Insurance Workflow Processes

Insurances Business Process Definitions & Templates

  • Workflow Template / Insurance / Property & Casualty

    Auto & Home Insurance Sales
    Auto & Home Insurance Sales is a process that involves the attraction and identification of potential customers, specifically for auto and home insurance. This process includes lead generation (information gathering, quote preparation, etc.), application approval or denial, policy selection, initial premium estimation and claims support (claim submission, data updates, policy adjustment, account retention or termination, etc.).
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  • Workflow Template / Insurance / Policyholder Services

    Bill Collection (Insurance Premiums)
    The Bill Collection (Insurance Premiums) process involves the collection of outstanding insurance premiums from individual clients. This process includes discrepancy identifications, account information updates and verification, payment processing (all payments are reconciled during this process) and account cancellation (if the outstanding amount is not collected or the customer wishes to cancel the account).
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  • Workflow Template / Insurance / Agent Revenue Production (Sales)

    Campaign Management: Group Insurance
    Campaign Management: Group Insurance process involves the development and management of promotional marketing campaigns for insurance carriers (specifically, group insurance quotes). This process includes the completion and review of the Presale Information Form (PIF), enrollment application completion and processing, promotion code generation and agent and group introductions. Ensure that agents on the field receive completed enrollment forms (enrollment forms must be signed and returned to the Sales Support Team), rates, GAS and Sold Case Memos.
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  • Workflow Template / Insurance

    Financial Product Development
    Financial Product Development deals with the initial concept development (sometimes called "ideation"), market analysis, product documentation development, internal approval and regulatory registration for new products launched by Financial Services companies (e.g., banks, insurers, investment managers, etc.). Financial products may include credit cards, insurance coverage, investment products (e.g., exchange traded funds, etc.), savings accounts and deposit accounts. Product Development teams, product managers and line of business executives coordinate to conduct full-scale cost/benefit and market analysis to determine if the product is viable. If the product is approved internally, documentation is compiled and submitted to regulatory agencies for approval. If the product is approved by the appropriate regulatory bodies, the teams must then prepare for a full-scale market launch.
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  • Workflow Template / Insurance / Policyholder Services

    Group Benefits Administration
    Group Benefits Administration is a process that involves the development, administration and management of insurance programs for large groups of individuals (typically employers or families). This process involves assigning potential customers to consultants, attending an implementation meeting with the customer (ensure that all information pertaining to the customer is taken down), receiving and reviewing enrollment applications, assigning appropriate insurance representative to the case and the internal maintenance (by the insurance representative) of the insurance policy.
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  • Workflow Template / Insurance / Agent Revenue Production (Sales)

    Group Quote Marketing
    Group Quote Marketing is a process that involves marketing and selling group policies to customers with the involvement of field agents and marketing managers. This process involves Presale Information Form (PIF) review and update (field agents must first foward all pertinent presale-information to the Marketing Group), the production of any relevant marketing materials (enrollment forms, rates, case memo, etc.) for a meeting with the prospective policyholder and the compliance review of the information within the company's system.
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  • Workflow Template / Insurance / Policyholder Services

    In-Force Customer Service (General)
    In-Force Customer Service (General) is a process that involves the reception of incoming calls and requests from current policyholders to assist with account updates, payments, insurance policy inquiries, account modifications or status updates. This process includes the reception of customer calls, customer issue resolution (if the Customer Service Representative is unable to resolve the issue, escalation may be necessary) and account processing (all changes made to the account must be noted).
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  • Workflow Template / Insurance / Agency Office Administration

    Insurance Licensing & Contracting
    Insurance Licensing & Contracting is a process that involves the licensing of new Insurance Sales representatives (agents, brokers), at the state level, as well as renewals and terminations of insurance licensing. This process includes obtaining a letter of certification and/or a renewal license from the representative's Insurance Department (all appropriate paperwork for the representative's appointment must be filled and submitted before certifications are obtained), the submission of an updated Central Registration Depository form to NASD (National Association of Securities Dealers) for approval and the dissemination of welcome materials to the contracted representative (all information concerning the new hire should be forwarded to HR, Payroll and Benefits). A termination letter should be prepared and forwarded to the Representative if the agent's contract is cancelled or if the agent resigns.
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  • Workflow Template / Insurance / Agent Revenue Production (Sales)

    Insurance Sales (General)
    Insurance Sales (General) is a process that involves the process of signing up a new client for a policy which involves an agent or a call center representative. The agent or representative discusses available insurance products with the prospective client who called and obtains all necessary information. The agent then determines eligibility and prepares a quote. Finally, payment is set up and the new policy goes to underwriting for final processing.
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  • Workflow Template / Insurance / Health Insurance

    Medical Claims Processing
    Medical Claims Processing involves receiving, processing and approving/denial of medical insurance claims. This process includes a case review (policy, type of injury, treatment of injuries, etc.), assessment of medical coverage, adjustments, payment request (if approved) and client notification (medical management reports, etc.). Though a number of people involved and the length of this process may be long, it is generally good practice to keep customers up to date.
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  • Workflow Template / Insurance / New Business Processing

    Online Insurance Sales
    The Online Insurance Sales process is designed to quickly and intiutively collect, through a series of online forms, the information required to generate an insurance quote for retail customers. Required information may include zip code, name, address, date of birth, vehicle identification number (for auto insurance) and existing insurance policy information (if applicable/available). After the website visitor has entered the requisite information, they are typically offered discounts for various related products/services offered by the insurer. After the application is completed, the customer is provided with a preliminary quote and, in most cases, the application is sent to the underwriting and sales teams to finalize the policy and onboard the new policyholder.
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  • Workflow Template / Insurance / Policyholder Services

    Premium Accounting
    Premium accounting is the review of recently on boarded insurance policies and the subsequent setup of payment methods for the policyholder(s). Any account issues, whether originating from the policy or the policyholder, is taken care of at this time. This process includes the setup of automated billing, as well as paper billing setup and invoice transmission. Should payment not be received by the company, this process also ensures the policies are cancelled.
    File Formats Available: PDF, Visio, PowerPoint | See More
  • Workflow Template / Insurance / Property & Casualty

    Property & Casualty Claims
    Property & Casualty Claims is a process that involves receiving, processing and approving/denying property and casualty insurance claims. This process includes damage review (losses recorded, loss verification, etc.), assessment of coverage, field inspection (if necessary), adjustments, payment request (if approved) and client notification. All field inspections must be scheduled with the insured and involves travel to investigation site, inspection, the estimation of the cost of repairs and issuance of check for the estimated cost of repairs (if possible).
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  • Workflow Template / Insurance / New Business Processing

    Prospect-to-Issue
    Prospect-to-Issue is a process that involves the processing of new business and/or renewals from insurance policyholders. This process includes the inspection of member ID cards (corrections are made where necessary), member ID card creation (database updates, appropriate ID card code integration, ID card printing) and the final approval of rates and provider contracts by Underwriting/Actuarial staff. Ensure that feedback from sales is analyzed to determine group rate changes or compliance.
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