Claims Project Group

Need

The main reason is to submit the actual eEG7 claims information to TBG17 in order to develop core com-ponents for the claims area. Besides that we also want to bring in the country specific claims information.

During the Vienna meeting December 2006 the eEG7 members decided to prioritise the needs as follows:

Functional areas
Primary Processes
1	Notification
2	Settlement (Claims Invoice)
3	Statistical report
4	Assessment request
4	Assessment report
5	Claim Covered confirmation
Related processes
6	Fraud prevention
7	Loss prevention

Classes of Business
1	Motor
2	Household
3	Commercial
4	Personal Injury
5	Workers compensation

Scope

In Scope
Development of Core Components

eEG7 data catalogue : SMILe
Local data catalogues : GDV, Telebib2, AFD, Slovenian claims catalogue, and catalogues from other interested eEG7 members.

Out Scope
Development of messages.
Healthcare claims handling.

Deliverables

Extended SMILe data model, updated with claims area
2 XSD’s for motor claims notification and settlement for test purposes, internal use
Submission of claims Core Components to TBG8 – TBG17

Inputs

Claims information from SMILe version 1
Local data catalogues

Timeframe

It was decided that the focus in 2007 will be on motor related claims information, specifically the claims notification and settlement. After finalisation of this first project phase the members will prioritise the next steps again.