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Improving Claims Operations: A Model-Based Approach

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The Service Productivity and Quality Challenge

Part of the book series: International Studies in the Service Economy ((ISSE,volume 5))

Abstract

The insurance business requires an insurance company to pay the insured in the event of a loss in return for the insured’s payment of the premium to the insurance company. In case of a loss, the insured files a claim with the insurance company, which then moves on to perform the necessary investigation and evaluation of the claim before making the appropriate payment to the insured. The process of claims investigation, evaluation and payment is known as the claims handling or claims adjustment process and is one of the most essential and basic functions of an insurance company.

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References

  • Apostol, T.M. (1974). Mathematical Analysis (Addison-Wesley Publishing Company, Reading, MA), 270–274.

    Google Scholar 

  • Apte, U.M., and R.A. Cavaliere (1993). “A capacity planning model for the claims handling process,” Mathematical and Computer Modelling 17(3), 67–82.

    Article  Google Scholar 

  • Apte, U.M., and G.G. Hegde (1991). “Cycle time improvement in service industry: Field study in insurance claims operation,” Working Paper, Cox School of Business, Southern Methodist University (Dallas, TX).

    Google Scholar 

  • Cissley, C.H. (1980). Claim Administration: Principles and Practice (International Claim Association, Cincinnati, OH).

    Google Scholar 

  • Crane, F.G. (1984). Insurance Principles and Practices (J. Wiley & Sons, New York, NY).

    Google Scholar 

  • Cummins, J.D., and S.E. Harrington (1984). “Econometric forecasting of automobile insurance paid-claims cost,” in J.D. Cummins (ed.), Strategic Planning and Modeling in Property and Casualty Insurance (Kluwer-Nijhoff Publishers, Boston, MA).

    Chapter  Google Scholar 

  • Hegde, G.G., S. Kekre, and S. Kekre (1991). “Engineering changes and time delays: A field investigation,” Journal of Manufacturing and Operations Management, forthcoming.

    Google Scholar 

  • Hogg, R.W., and S.A. Klugman (1984). Loss Distributions (J. Wiley & Sons, New York, NY).

    Book  Google Scholar 

  • Magarick, P. (1989). Casualty Insurance Claims: Coverage, Investigation, Law (3rd ed.), (Clark Boardman Company Ltd., New York, NY).

    Google Scholar 

  • Martin, F.H. (1986). “Claims investigations — Are they going out of style?” CPCU Journal 39(2).

    Google Scholar 

  • Paulson, A. S. and N.J. Fans (1984). “A practical approach to measuring the distribution of total annual claims,” in J.D. Cummins (ed.), Strategic Planning and Modeling in Property and Casualty Insurance (Kluwer-Nijhoff Publishers, Boston, MA).

    Google Scholar 

  • Peterson, T.M. (1981). Loss Reserving: Property/Casualty Insurance (Ernst & Whinney, New York).

    Google Scholar 

  • Stalk, G., Jr., and T.M. Hout (1990). Competing Against Time (The Free Press, New York, NY).

    Google Scholar 

  • Stevenson, D.F. (1988). “Is it short-sighted budgeting to reduce defense costs,” Claims (February 16, 1988).

    Google Scholar 

  • Webb, B.L., J.J. Launie, W.P. Rokes, and N.A. Baglini (1981). Insurance Company Operations, vol. 2, (2nd ed.) (American Institute for Property and Liability Underwriters, Malvern, PA).

    Google Scholar 

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© 1995 Springer Science+Business Media Dordrecht

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Apte, U.M., Cavaliere, R.A., Hegde, G.G. (1995). Improving Claims Operations: A Model-Based Approach. In: Harker, P.T. (eds) The Service Productivity and Quality Challenge. International Studies in the Service Economy, vol 5. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-0073-1_11

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  • DOI: https://doi.org/10.1007/978-94-011-0073-1_11

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-4036-5

  • Online ISBN: 978-94-011-0073-1

  • eBook Packages: Springer Book Archive

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