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Claims Management System - RiverStone

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Overview

DOCOsoft is a market-leading provider of award-winning claims management, analytics, and workflow software solutions for the global (re)insurance and financial services markets. Many of the world’s leading carriers rely on DOCOsoft to deliver the mission-critical claims services on which their balance sheets and reputations depend.

The DOCOsoft CMS handles claims worth more than £15 billion annually, for a client community that includes a third of the Lloyd’s market. Half of all claims messages in London go through the DOCOsoft CMS, which handles more than 17,000 claims messages a day.

With more than 20 years’ deeply immersed hands-on experience, DOCOsoft is widely acknowledged as the Lloyd’s and London Market’s best respected, hardest working, most knowledgeable claims software provider.

The strength of its reputation is reflected in DOCOsoft’s stable and expanding top-tier client base, which includes: AXA XL, Starr, Markel International, Managing Agency Partners, Faraday, Talbot AIG, AXIS Specialty, AEGIS, Munich Re Syndicate Limited, SCOR Channel, W. R. Berkley, Enstar, The Hartford, Chubb, Canopius, Apollo, Berkley Re, Dale Underwriting, Argenta, and Ark Underwriting.

DOCOsoft’s innovative cost-effective solutions are continuously improved to keep pace with a fast-changing global (re)insurance market and to leverage the possibilities created by new technological developments.

Since 2015, DOCOsoft has been closely involved in harnessing and extending the innovative Writeback functionality that connects carriers’ systems with the market’s central claims systems. More recently, DOCOsoft has been leading the way among vendors as it engages proactively with the practicalities of Blueprint Two to ensure it clients derive maximum benefit and experience minimum disruption from London’s digitisation initiative.

Developed in close consultation with its users, DOCOsoft’s highly configurable user-friendly claims management system (CMS) delivers a compelling array of benefits including significant cost efficiencies and powerful analytics solutions.

DOCOsoft’s core CMS product frees carriers from the inefficient and unreliable technology that held back their claims teams in the past. The DOCOsoft CMS abolishes the laborious manual processes and duplication of effort that characterises other systems and delivers game-changing added value and competitive advantage with an exceptional range of tangible benefits that includes

  • Cutting claims handling turnaround times by up to 50%
  • Saving at least 10 minutes per transaction
  • Saving up to 625 person-days per annum (for a typical claims team handling 30,000 claims
  • Replacing as many as 18 actions across seven different systems and eight separate processes, to handle a single claim
  • Enabling 24/7 claims response activity.

Users of DOCOsoft’s market-leading CMS also benefit from a development pipeline that continuously adds new functionality, connectivity and efficiency, reducing down-time, enhancing data-capture quality, and better supporting compliance procedures. DOCOsoft is continuously embedding innovative analytics capabilities into its CMS, enabling helping its clients gain strategic, competitive and cost advantages.

As they face global competition, data overload, stringent regulatory, risk and compliance requirements and radically changing consumer behaviours, (re)insurance carriers need a dependable, responsive and innovative claims technology partner more than ever. DOCOsoft is that partner.

DOCOsoft has won the London Market Technology Initiative of the year award, the National Fintech Award and the Irish Times Innovation Award in the FinTech Category. DOCOsoft was awarded the ACORD Case Study Award.

DOCOsoft is certified for ISO 27001 and is a registered member of ACORD, providing certified solutions to the London Market.

DOCOsoft is an Associate member of the Lloyd’s Market Association (LMA) and the International Underwriters Association (IUA).

Key Features

DOCOsoft's key features include the following:

Cost effective Solution

We understand the business you’re in, so we can help you reduce the overall technology cost due to frequent changes in industry trends. We give you a cost-effective solution to automate routine and unproductive tasks, freeing many days of expert adjusters’ time to focus on more important tasks like maximizing overall productivity as part of continuous improvement. Our solutions offer excellent value for money with an assured early return on investment.

Automated intelligence

Our constantly evolving CMS (and the specialist modules that complement it) keep you ahead of the game, flexing to deliver what you want, when you need it. At DOCOsoft we’re focused on leveraging the power of AI and machine learning to help you optimise your claims performance. Our best-in-class software delivers game-changing data analytics capabilities - giving you the insights you need to outperform your competitors.

Cutting through complexity

Our user-friendly, customisable screens give users total oversight of all activity, making easy work of monitoring and decision-making. As a DOCOsoft CMS user, you’ll always have the information and the insight you need, right there at your fingertips. We give you the tools you need to negotiate today’s complex and fast-moving claims environment with confidence.

A partner you can count on

DOCOsoft has a long track record of working with many of the world’s leading (re)insurers, When you partner with us, you benefit from a level of engagement and customer support you simply won’t get from any other technology vendor. We work closely with our clients to build the solutions they need to take both challenges and opportunities in their stride.

