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The Insurance Document Vendor ES bundle provides insurance companies with the ability to seamlessly interface SAP Claims Management with third-party document vendors such as Skywire and Document Sciences.

A key pain point for insurance companies is the number of forms they must file, particularly for workers' compensation claims. In the US alone, 50 states mean 50 different forms---forms that change on a regular basis. For this reason, insurance companies frequently outsource this problem to a document vendor. This ES bundle provides enterprise services, that allow claims handlers to work with claims-related documents from these third parties and incorporate them into their normal everyday tasks within SAP Claims Management. From within SAP Claims Management, claims handlers and other users can:

  • Display a list of relevant forms and templates for standard documents (a list that is populated by the document vendor's system in real-time)
  • Select a form and merge claims data into it to create the desired document
  • Approve the document, modifying it first if needed
  • Store the document either with the claim itself or as a link to the document on the document vendor's system, depending on the policy of the insurance company with regard to document archival 

Insurance Document Vendor (click to enlarge)


The System Landscape

The Insurance Document Vendor ES bundle leverages enterprise SOA through communications between SAP Claims Management System and third-party document vendors such as Skywire. The enterprise services in this ES bundle are based on the ACORD industry standard and are mapped to document vendor web services, using SAP NetWeaver Process Integration (formerly called XI).

Audience

Any business that runs SAP Claims Management, including insurance companies as well as companies and other organizations that practice self-insurance, will benefit from deploying the Insurance Document Vendor ES bundle.

The roles in the insurance industry that will use this bundle include:

  • Clerk
  • Claims handler

    For details on Service Operations, Business Objects and Process Components, please check the ES Workplace.


How to Use This ES Bundle

The sheer number of claims that today's insurance companies must process on a daily basis necessitates a means by which the related documentation can be produced rapidly and accurately. Once it has been produced, it must be provided not only to the parties involved in the claim but also to various government agencies that require insurance companies to provide them with suitable copies of this documentation.

By streamlining document handling, claims can be settled more quickly. This is key to the bottom line because the longer it takes for an insurance company to settle a claim, the higher the costs of the overall claims process. To maintain their competitive edge and profit margins, insurance providers want to decrease the time it takes to process a claim.

Other benefits of deploying this ES bundle include:

  • improved accuracy in claims handling (the document vendor's system provides key content forms that are always up to date)
  • a seamless process within SAP Claims Management to handle these documents

Without this ES bundle, either claims handlers would have to access multiple applications (that would still not be integrated) or insurance companies would have to invest in a custom integration using older programming methods. Because the services in the Insurance Document Vendor ES bundle are called directly from within SAP Claims Management System, there is no need for custom integration. The use of enterprise services here provides a simple and robust integration with little effort on the part of the insurance company.


The following section explores two use cases for the Insurance Document Vendor ES bundle. Each use case provides concrete examples and shows how different outcomes can be achieved by using the enterprise services in different combinations. While these examples illustrate a few of the ways that this ES bundle could be used, the intention is to show the flexibility and reusability of these business objects and enterprise service operations so that you will have a clearer understanding of how to best deploy them in your own environment. This wiki is also a space for you to share knowledge and collaborate with others who are implementing the Insurance Document Vendor ES bundle.

Figure 1. List of documents, populated by document vendor (click to enlarge)

Use Case 1: Creating an Insurance Document

Fritz, a claims handler with Blue Sky Insurance, has just received an auto insurance claim. The claim will require a number of documents. Fritz enters data about the claim in SAP Claims Handling. To begin creating documents with relevant information, he selects Documents under Claims Overview to display the Correspondence to Be Sent screen. By clicking on the drop down menu for forms, the Query Document Template enterprise service operation retrieves a list of relevant documents from the document vendor. Fritz selects a form and a recipient. He then clicks on a Preview button, which invokes the Request Document Creation using Document Template enterprise service operation, which retrieves the selected form from the document vendor and merges the relevant data from this claim into the form.
At this point, Fritz can publish the document by clicking on Publish/Archive or click on Cancel if he wants to make modifications before publishing the document.

Figure 2. The document in preview mode, with data from SAP Claims Management merged in (click to enlarge)

Use Case 2: Modifying an Insurance Document

Fritz sees that the form requires additional information that is not being sent by the SAP system, so rather than entering it manually, he cancels the previewed document and talks to an administrator. The administrator specifies the data to include and Fritz again presses the preview button, which invokes the Request Document Creation using Document Template enterprise service operation, which retrieves the selected form from the document vendor and merges the relevant data, including the data elements just selected, into the form.

Fritz enters an edit mode from the preview and adds additional data, such as the odometer reading from the damaged vehicle. The document is now complete and ready to be published.

Use Case 3: Publishing an Insurance Document

Now that the document has all the necessary data, Fritz publishes it by clicking on the Publish/Archive button, which invokes the Request Document Publication enterprise service operation. Fritz associates the resulting document with, in this case, the Damaged Object (the car), as shown in Figure 3.

Figure 3. Associating the document with the damaged object (click to enlarge)


System Requirements

Related ES Bundles

SOA Homepage on SDN

Skywire Software
Document Sciences
ACORD standard