Insurance Claims Management
First notice of loss, triage, investigation, reserving, adjustment, settlement, recovery and subrogation, litigation, fraud / SIU, and catastrophe response across all insurance lines.
Insurance Claims Management (BC-2160) is a level-1 business capability in the Insurance model. The catalog holds 0 API surface(s) from 0 provider(s) that can perform some part of it. Reach is the vendor surface that lands on this capability — it is not a claim about what any particular organisation has deployed.
Authorities this capability cites
Cited by the capability model itself. These frameworks are referenced, never redistributed, and citing one does not imply its owner endorses this listing.
- https://www.acord.org/standards/reference-architecture
- https://www.iaisweb.org/icp-online-tool/
- https://www.lloyds.com/conducting-business/claims
Sub-capabilities
First Notice of Loss Management BC-2160.10
Multi-channel FNOL intake, coverage verification, registration, and acknowledgement.
Claims Triage & Segmentation BC-2160.20
Severity scoring, straight-through routing, adjuster assignment, and specialist routing.
Claims Investigation & Adjustment BC-2160.30
Field and desk adjustment, damage assessment, liability determination, and SME consultation.
Claims Reserving Management BC-2160.40
Initial case reserve setting, re-estimation, and IBNR coordination.
Claims Settlement & Payment BC-2160.50
Settlement negotiation, indemnity and expense payments, salvage, and recovery / subrogation.
Claims Litigation Management BC-2160.60
Litigation strategy, defence counsel coordination, and litigation cost tracking.
Claims Fraud & SIU Management BC-2160.70
Suspicious-claim detection, SIU investigation, fraud referral, and anti-fraud analytics.
Catastrophe Claims Management BC-2160.80
CAT event activation, surge capacity, CAT claims tracking, and CAT recovery coordination.
Providers that reach this capability
No provider in the catalog currently publishes an API surface that reaches this capability. That is a real answer, not a gap in the page: much of what an enterprise does runs on internal systems that publish no API at all.