
Fraud Prevention In Online Processing Of Insurance Claims: Basis For Enhanced Guidelines
ABSTRACT
Claim management is a major concern for insurance companies. Effective
claim management can save your company effort and money while improving
customer satisfaction and customer retention. Although manual paperwork may be
required, tools and technologies such as claim management software can help
businesses automate processes to increase profitability. The claim process is
an important moment in customer
relationships in non-life insurance. To maintain and expand market share,
insurers need to focus on improving their customers' experience through online
processing
The purpose of this investigation was to improve the fraud prevention policy when processing insurance claims online. In
particular, we are looking for answers to achieve the following goals: 1.) To
determine the degree of effectiveness of online claims processing for motorcar
insurance. 2.) To identify the different variables that help in preventing
fraud. 3.) To know the recommendation
offered by the respondents on insurance training. 4.) To describe the different fraud in claims
processing for motorcar insurance in terms of gravity. 5.)
To develop an enhanced policy on how to prevent fraud in motorcar insurance
claims.
A descriptive method was used in this study. In
selecting 60 car employees and customers, researchers used the purposive
sampling and structured questionnaires
were used as the primary means of 60 respondents. Random interviews with
owners, managers and customers were conducted as part of a meeting with a group
of respondents. Statistical tools used to display, analyze, and interpret data are percentages, weighted averages,
Likert scales, and rankings.
The most important conclusions are: 1. ) Younger
generations or young professionals still preferred to insure their vehicles in
the event of an accident, especially in these times when traffic is increasing,
with the service provider's excellent insurance concept. 2.) More and more male
customers prefer insurance services.
They are more aggressive driving style. These drivers assume a high probability
of an accident. 3.) Married vehicle owners are more responsible driver. It is
believed that by getting insurance coverage for the utility of the vehicle,
they will appreciate their vehicle more. 4.) College graduates are already
employed, so it is assumed that they
already have a vehicle when their
income increases. Similarly, not all employees decide on their degree.
5.) The level of claims processing transactions is the fast-tracking
transaction they used, significantly reducing the latency of both claims
handlers and customers from the previous peak of weeks to just days. 6.) They
will pursue strategies to further improve the process for processing claims
online, adapting technologies such as service access and payment processing to
claims, and providing quality service to our customers. 7.) Various training
programs in the field of modern technology will greatly help employees acquire
knowledge of modern technical equipment. Insurers may require video quality and
fair and impartial processing if they have sufficient knowledge of claim
processing and claim adjustment. 8.) If the processor and adjuster are unaware
that the fraud case is involved, have no knowledge of the underwriting aspect,
and can handle the fraud without using the latest technology, then the car
insurance claim needs various serious fraud cases.