HomeOwner First Loss Collaboration Overview

IBM(R) WebSphere(R) Business Integration Collaboration for HomeOwner First Loss is designed for a typical insurance scenario where a client wishes to submit an initial notice of loss against an existing homeowner's policy. The end user is an existing client with a valid policy. When the client's request is received, this collaboration allows the financial institution to quickly generate a notice of claim and provide a relevant response.

Business rules

The following business rules apply to the HomeOwner First Loss business process:

System assumptions

Like the other WebSphere Business Integration for Insurance collaborations, HomeOwner First Loss utilizes the IBM WebSphere InterChange Server. IBM WebSphere connectors are used to connect to other applications that participate in the collaboration object.

The following applications are also assumed to participate in the HomeOwner First Loss collaboration object: 

This collaboration object uses a Pub/Sub engine to post responses.

The following diagram illustrates the system features that are expected to execute this collaboration object, including IBM WebSphere connectors:

 

ValidateLossInputAndSubmitClaim system assumptions diagram

 

Use Case

This process demonstrates a typical homeowner's insurance scenario where a client wants to issue a first claim against an existing homeowner's policy for a loss that has occurred. The process begins when the client uses a browser to provide details of the policy holder, and is completed when verification of the claim has been published to all interested systems.

Actors

The HomeOwner First Loss use case has a single actor, a client of the insurance provider. The client has an existing homeowner's policy with the insurance provider and wants to submit an initial claim for loss against the policy.

Use case flow

The following tables describe the main course and the alternate courses that can be followed in the HomeOwner First Loss use case:

Main course
# Activity by the actor System activity Reference
M1 Client submits a claim for a first loss against a homeowner policy. Receives client information  
M2   Retrieves client information 1
M3   Retrieves policy information 2
M4   Submits loss information 3
M5   Retrieves claim information 4
M6   Publishes a response message to client with claim information or notice of request failure  
Alternate course
# Activity by the actor System activity Reference
1   Submitted client information does not match information on record M6
2   Submitted policy information does not match information on record M6
3   Submitted loss information is not able to be processed M6
4   Submitted claim information does not match information on record M6

The following activity diagram illustrates the HomeOwner First Loss use case:

Activity diagram for Homeowner First Loss

Business examples

The following business examples show situations where the HomeOwner First Loss use case is realized.

New claim submitted with accurate client data

  1. A client suffers a loss and wishes to make an initial claim against an existing homeowner's policy.
  2. The client submits the request for a claim, using a Web browser to enter their current user and loss information.
  3. The client and policy information are retrieved by the insurance provider's system.
  4. The loss information is submitted, along with the relevant client and policy data
  5. A response message is quickly returned to the client's system, providing the accurate claim information according to the terms of the policy.

New claim requested with incorrect client data

  1. A client suffers a loss and wishes to make an initial claim against an existing homeowner's policy.
  2. The client submits the request for a claim, using a Web browser to inadvertently enter incorrect user and loss information.
  3. The client information cannot be retrieved by the insurance provider's system.
  4. A response message is quickly returned to the client's system, indicating that the client data cannot be found in the insurance provider's records.
  5. The client contacts the insurance provider and the reason for the non-match is quickly determined.

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