Insurance Management

Insurance Management is a purpose-built module that handles the full lifecycle of insurance - from the first enquiry through to claim settlement. It is used by insurance teams, HR departments, and accounts staff to manage policies, collect premiums, and process claims in one connected system.

What This Module Does

Every insurance operation - selling a policy, collecting monthly premiums, handling a claim - involves multiple people and steps. Without a shared system, teams end up chasing each other on email, missing payment deadlines, and losing track of where each case stands. Insurance Management solves this by putting the entire lifecycle in one place:

A customer or employee applies for insurance coverage
The team reviews and approves the application
The system creates the policy and generates a complete payment schedule automatically
Invoices are raised each month without manual work
When a claim is made, the team reviews it and the system creates the payment and closes the billing cycle

Every step is connected. Every team sees the same information. Nothing falls through the cracks.

Who Uses This Module

Role	What They Do Day-to-Day
Customer Service Team	Handles new applications - creates proposals, starts the policy review process, uploads documents
Insurance Billing Specialist	Verifies applicant identity (KYC), manages premium schedules, processes claims and invoices
Insurance Manager	Approves or rejects proposals and policies, reviews claims, oversees the full operation
HR Team (HR User / HR Manager)	Handles employee insurance requests - approving family add-ons and managing deductions
Accounts Team	Processes invoices and payment entries for premium collection and claim payouts
Employees	Submit requests to add family members to their health insurance coverage; view their own policy

End-to-End Lifecycle

The insurance process follows a fixed sequence. Each step depends on the one before it.

Proposal submitted

The Customer Service team records the applicant’s details and submits a Policy Proposal for review.

Proposal approved

The Insurance Manager reviews and approves the proposal.

Policy created and KYC completed

The Customer Service team creates the Insurance Policy. The Billing Specialist verifies documents through KYC, and the Insurance Manager gives final approval.

Premium schedule created automatically

The moment the policy is approved, the system generates the complete instalment schedule for the policy term.

Sales invoice generated automatically each period

The system raises a Sales Invoice for each instalment as it falls due.

Premium paid

The accounts team records payment against each invoice.

Claim filed (if needed)

If the policyholder experiences a covered event, the Billing Specialist raises an Insurance Claim.

Claim approved and payment entry created automatically

The Insurance Manager approves the claim, and the system immediately creates a Payment Entry for the payout.

Claim paid and premium schedule closed automatically

Once the claim is marked as paid, the system closes all remaining instalments and the premium schedule ends.

Nothing in this chain is skipped. A policy cannot exist without an approved proposal. A premium schedule cannot exist without an approved policy. A claim cannot be settled without an active schedule.

Feature Overview

The module contains these features, organised by their role in the lifecycle: Setup (configured once by your administrator)

Feature	Purpose
Insurance Category	Groups similar types of insurance together (e.g. Health, Life, Accident)
Insurance Product	The specific plan being offered - defines coverage amount, premium rates, term, and eligibility rules
Insurance Document Type	The types of documents applicants must submit (e.g. ID Proof, Medical Certificate)
Claim Type	Categories of claims the insurer accepts (e.g. Medical, Accidental, Life)
Insurance Premium Slab	Age-based premium rate tables attached to a product

Day-to-Day Operations

Feature	Purpose	Who Uses It
Policy Proposal	Captures a new insurance application before the policy is formally issued	Customer Service, Insurance Manager
Insurance Policy	The live insurance contract - the central record everything else links to	Customer Service, Billing Specialist, Insurance Manager
Insurance Premium Schedule	The complete table of monthly payment instalments for a policy	Billing Specialist, Accounts
Insurance Claim	Records an incident and manages the claim review and settlement	Billing Specialist, Insurance Manager, Accounts
Insurance Member Request	Allows employees to add family members to their health insurance	Employee, HR User, HR Manager
Employee Health Insurance Management	Tracks an employee’s group health insurance details	HR Manager

Supporting Records (created automatically or linked)

Feature	Purpose
Insurance Policy Member	Lists each person covered under a policy
Nominee Beneficiary	Records who receives the benefit in the event of death
Insurance application Document	Stores uploaded files and identity documents
Insurance dependent details	Family member details added through a member request

Your Workspace

When you open the Insurance Management workspace, everything you need is organised into three sections.

