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Post
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Published
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dfd-modelling
summary
This is a business process model documented as a context diagram and a Data flow diagram (DFD)
category
Business Analysis
tags
Data Flow Modelling
Finance
date
Jan 11, 2023 11:19 PM
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dfd_modelling
jasonxsiuUpdated Aug 14, 2021

Business modelling for insurance claiming process

What am I trying to do and achieve?

This is a business process model documented as a context diagram and a Data flow diagram (DFD)

Scenario

The business process is a insurance claiming process of an automobile insurance company. The claim is for repairing of an automobile using one of their pre-approved mechanics.

Why

When a client makes claims for automobile repairs, e.g. collisions, fire damages or damages due to natural disasters such as flood, the client can either call the insurance help centre to inform them about the nature of the claim and provide descriptions of the damages, or they can complete the claim form online via the company website – so they have time to think about the incident and describe it clearly.
Either way, the insurance officer first checks the validity of the insurance policy by entering the policy number to the system. In case the client lost the policy number, client’s personal details such as full name, phone numbers, etc can be used to lookup for their insurance policies. Claims may be rejected if the policy number is expired and the client’s personal details cannot be found in the system. After verification of policy number, the officer will retrieve the automobile information, policy coverage, excess fee, etc from the database. At the back end, the policy number is retrieved from the Policy master data which also contains the details of policy coverage and automobile information. Client’s personal details are stored in Customer master data.
When a claim is successfully lodged, the system generates a case reference number, which is saved in the Case event data. The client may use this reference number later, e.g. to check for the claim status, details of repair work, etc. Then, the officer will retrieve a list of certified mechanics that meet the case requirement.

How

The deliverables are a context diagram and DFD.
Analysis on Gearbest’s Business Process Improvement System Analysis for a university PhD Research Meeting System