Integrated Platform

Our claims technology provides a complete integrated solution that replaces outdated legacy systems and technology that provides a customizable full-life-cycle claims solution that integrates with your underwriting system

Leveraging Insights

DOCOsoft helps you leverage data insights, improve customer satisfaction, reduce costs, and process claims more efficiently

Empowered Analysis

Our system enables powerful analysis, generating fresh insights into everything from claims reserving to new and emerging risks like cyber

API Friendly Platform

Our system can plug in external APIs with cross functional utility, helping you integrate internal and external data.

The major features of the DOCOsoft CMS are outlined below:

  • WriteBack (Bureau Messaging functionality) response screen (similar to ECF2 CAS);
    • Layout similar to ECF for familiarity; Replicates Lloyd’s, LIRMA & ILU response screens for multi-Market; Ability to copy Public & Private comments to Internal Notes; Spellcheck on Comments; Templates in Private Comments; Cause Code selection from dropdown lists
    • Flexible workflow tool to assist in management of the full claim lifecycle
  • Real Time Messaging System
    • Notification of claims received within seconds of Broker
  • Screen layout and User Interface
    • Screen layouts designed by Market Peers and London Claims Adjusters
  • Claims Handler Dashboards
    • Favourite Claim; Recently Handled Claims; Configurable and ability to personalise
  • Team Manager Dashboards
    • Configurable at team level and ability to personalise
  • Head of Claims Dashboards
    • Configurable at overall Claims Department level and ability to personalise
  • Claims Console
    • Claim overview at UCR level
  • Claim Summary information including high level policy validation and pre-acceptance checks
    • Integrated platform with a single user interface connected to internal and external third party data sources
  • Pull out screens from menu
    • Ability to pull screens from menu to display side-by-side on dual monitors
  • Enriched ECF data including Loss Narrative and broker information
    • The Write Back message contains over 300 fields of data
  • Market comments at TR and UCR level
    • All Market comments are presented clearly within the DOCOsoft CMS negating the need to view these on ECF
  • Market documents at TR, UCR and UMR level
    • All Documents are pulled from the IMR and presented clearly within the DOCOsoft CMS
  • Ability to load documents back to IMR
    • Includes ability to restrict broker access to documents loaded to the IMR
  • Outbox for claims awaiting authorisation through Write Back
    • Claims will be collected here if responded to outside of CLASS hours
    • Providing users with 24-hour access to agree claims
    • In the event of DXC Outages, DOCOsoft shall enable the write back response retry mechanism which will continue to send a handler's response in a regular frequency until a successful receipt message has been received from DXC
  • Automatic alerts if claim response fails validation requiring additional action by the Handler
  • Incomplete claims tasks if not fully processed within 30 days, including chase-up email templates
  • UMR hyperlink - Hyperlink to display all claims linked to a specific UMR
  • Conflict of Interest
    • Allowing users to set conflicted handlers against claims so that they are unable to view them within the CMS
  • Full Diary Management including Diary Reasons
    • Configurable diary reasons can be set up for reporting purposes
  • Notes Management
  • Peer Review Workflow
  • Manager Approval Workflow
    • Assisting in providing an automated control framework in the claims operations
  • PDF of Full claims details with ability to email out
  • PDF of full claim details with ability to email out
  • Reserve & Fees
    • Profiling to deliver fast and accurate indemnity, fee and expense reserving
  • Full Suite of MI & Reports
    • Enhanced reporting with analytics capability to help drive efficiencies
    • All information is fed into a dedicated DOCOsoft Data Warehouse
  • Data Capture
    • Allowing for proactive management of claims through bespoke handling strategies
    • e.g., Subrogation including:
    • Likelihood Percentage
    • Expected Amount
    • Subrogation Received
    • New Subrogation fields added to Claim Details Report
  • ACORD DRI
    • DOCOsoft CMS will regularly poll the IMR to pull down associated documents as and when they are put up by the broker
    • Upload documents to IMR, with ability to exclude broker access.
  • Non-Bureau / Non ECF Manual Claims
    • Providing the ability to manually create claims within the system
    • Claims can remain manual or merge with ECF claims at any point in time
    • Provides same oversight – Manager Approval, Peer Review, etc. – as ECF claims
  • DOCOsoft File Viewer (DFV) Module
    • Quick link options
    • Easy to select specific documents, and discard irrelevant ones
    • Includes email attachments
    • Contents page file for quick search
    • View thumbnails and navigate to individual pages with ease
  • Email Claims Module
    • Email Tasks shall be created automatically
    • Email Tasks shall be routed to an Email inbox in the DOCOsoft CMS
    • Ability to link to claims via either attaching or creating new activities
    • Manager Access to view all email tasks
    • Email tasks can be taken up into Claim Tasks if required
    • Reporting on email tasks including SLAs
  • Sanctions Checking Module
    • Automatic population of Insured, Reinsured or Claimants to be added as beneficiaries for Sanction checking
    • Beneficiaries are then carried forward on future transactions reducing the need for rekeying
  • DOCOinsights;
    • DOCOinsights is a visual analytics module. It gives claims managers oversight of all claims activity, claims and policy data. It allows managers to track performance and consistency across teams. DOCOinsights also highlights trends across financial values and assess reserve accuracy
    • On Demand self-serve reporting and analytic capability
  • Expert Management
    • The DOCOsoft CMS provides a module which allows for integration with the Gemini platform's API. Gemini is a centralised Expert Management platform built for the London Market (Lloyd's) which will allow Expert Appointments carried out on claims within the market to be captured in one place, reported on with a variety of different MI reports and speed up and simplify the invoicing process for the payment of these Experts.
    • This can enable the monitoring of spend against Experts.
  • Straight Through Processing (STP)
    • STP is a service that automates manual claims adjusters' agreements, subject to their organisation's Business Configurable Risk Appetite. The combination of the following configurable fields can define and set your Risk Appetite:
      • Carrier Code
      • Class of Business
      • Role
      • Transaction Type
      • Triage Category
      • Financials:
        • Incurred/Incurred Movement Limit
        • Lead Reserves Limit
        • Lead Reserve Fee Limit
    • Future transactions are opted into an Auto Agreement / Response Process.
  • DOCOsoft Bots
    • The diary management of Lloyd’s files is a process that Insurers are adhering to following the implementation of DOCOsoft. Claims require that a file is reviewed, and records kept of this review.
    • Implementing RPA avoids the need for manual processing of diary entries in DOCOsoft which is repetitive & rule-based, therefore, reducing costs and allowing technical Claims Handlers to focus on value-added, more complex tasks. DOCOsoft has developed bot software technology that makes it easy to automatically carry out those repetitive, low-value tasks. DOCOsoft Diary bots are not physical robots, but digital co-workers

