Description of the process deployment of the Loss Adjustment System based on the business process management platform OpenText MBPM.

At the end of 2012 the Insurance Guarantee Fund decided to select a contractor and implement a project of a new loss adjustment system based on the business process management platform OpenText MBPM. Requirements set for the contractor defined the need for a full analysis of the status quo, analysis of needs, system construction and production commissioning in just one year from the date of commencement of the project.

The reasons for the start of the project
• Functional limitations and the end of life cycle of the existing system to support loss adjustment area
• Identification and description of the current functioning of the Division of Loss Adjustment due to personnel changes in the Fund
• Required optimisation of loss adjustment processes
• Adaptation of the organisation to the new accounting policies of the Fund

Objectives of the project
• Transition from the registration system to the process system
• Organising the existing loss adjustment processes
• Introduction of process transparency for all participants and supervisors
• Flexible management of people and tasks
• Improvement of the timeliness of loss adjustment
• Better implementation control
• Providing management information
• Elimination of paper documents
• Improvement of communication between organizational units of the Fund and the introduction of new channels of external communication
• Automation of communication with the financial system Oracle EBS
• Management of financial reserves in accordance with the new legal requirements
• Integration with the processes of the Departments of Fees, Recourse, Call Centre and Information Centre.

As a result of the analysis of needs performed, the need to automate the following processes and to develop interfaces to external systems was identified:

Identified processes:
• The process of distributing documents in the area of loss
• Loss Event Electronic Folder
• Loss Electronic Form
• Loss adjustment
• Handling appeals
• External and internal expertise
• Handling pensions
• Handling unidentified incoming letters
• Handling Interventions
• Handling Court Cases

Identified interfaces:
• Office management system
• Call Centre system
• CEPIK (Central Vehicle and Driver Register) database
• PESEL (Polish Resident Identification Number) database
• Database of the Motor Vehicle Insurance Information Centre
• Charge System
• Oracle EBS financial and accounting system
• Recourse (recovery) management system
• Actuarial tools to estimate pension reserves
• SAS Institute – the Fund's data warehouse

Communication with external systems was to be based on messages and services defined on the Oracle Service Bus.

The process is responsible for the identification of the submissions made to the department of loss adjustment from the IGF office, call centre and the Fund e-mail boxes. The documents may refer to new loss records or documents incoming to the existing processes and Cases in the system.
The Operator after examination of the documents decides whether to register a new loss event electronic folder and related loss or assign the documents to the existing Cases in the system. The registration of a new loss automatically launches the loss adjustment process. When the Case cannot be identified for the document sent, a process known as the process of unidentified letters starts, within which the letters are passed to a separate process responsible for the preparation of responses to unidentified letters.
In the process, cases of handling documents incorrectly submitted to the IGF office or incorrectly assigned to the existing Cases in the system and mandating the necessity of assigning the document to additional Cases are also supported.
 

The Loss Event Electronic Folder Process is used to register a new Event from the level of the Document Registration in the Loss Adjustment Area process and update the existing Event from the level of any Substantial Cases in which the event update will be made available.
The Loss Event Electronic Folder is a compendium of knowledge on all elements registered in the system associated with the transport or agricultural event. The information stored in the Loss Event Electronic Folder includes:

• Loss event data
• All entities associated with the Event, Losses and related processes, including a complete history of changes to the data of these entities
• All objects associated with the Event, Losses and related processes, including a complete history of changes to the data of these objects
• Information on financial reserves collected for the purpose of handling the Event with a full history of changes to their value at the time
• Information on related Losses and processes in the system
• All decisions made in the system related to the Event
• All documents assigned to the Event, related Losses and processes covering incoming, outgoing and internal documents
• Detailed information on the payment of compensation and payment of costs associated with handling the Event.
 

The system allows for creating any number of Losses for each Event. One loss refers to one injured party in the Event.  The Loss Electronic Folder Process is used to register a new Loss assigned to the Event from the level of the Document Registration in the Loss Adjustment Area process and update the existing Losses from the level of any Substantial Cases in which the loss update will be made available.
The Loss Electronic Folder is a compendium of knowledge on all elements registered in the system associated with the loss. The information stored in the Loss Electronic Folder includes:

• Loss data
• All entities associated with the Loss and related processes, including a complete history of changes to the data of these entities
• All objects associated with the Loss and related processes, including a complete history of changes to the data of these objects
• Information on financial reserves collected for the purpose of handling the Loss with a full history of changes to their value at the time
• Information on related processes in the system
• All decisions made in the system related to the Loss
• All documents assigned to the Loss and processes covering incoming, outgoing and internal documents
• Detailed information on the payment of compensation and payment of costs associated with handling the Loss.
 

The Loss Adjustment Process is used to handle the loss adjustment by the IGF loss adjusters and handle information flow in the area of making and approving decisions or substantive writings during the process. The process controls the appropriate manner and sequence of the loss adjustment, timely performance of specific tasks as well the as decision-making and compensation process. The basic functions of the system include:

• Making substantial decisions and their approval according to the defined competencies
• Preparation and generating letters and other correspondence with contractors,
• Support for financial reserves,
• Payment of compensation and payment of loss adjustment expenses
• Support for making settlements with injured parties
 

The Pension Handling Process is responsible for the support and control of tasks related to handling pensions granted to parties injured in the Insurance events. The process includes the preparation of pension proposals, negotiations on a pension granted, and handling of the drafting and control of pension schedules. Additionally, the system supports decision-making on the capitalisation of pensions and cyclic control of the need for further payment of pension to the annuitant.

The process is responsible for supporting the implementation of tasks of the legal department in cooperation with loss adjusters in the field of active and passive litigations relating to compensation for injured parties. The system supports a complete cycle in litigation, both by the Fund's legal advisers and external law firms in all instances of judicial proceedings.

The system has been implemented and operated by the Insurance Guarantee Fund from the beginning of 2014. With the management though business processes, new organisational rules have been implemented and the loss adjustment and handling processes have been significantly streamlined. The system may be subject to full parametrisation made available to the Owner of the business processes, so that new rules for acceptance, communication, documents and letters templates, rules for process preservation and most parameters that control the processes are introduced without interfering with the computer code of the system.
All the project objectives have been achieved.

DUE TO THE AUTOMATION DEPLOYED:

• the customer gained full control of the loss adjustment processes;
• work with paper documents has been eliminated, all documents are handled electronically;
• processes of acceptance and implementation of decisions have been streamlined;
• timeless indicators of loss adjustment have been improved;
• all repetitive tasks have been automated, allowing users to devote more time to working and making substantive decisions.
 

The Insurance Guarantee Fund is an institution operating under the provisions of the Act of 22 May 2003 on compulsory insurance, Insurance Guarantee Fund and Polish Motor Insurers' Bureau.

The IGF deals with the control and punishment of the uninsured and payment of compensation to victims of accidents caused by uninsured vehicle owners and uninsured farmers. The IGF also pays compensation to the injured when a road accident perpetrator fled the scene and it is unknown.