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Insurance Industry Overview:

Insurance is a contract binding an insurance company to compensate a beneficiary for the loss of life or loss or damage to property of a person insured. Benefits accrue due to an individual due to statutory obligation of the benefit provider to compensate for the expenses involved in health care, retirement plans of the beneficiaries by entering into a contract with the provider either singly or in groups by paying a predetermined premium at predetermined intervals.

The process of Insurance and Benefit Management Business can be grouped under three main categories. These are Products, Processes and People.


 

The processes involved in Insurance and Benefits Management Business are described below:

a) Publicity and Promotion of Products.
b) Product Evaluation.
c) Enrollment of Beneficiaries for the Plans.
d) Receipts and Accounting of Premiums.
e) Processing and Settlement of Claims.
f)  Payments Processing and Settlement of Accounts with Vendors.
g) Payments Processing and Settlement of accounts with Agents/ Brokers.
h) Routine and Exception Reporting for Management Control.
i)  Customer Relations Management with Beneficiaries and Vendors.
j)  Accounting and Audit.
System Administration.

Third Party Administrators - [TPA]: The job of a Third Party Administrator is to maintain databases of policyholders and issue them unique identification numbers and handle all the post policy issues including claim settlements.

Case Studies:

 
 
 
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