Key Benefits

Some of the key benefits from the DOCOsoft platform include:

  • Advanced data analytics tools
  • Automation of low-value tasks
  • Enhanced customer satisfaction
  • Faster claims turnaround times
  • Greater reserving accuracy
  • Improved adjuster productivity
  • Insightful management information
  • Protection for your bottom line
  • Reduced information leakage
  • The power of AI and machine learning
  • Unbeatable customer support

Companies partnering with DOCOsoft will benefit from the following:

  • A simple, cost-effective and proven claims solution - Providing a complete integration solution for efficient claim handling.
  • Quicker decision making, removing duplication of effort, better management oversight, greater confidence in data and with proven efficiency savings - Helping leverage data insights, improve customer satisfaction, cut costs and process claims more efficiently.
  • DOCOsoft CMS is endorsed by top London Market insurance carriers
  • Customers are part of our partnership community, shaping the future of DOCOsoft and its offerings. DOCOsoft offers a User Community Group, bringing all its clients together - User Groups, Best Practice Groups, socials, and networking events will all be available
  • DOCOsoft CMS product design and intuitive UI has been enhanced by our experience in the London Insurance Market over many years taking into consideration feedback from business users and claims teams - Providing a configurable core workflow full-life cycle claims solution.
  • DOCOsoft’s approach to customer service. The team have received several client testimonials quoting our "outstanding customer service", "positive experience compared with other suppliers", "Intuitive & user-friendly system" and our "‘can do attitude"
  • A system that works in Cross Market – Lloyd’s, Companies, Bureau & Non-Bureau
  • Seamless integration with Document Management Systems - Integrations with internal and external data sources
  • Integration with Underwriting systems to provide policy information and validations
  • DOCOsoft owns the IPR (Intellectual Property Rights) to all our technologies which have been developed in-house over many years
  • DOCOsoft has considerable experience of deliveries to London Market Carriers, all delivered on time, within budget and fit for purpose
  • DOCOsoft is engaged with central bodies (e.g. Lloyd’s) on market initiatives such as Central Services Refresh Project, Future@Lloyd’s, ECF2 Write Back, Gemini, SCAP (Single Claim Agreement Party), SCAS (Small Claim Auto Settlement), Part VII Transfer & Claims Scheme changes - Enabling DOCOsoft to take advantage of opportunities that arise from technological developments from both central services and outside central services.
  • DOCOsoft regularly engages with other market bodies including DXC, LMG, Lloyd’s Claims and as associate members of LMA, IUA, and ACORD
  • Dedicated Account Manager with regular reviewing meetings - Designated point of contact with quarterly meetings and customer success workshops.
  • Services of DOCOsoft Project Team throughout implementation - every customer will be assigned a dedicated Project Manager and Business Analyst. Training and Administration assistance will be provided throughout as well as go live support.
  • In-house frontline and second line support - Email, phone, and operational assistance as well as an active monitoring service.

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