Life

The STEP Life Claims Portal allows a claim to be initiated by the “Claims Processor” role. The Claims’ rules are derived from the Benefits/Coverages/Policy Provisions and Accounting rules that dynamically adjudicate the claim based on the event type and the plan code for the claim. Riders associated with a Life base product are adjudicated based on the plan code rules that are configured as part of the Product configuration for the Carrier Product. Similarly, Death benefit claims are adjudicated based on the Claim Requirements set up as part of the Product Configuration. These requirements are typically the Claim Form, Evidence of Death, Physician’s statement, etc.

Straight-through processing and interfaces to Social Security Administration data sources such as the Death Master File allow the evidence to be gathered online for faster processing of the claims. Settlements for the claims are also processed electronically using straight-through techniques to identify and validate beneficiary information and payout/settlement requirements rules configured as part of the Product Configuration. Claims workflows including audits and approvals are also configured as part of the Carrier Product configuration.