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[TAI FAQ] TAI Claims Module

December 4, 2018 / FAQ

 TAI_FAQ_Claims Module

Are you currently leveraging all processing and reporting capabilities of TAI’s Claims Module? Claims are a key component to reinsurance operations; the TAI Claims Module can be used to help streamline this aspect of your business. Read this FAQ blog to understand the benefits of the module and clarify common misconceptions about TAI Claims. 

How can TAI users benefit from the Claims Module?

Internal tracking and reporting:
  • Enables better accuracy and up-to-date information, stored in one place

Transaction logging:

  • Creates a permanent history of each claim as it progresses from initial notification through collection, for auditing or research purposes

Produce claims accounting extracts:

  • Eliminates the manual process as users can feed claims information directly to their GL

Direct interface to claims admin system:

  • Enables faster internal notification of claims which means the claims process can be started sooner

Streamlined notices

  • Reduces delays in payment due to faster and more accurate reporting to reinsurers 

Can the module be used to process claims for reinsured living benefits?

Yes, the TAI Claims Module can be used to process living benefits which is performed in the Living Benefits History (Figure A) and Living Benefits Maintenance Screen (Figure B). This can help improve operational controls and efficiency by automating the recurring claims and pulling the information directly from the claims admin system.

FAQ_Claims Module_1
Figure A - Living Benefits History Screen in TAI .Net
FAQ_Claims Module_2
Figure B - Living Benefits Maintenance Screen in TAI .NET

Can the module be used to administer accelerated benefits?

Yes, the TAI Claims Module can be used to administer accelerated benefits which is performed in the screen below (Figure C). These types of products are becoming more prevalent in the industry and require unique handling based on reinsurance arrangements, which can be processed in the Claims module with a combination of existing functionality and custom modifications.

FAQ_Claims Module_3
Figure C - Administer Accelerated Benefits in TAI .Net

Can critical illness claims be administered in the TAI Claims Module?

Yes the module can be used to administer critical illness claims and is performed in the following screen (Figure D).

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Figure D - Claims Summary in TAI .NET

Can TAI .NET pull claims data directly from a claims system?

Yes, the most efficient way to use the TAI Claims Module is to have the TAI support team set up a connection between your claims system and TAI so the data feeds directly into it. This eliminates the need to wait for manual data pulls which inherently speeds up the process.

What is the Claims EDI Extract?

The Claims EDI Extract is a comprehensive data feed for both insurers and reinsurers. It helps streamline claims reporting by eliminating the need for paper notices, reducing the risk of missing data, improving data quality and facilitating open and pending claim reconciliation.

What is the Claims Reimbursement Extract?

The Claims Reimbursement Extract is an electronic recording of payments which automates and enhances the tracking of collected claims. It supports all types of claims, eliminates the claim payment screen and helps improve timely reporting of payments.

Is an upgrade required to gain access to Claims EDI Extract and Claims Reimbursement Extract?

No, an upgrade is not required to gain access. It is a small project and does not have a huge cost associated with it. They can be applied to either Mainframe or TAI .NET. If you have 3.4, you already have these enhancements on your system.


Catch up on our previous FAQs: 


Written by
Pete Murphy