Insurance Management workspace showing number cards at the top, workflow pipeline in the middle, two charts below, and three card groups at the bottom

Top Section - Number Cards

Eight live counters update automatically throughout the day, giving you an instant status check without opening a single record.

Middle Section - Visual Workflow Pipeline

Three visual pipelines show you the stages every record passes through: Insurance Process Insurance Claim Process Employee Insurance

Lower Section - Charts

Two charts give you a visual picture of your insurance portfolio and product mix.

Bottom Section - Quick Access Cards

Three card groups give you one-click access to every form you use regularly.

Card Group	Contains
Insurance Management	Insurance Category, Insurance Product, Policy Proposal, Insurance Policy, Insurance Premium Schedule, Sales Invoice, Payment Entry, Insurance Claim
HR Masters	Employee, Salary Component, Salary Slip, Insurance Member Request
Masters	Item, Customer, Supplier, Insurance Document Type

Number Cards - Monitoring Daily Operations

The eight number cards on the workspace are your primary monitoring tool. Check them at the start of each day to understand what needs attention.

Insurance Management workspace showing eight number cards arranged in a row: Approved Policies, Approved Proposals, Policies in KYC Pending, Rejected Policies, Rejected Proposals, Paid Instalments, Approved Member Requests, Rejected Member Requests

Card	What It Shows	Who Should Act	What To Do
Approved Policies	Total policies that have completed all approvals and are active	Insurance Manager	Confirm all approved policies have a premium schedule. If any don’t, alert your administrator.
Approved Proposals	Total proposals approved and ready to become policies	Customer Service Team	Convert each approved proposal into a policy. Don’t leave them sitting approved without follow-up.
Policies in KYC Pending	How many policies are waiting for identity verification	Insurance Billing Specialist	Open each pending policy and complete the KYC review. A high number here means applicants are waiting.
Rejected Policies	Total policies that were declined	Insurance Manager	Review rejections periodically to identify patterns - are the same documents always missing?
Rejected Proposals	Total proposals that were declined	Insurance Manager	Check whether applicants were informed and whether corrected applications were resubmitted.
Paid Instalments	Count of premium invoices that have been paid	Billing Specialist / Accounts	Use as a collection health indicator. Compare to total invoiced to understand payment rate.
Approved Member Requests	Employee family add-on requests that were approved	HR Team	Confirm the salary deduction has been applied correctly for each approved request.
Rejected Member Requests	Employee family add-on requests that were declined	HR Team	Ensure the employee was informed of the reason and knows how to reapply if circumstances change.

Click any number card to open the filtered list of records behind that number. This takes you directly to the relevant records without needing to search.

Dashboard Charts - Monitoring Your Portfolio

Two charts on the workspace give you a visual overview of the insurance portfolio.

Insurance Management workspace showing two charts side by side: a donut chart for Sum Assured by Company and a bar chart for Policy proposals by product

Insurance Sum Assured by Company

Chart type: Donut What it shows: The total coverage amount (sum assured) distributed across each insurance company you work with. When to use this: Check this when you want to understand how your coverage commitments are spread across providers. A single provider holding most of the coverage indicates concentration risk. Use it during portfolio reviews or when considering adding a new provider. Who uses it: Insurance Manager, senior team members reviewing provider relationships.

Insurance Product Policy Term (Policy Proposals by Product)

Chart type: Bar What it shows: The volume of proposals grouped by insurance product - which plans are being applied for most frequently. When to use this: Use this to spot which products are most in demand and which are rarely chosen. A product with very low uptake may need repricing or better communication. A product with very high uptake may need more staffing to handle the applications. Who uses it: Insurance Manager, Customer Service Team leads.

Notifications & Alerts

The system sends two automated email notifications related to insurance. Both go directly to the policyholder without any manual action from the team.

New Policy Created - Email to Policyholder

When it fires: The moment a new Insurance Policy is approved and submitted. Who receives it: The policyholder (the customer or employee the policy was issued to). What the email contains:

Applicant name and contact details
Insurance company and product name
Proposal date, policy start date, and policy status
Coverage amount (sum assured)
Premium payment mode, premium amount, and total premium
Policy duration
Registered address

What you need to do: Nothing - this email goes out automatically. If a policyholder says they did not receive the confirmation email, check that their email address on the policy is correct. If it is correct, contact your administrator to check the email delivery logs.

