Claims Processing Centre (CPC / ICAP)

1. Overview
Integrated Claims and Automotive Portal (iCAP) functionality is to provide:

• Enhance centralised information repository system for Motor Insurance Claim (MIC) transactions which are: Own Damage (OD), Third Party (TP), Knock-for-Knock (KFK). All the transmitted claims transactions details will be captured by iCAP, as the information flow between the MIC-Users (i.e. Repairer, Insurer, Adjuster and Lawyer) via the integrated MIC-Software House (SH) systems (i.e. Merimen and OneWorks).
• Enhance centralised information repository database for Vehicle Parts and Pricing, Vehicle Specific Repair Times, Vehicle Repairing Methodology.
• Enhance Vehicle Claims Reporting facility for subscribed Insurance users.
• Fraud Detector capability for the claim transactions.
• Info sharing capability.

The Benefits:

• No restriction of users using any estimating system.
• All type of estimate claims submission will be captured.
• Enhance data mining for wider claims type coverage.
• Any service provider (Software Houses) can come into the market to market their estimating system for any MIC-Users (cross-platform sending/receiving of MIC transactions).
• Case Status driven transaction for better flow control checking and alert any transaction irregularity.

The iCAP development plan will be in three (3) phases:
Phase-1

• Merging of CPC and eKFK Portal data.
• Capture all the transmitted MIC transactions details between the MIC-Users via the MIC-SH systems.
• Repository for the Vehicle Parts and Pricing database.
• Repository for the Vehicle Specific Repair Times database.
• Repository for the Vehicle Repairing Methodology database.
• Vehicle Claims Reporting System integration.

Phase-2

• Fraud Detection System integration.

Phase-3

• Information sharing facilities with relevant industries and regulatory bodies.

2. Scope
The scopes of iCAP portal functionality are:

1. iCAP will be a “gateway” with the following capability:
   • Able to receive and relay all the MIC transactions being transmitted via the MIC-SH systems.
   • Able to capture all the MIC transactions movement details between the MIC-Users via the MIC-SH systems.
   • Allow cross platform exchange of information (i.e. a standard data exchange file) between the MIC-SH systems, where the claim details created in a particular SH system can be read and updated by other SH system, and vice-versa.
   • All MIC transactions must be controlled base on Case Status.
   • Enhance the capability to detect any claim transaction with missing Case Status that bypass the iCAP. For example:
     • An estimate claim cannot be approved without a submitted estimate claim transaction.
     • Attempt to submit a claim supplementary without getting the estimate claim authorised transaction.
2. Enhance the capability to detect and log what kinds of vehicle information (i.e. Parts, Prices, Labour Times, etc.) are being retrieved by which MIC-Users.
3. Enhance the Vehicle Claims Reporting System with more captured claim details information.
4. Allow the integration with the Fraud Detection System for data scanning on the enhance-captured details information.
5. Able to export ad-hoc information in a specify format (i.e. PDF, CSV, etc.)
6. Able to provide ad-hoc information linkage to the external party via a standard data exchange file, i.e. XML format.