adjusted and still be acceptable to that party.

The settlement process can be synchronous or asynchronous as according to the convenience of the parties.

Repeated e-Negotiation till a resolution is found.

Assistance of Final Facilitator (software inbuilt) can be sought, whose subsequent decision in respect of disputes would be final.

An automatic Agreement would be generated on settlement.