Act-isure claims management allows a client to define the type of claims processing environment they want. The way in which the client configures the system will allow a range of options from partial automation to fully automatic claims adjudication. Full integration with the policy system means it is impossible for a client to claim for benefits they have not purchased and/or no longer posses at the date of claim. Act-isure claims is designed to minimise claims leakage, reduce the levels of expertise required to process complex claims whilst maximising the level of service provided to the claimant at this key ‘moment of truth’ – the moment where the client assesses the level of service you provide. Key characteristics are:

1. Act-isure has transformed claims processing to a simple task.  A familiar (Explorer like) tree structure of policyholder and beneficiaries allows an assessor to post a claim against any beneficiary, not just the policy and to manage the claim through its complete lifecycle
2. Act-isure claims is a ‘knowledge’ system –it collects and understands information concerning related conditions and procedures, etc. in order to aid the assessor – maximising efficiency and service levels
3. It provides automatic assessment/warning of exclusions, benefit levels, excesses, etc. to ensure the claim is processed accurately and quickly
4. Specific claims screens can be provided for specific product types - all with a common look and feel – maximising usability and ease of training.  Four claims sub systems are available, each providing tailored screen sets for different claim assessment needs:
   1. Standard PMI claims systems for single currency usage
   2. International claims system including US style claims features
   3. Cash plan claims system for high volume, low value products
   4. STP (Straight Through Processing) incorporating automatic invoice recognition

5. Act-isure allows clients to offer multiple types of product with different impairment and repair coding structures (e.g. in medical ICD and CCSD, CPT coding structures, in Pet conditions and treatments by species, in Dental by dental condition and procedure, in Travel by category of loss etc)
6. Act-isure supports the management and application of fees and agreements with various types of provider for various types of agreement (complexity based, provider based, procedure based etc)
7. Network management facilities are provided
8. Management of invoices in multiple currencies is by automatic triangulation of invoice currency amount to the currency in which benefits are defined.  Assessors need to simply load the invoice not concern themselves with currency implications
9. Act-isure provides a life time view of claims history thus transforming the level of knowledge available to the call agent at point of claim