Question: Create a complete process map model for the company's insurance claim evaluation procedure. The car accident claim handling process starts when a customer submits a
Create acomplete process map modelfor the company's insurance claim evaluation procedure.
The car accident claim handling process starts when a customer submits a claim with the relevant documentation. When a claim is received, a claims officer first checks if the claimant is insured. If not, the claimant is informed that the claim must be rejected by sending an automatic notification via a SAP system. Otherwise, a senior claims officer evaluates the severity of the claim. Based on the outcome (simple or complex claims), the relevant forms are sent to the claimant, again using the SAP system. Once the forms are returned, they are checked for completeness by the claims officer. If the forms provide all relevant details, the claim is registered in the claims management system. Otherwise, the claimant is informed to update the forms via the SAP system. Upon reception of the updated forms, they are checked again by the claims officer to see if all details have been provided. Next, the Evaluation department receives the claim and verifies the insurance. Next, an assessment is performed. If the assessment is positive, an automotive body shop is phoned to authorize the repairs and the payment is scheduled (in this order). Otherwise, the claim is rejected. In any case (whether the outcome is positive or negative), a letter is sent to the customer (SAP system) and the process is considered to be complete.
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