Example of the New Insurance Policy Created email showing policyholder details, insurance details, and premium information in a formatted layout

Premium Payment Reminder - Email to Customer

When it fires: When a Premium Schedule instalment’s due date is today. Who receives it: The customer linked to the premium schedule. What the email contains:

Policy number
Premium amount due
Due date

What you need to do: If a customer says they did not receive a payment reminder, check that today’s date matches the instalment’s due date and that the customer’s email is correctly linked to the premium schedule.

The payment reminder only fires if the due date on the instalment matches today’s date exactly. If the instalment date was missed (e.g. the system was down), the reminder will not be re-sent automatically. You may need to follow up with the customer manually.

Complete Workflow - Start to Finish

Here is the full journey a typical insurance case follows, from the first customer enquiry to final settlement. Day 1 - Application A customer or employee approaches the insurance team wanting coverage. The Customer Service team opens a new Policy Proposal, records the applicant’s details, selects the insurance product and coverage amount, and uploads the required documents. They submit the proposal to the Insurance Manager for review. Day 1 or 2 - Proposal Approval The Insurance Manager reviews the proposal on the workspace. The Approved Proposals number card shows how many are waiting. The Manager clicks Approve (or Reject). If approved, the proposal status changes to Approved. The Customer Service team is now ready to create the policy. Day 2 - Policy Creation and KYC The Customer Service team converts the approved proposal into an Insurance Policy and clicks Initiate to start the review process. The policy moves to Initiated status. The Customer Service team then sends the documents for identity verification by clicking Review - the policy moves to KYC Pending. The Policies in KYC Pending number card on the workspace now increases. Day 2 or 3 - KYC Verification The Insurance Billing Specialist opens the policy, reviews all documents and identity details, and clicks Complete KYC. The policy moves to Approved status. Immediately after KYC - Automatic Setup The moment the policy is approved and submitted, the system does three things automatically:

Creates the full Insurance Premium Schedule with a row for every monthly instalment over the entire policy term
Sends the Policy Confirmation email to the policyholder
Raises the first instalment’s Sales Invoice and marks that instalment as Invoiced

Every Month - Premium Collection The Accounts team processes the monthly Sales Invoice and records payment. Each instalment in the schedule moves from Invoiced to Paid. If a Claim is Needed - Claim Filing When an incident occurs, the Insurance Billing Specialist opens a new Insurance Claim, links it to the policy and schedule, records the incident date, describes what happened, enters the claimed amount, and uploads the supporting documents. The claim is submitted. Claim Review The Insurance Manager reviews the claim, sets the approved payout amount, and updates the claim status to Approved. Automatic Payment Entry The moment the claim is approved and saved, the system automatically creates a draft Payment Entry addressed to the insurance company for the approved amount. The Accounts team processes and finalises this payment. Final Settlement Once the insurance company pays out and the payment is confirmed, the team updates the claim status to Paid. At that moment:

All remaining unpaid instalments in the premium schedule are automatically closed
The premium schedule status changes to Closed
No further invoices are raised
The insurance lifecycle for this policy is complete

Daily Tasks by Role

Customer Service Team - Morning Checklist

Check Approved Proposals card - convert any approved proposals into policies
Check open Policy Proposal list - follow up on proposals still in Draft
Initiate KYC on any newly created policies

Insurance Billing Specialist - Morning Checklist

Check Policies in KYC Pending card - open each pending policy and complete verification
Review open Claims - check for any newly submitted claims that need review
Check premium schedule instalments - monitor for overdue items

Insurance Manager - Morning Checklist

Review new Policy Proposals awaiting approval
Review any Claims in Approved status awaiting payout
Check Rejected Policies and Rejected Proposals cards for patterns
Review the Insurance Sum Assured by Company chart periodically for portfolio balance

HR Team - As Needed

Review Insurance Member Request Approved and Rejected cards
For approved requests, confirm salary deductions have been applied
For rejected requests, inform the employee with reasons

Accounts Team - Daily

Process open Sales Invoices for premium instalments
Process Payment Entry records created after claim approval

What Each Page Covers

Page	What You Will Learn
Policy Proposal	How to create and submit an insurance application
Insurance Policy	How to issue a policy, complete KYC, and get final approval
Insurance Premium Schedule	How to read and manage the payment schedule for a policy
Insurance Claim	How to file, approve, and settle a claim

Law Management

CA Practice Management

Insurance Management

What This Module Does

Who Uses This Module

End-to-End Lifecycle

Feature Overview