HEALTH INSURANCE MANAGEMENT
This module simplifies the management of health insurance policies in Odoo. It allows users to create, update, and track policies, manage claims, and monitor renewals, all within an intuitive interface. Enhance your health insurance operations with streamlined processes and integrated reporting.
Highlighted Features
Policy Management
Effortlessly create and manage health insurance policies, ensuring that all relevant details are organized and easily accessible for both administrators and policyholders, enhancing overall efficiency.
Claims Handling
Streamline the claims process with a user-friendly interface that allows for easy submission and tracking, significantly reducing processing times and improving customer satisfaction through timely resolutions.
Renewal Tracking
Benefit from automated reminders for upcoming policy renewals, helping users stay informed and proactive in maintaining their coverage without any lapses, ensuring continuous protection.
Penalty Management
mplement configurable penalties for late payments or claims, promoting compliance and timely actions while maintaining a fair approach to policy management and customer relations.
Scheme Management
Define and manage a variety of health insurance schemes tailored to meet diverse customer needs, allowing organizations to offer flexible options that cater to different demographics.
Scheme Types
Support for multiple scheme types, such as individual, family, and group plans, provides flexibility in policy design, enabling users to choose the best fit for their circumstances.
Reporting
Generate insightful reports on policy performance, claims statistics, and renewal rates, empowering organizations to make informed decisions and optimize their health insurance offerings effectively.
Comprehensive Policy Oversight
Users can create, update, and maintain thorough records of health insurance policies, ensuring that all information is organized, easily accessible, and current for effective management.
Efficient Claims Processing:
The module offers a streamlined approach for submitting and tracking claims, significantly reducing processing times and enhancing customer satisfaction through prompt updates and resolutions.
Automated Renewal Notifications
Automated alerts inform users of upcoming policy renewals, helping to prevent lapses in coverage and ensuring that policyholders remain protected without any interruptions.
Configurable Penalty Framework
Administrators can set up configurable penalties for late payments or claims, promoting compliance and encouraging timely actions while fostering positive customer relationships.
Diverse Scheme Administration
Users can create and manage a variety of health insurance schemes tailored to different customer needs, enhancing service offerings and allowing for customization based on specific requirements.
Variety of Scheme Categories
The module accommodates multiple scheme categories, including individual, family, and group plans, providing flexibility in policy design and enabling users to select the best options for their needs
Insightful Reporting Capabilities
Generate comprehensive reports on policy performance, claims statistics, and renewal rates, facilitating informed decision-making and helping organizations optimize their health insurance operations effectively.
User Configuration
Users are categorized as either insurance management users or insurance management managers.
Reminder Interval Setup
Insurance > Configuration > Settings. This section allows configuration of the number of days prior to sending reminder emails for policy renewal, EMI installments, and invoice due dates, as well as the maximum interval before policy expiration.
Sub Policy Types
Insurance > Configuration > Sub Policy Types. Here we need to incorporate sub-policy types for health insurance.
Document Configuration
Insurance > Configuration > Document Types. Here we need to incorporate document types for policy details.
Configuration of Scheme
Insurance > Configuration > Schemes. We can configure scheme details by adding policy type, sub policy type, claims allowed per year , etc.
Policy Amount Configuration
Here we need to set different health insurance policy amounts for various age groups and time periods. We can adjust coverage to match the needs of different ages and offer flexible payment options.
Sum Assured Configuration
Here we need to set different sum assured as per different policy amount.
Commision Configuration
Here we need to configure commision for the agents percentage wise.
Penalty Configuration
Here we can configure the penalty amount for renewal of policy if the policy is lapsed it can be a fixed amount or some percentage of policy amount.
Policy Document Upload
Here we can upload any scheme related document.
Agent Details
We can see the details of Agents under Insurance > Agent Details > Agent Details and by clicking NEW button we can create agent by filling the mandatory fields.
Customer Details
We can See the Details of Customers under Insurance > Insurance Management > Customers and by clicking NEW we can create new customers by filling up mandatory fields.
Policy Details
We can see all policies under Insurance > Insurance Management > Policy and by Clicking NEW we can create new policy as per customer requirements.
Policy Creation
We can create a policy by filling up mandatory details such as Customer, Agent, Policy type, Sub Policy type, etc,. The system will raise warning if any of the mandatory sections has not been filled up.
Adding Insured Members
Add insured members before confirming the policy, if there will be no insured members then the system will raise an Validation Error.
Policy Confirmation
Once we added Insured members successfully then we can the confirm the policy by clicking Confirm button.
Generating EMI(S)
After clicking the GENERATE EMI(S) Button emi's will be generated according to policy amount and duration.
Adding and Verifying Documents
After Generating emis we need to add and verify documents needed.
Paying First Instalment
Before Starting the policy the Customer need to Pay the first instalment for the policy
Starting The Policy
After Paying the First Instalment and verifying all documents we can start the Policy by clicking the START button.
Generating Commision
After Policy has been started then we can generate commission by clicking GENERATE COMMISSION button
Commission Details
After generating commission we can confirm the commission bill and register payment.
Generating Claim Request
After Policy is started then we can generate claim request by clicking CREATE CLAIM button.
Confirming Claim Request
After creating claim request we can confirm claim by adding necessary details then clicking CONFIRM button.
Approving Claim Request
After confirming the claim request, we need to upload and verify the documents to approve the claim request by clicking APPROVE button.
Settling Claim Request
After Approving the claim request we can settle the claim request by clicking the SETTLE button.
Viewing Claim Request
We can view all claim request generated in Insurance > Configuration > Policy Claim
Policy Lapsed
In the event that an installment payment is not received by the due date, the policy will enter a lapse stage following the configured grace period.
Adding Penalty
In order to renew the policy, the customer is required to remit the penalty fee as specified in the policy's scheme. To apply the penalty, please select the Penalty button, which will subsequently add the penalty amount to any outstanding installments.
Penalty Amount
In the generated invoice the penalty amount is added.
Renew Policy
Once all due invoice paid with penalty amount by clicking Renew button we can renew the policy.
Renew Validation
If invoices are not paid and we renew the policy then system will raise a validation.
Policy Renewed
Once policy renewed, it will be back to running stage.
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| Availability |
Odoo Online
Odoo.sh
On Premise
|
| Odoo Apps Dependencies |
•
Discuss (mail)
• Invoicing (account) |
| Community Apps Dependencies | Show |
| Lines of code | 3805 |
| Technical Name |
scs_insurance_management |
| License | LGPL-3 |
| Website | http://www.serpentcs.com |
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