An investigation on claims handling processes: a case of Zambian insurance companies

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Jere, Karlos Busiku
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The University of Zambia
Insurance is a contract of reimbursement against specified risks such as fire, earthquakes, floods, theft. (Mayer 2010). The Zambian Insurance industry has over 40 General Insurance providers, offering Insurance products and services to only 2.8% of the population (I.A.Z, 2018). However, in their efforts to improve on service delivery, Insurance Companies have turned to the use of Internet and Communications Technologies and ecommerce platforms. Despite these initiatives, Insurance Companies are still having challenges with insurance fraud, as it raises their paid out claims budget, resulting in reduced profitability. Other associated negatives are threats to brand loyalty, reputation and customer service. This dissertation sought to investigate the insurance claims management systems and develop a web based application for Insurance Claims Management. A baseline study was conducted, targeting the top 10 Insurance companies and their Clients within the district of Lusaka. The study identified security weaknesses in the insurance claims cycle, primarily, the claims notification, document submission and initial claims processing phases. Given the weaknesses identified by the study, it is not surprising that fraud is prevalent in the industry, as it is a product of inherent security weaknesses in the Insurance claims cycle processes. The researcher sought to address the identified challenges by way of developing a web based application called INSUR AID, to help improve Insurance Claims handling. Results from the study were used to draw up the Systems Requirements Specifications document, upon which INSUR AID Prototype was developed. The study results were peer reviewed by the International Journal of Innovative Research in Science, Engineering and Technology (IJIRSET) and published in the June 2019, publication. (Jere and Banda, 2019).