A new digital solution for the Insurance Ombudsman

The Insurance Ombudsman handles insurance complaints. These are disputes about the execution of an insurance contract against an insurance company, an insurance intermediary or Datassur. There is an annual analysis of the complaints received. Evenso, all complaints are compiled to an an annual report  with conclusions.
The procedure to file a complaint is in writing. Consequently, if you wish an intervention, you must submit the complaint form. 
Upon receipt of the complaint, the insurance intermediary concerned, the insurance company or Datassur is contacted. Once the latter communicates an opinion, the Ombudsman will further investigate the case and provide a reasoned opinion with a view to an amicable solution.

The solution consists of a combination of Nimbl case management and SharePoint Online document management. Technically, contact management is integrated with a data source from FSMA. Functionally, the solution consists of a back-office application for the Ombudsman to handle incoming reports; a digital portal to file and follow up on a claim and, thirdly, a partner portal for the insurance organisations to follow up cases against their organisation and view statistics. 

A comprehensive submission form allows the complaint or additional information to be submitted digitally from the digital portal. A new case is automatically created or an incoming communication is added to an existing case. Via overviews in the back office, the case work can be viewed and distributed among the case handlers. The case detail screen provides an overview of the most important deadlines and actions to take. The tasks and actions stem from an underlying process model. This also determines the deadlines within which certain tasks must be performed, as well as ad hoc actions that must be possible for the case handlers at all times. Customised templates for communication (messages, e-mails and letters) ensure fast and efficient communication. The reporter is notified with an e-mail that there is a new message on the digital portal. A document can also be attached to that message. Nimbl also makes every performed action visible in an overview so that the history is clear for every employee.

Insurers can query the statistics at all times in real life to see the number of complaints by status, type, category, turnaround time, resolution proposal, etc.

The digital portal is built with the standard Nimbl components and customised to the client's look and feel.