1. Claims Reporting Overview

2. Agenda Methodology Key Performance Indicators Key Reporting Metrics
Reporting Pyramid
Technology and Architecture
Key Performance Indicators
Claim KPI Definitions
Key Reporting Metrics
Claims Ratios
Claims Measures
Claims Metrics
Dashboards
Overview
Claims Financial Focus
Claims Metric Focus
Claims Historical Focus
Claims Graphical Reports
Overview
Claim Metrics
Claim Timeliness
Incurred Losses
Estimated Loss Trend
Paid vs. Denied
Paid vs. Recovered
Loss History
Timeliness
Claims Register Reports
Report Definitions

3. Methodology - Reporting Pyramid
The Business Intelligence reporting structure offer by Oceanwide is built in three distinct layers, with each layer increasing the granularity of detail exposed in the reports:
Level 1 – Dashboard The dashboard reports are intended to give at a glance snapshots of Key Performance Indicators and summary trends.
Level 2 – Graphical Reports The graphical reports are available within dashboards and from drill downs or links in dashboards, they are intended to give a breakdown of high level trends across lines of business, geographical areas etc.
Level 3 – Register Reports The register reports are intended to give granular detail level reporting, typically the reports will offer advanced filtering and distribution options to allow for reporting of specific areas of interest in detail (e.g. Claim Payment Details).

4. Methodology - Technology and Architecture
The Oceanwide Business Intelligence platform is built on SQL Server databases and IBM Cognos.
IBM Cognos allows for the creation of static reports, ad-hoc reporting, scheduling and distribution of reports in various formats and methods (i.e. HTML/PDF/EXCEL formats, /file system distribution).
The diagram below outlines the database and ETL architecture of the platform:

5. Agenda Methodology Key Performance Indicators Key Reporting Metrics
Reporting Pyramid
Technology and Architecture
Key Performance Indicators
Claim KPI Definitions
Key Reporting Metrics
Claims Ratios
Claims Measures
Claims Metrics
Dashboards
Overview
Claims Financial Focus
Claims Metric Focus
Claims Historical Focus
Claims Graphical Reports
Overview
Claim Metrics
Claim Timeliness
Incurred Losses
Estimated Loss Trend
Paid vs. Denied
Paid vs. Recovered
Loss History
Timeliness
Claims Register Reports
Report Definitions

6. Key Performance Indicators – Claims KPI Definitions
The following KPIs are available to be included in Claims Dashboards:
Name
Definition
NoI Count
The number of Claims currently in Notice of Intent status
FNoL Count
The number of Claims currently in First Notice of Loss status
HVC Count
The number of Claims with a Reported Loss Amount equal or greater to the configured High Value Claim amount of the Product
Incidents
The number of Incidents which have claims in Notice of Intent or Open status
Catastrophes
The number of Catastrophes which have claims in Notice of Intent or Open status

7. Agenda Methodology Key Performance Indicators Key Reporting Metrics
Reporting Pyramid
Technology and Architecture
Key Performance Indicators
Claim KPI Definitions
Key Reporting Metrics
Claims Ratios
Claims Measures
Claims Metrics
Dashboards
Overview
Claims Financial Focus
Claims Metric Focus
Claims Historical Focus
Claims Graphical Reports
Overview
Claim Metrics
Claim Timeliness
Incurred Losses
Estimated Loss Trend
Paid vs. Denied
Paid vs. Recovered
Loss History
Timeliness
Claims Register Reports
Report Definitions

8. Key Reporting Metrics – Claims ratios
The following Claims Ratios are available to be included in Claims reports:
Name
Definition
Loss Adjustment Expense Ratio
The sum of Loss Adjustment Costs divided by the sum of Earned Premium, where the Loss Adjustment Cost is the sum of the Actual and Reserved Loss Expenses
Loss Incurred Ratio
The sum of Claim Payment amounts and changes in Reserve amounts divided by the sum of Earned Premium

9. Key Reporting Metrics – Claims Measures
The following Claims Measures are available to be included in Claims reports:
Name
Definition
Claim
Request for payment based on terms of policy
Reserve
Amount reserved to pay unsettled claim
Cost
Expenses of adjusting Claim Case (i.e. surveyor costs, legal fees)
Paid
Amount paid to claimants and other claim parties
Incurred
Amount paid and open Reserve amounts
Net Incurred
Amount paid and open Reserve amounts less Reinsurance amounts
Severity
Severity level of claim
Subrogation
Amount recovered to offset loss amount
Litigation
Indication that the claim is in legal dispute
Suspended
Claim is awaiting non adjuster activity or evidence

10. Key Reporting Metrics – Claims Metrics
The following Claims Metrics are available to be included in Claims reports:
Name
Definition
Aging
Number of days the claim case has been open
Reporting Time
Number of days from loss occurrence to notice of intent recorded
Settlement Time
Number of days for claim payment from notice of intent recorded
Cycle Time
Number of days for claim case to be closed from notice of intent recorded
Frequency
Number of claims divided by number of exposures (coverages)

11. Agenda Methodology Key Performance Indicators Key Reporting Metrics
Reporting Pyramid
Technology and Architecture
Key Performance Indicators
Claim KPI Definitions
Key Reporting Metrics
Claims Ratios
Claims Measures
Claims Metrics
Dashboards
Overview
Claims Financial Focus
Claims Metric Focus
Claims Historical Focus
Claims Graphical Reports
Overview
Claim Metrics
Claim Timeliness
Incurred Losses
Estimated Loss Trend
Paid vs. Denied
Paid vs. Recovered
Loss History
Timeliness
Claims Register Reports
Report Definitions

12. Dashboards - Overview
The dashboards offered are focused on distinct areas of interest:
Financials
Intended for users focused on the financial performance of products over time and current liabilities
Metrics
Intended for users focused on the volume of claims and processing times of claim cases
Historical
Intended for users focused on the historical performance of products and the loss levels experienced
Each dashboard is laid out to provide KPIs at a glance, a main graphical report and two secondary graphical reports.

13. Dashboards – Claims Financial Focus
The diagram below illustrates a financially focused claim dashboard:

14. Dashboards – Claims Metrics Focus
The diagram below illustrates a metrics focused claim dashboard:

15. Dashboards – Claims Historical Focus
The diagram below illustrates a historically focused claim dashboard:

16. Agenda Methodology Key Performance Indicators Key Reporting Metrics
Reporting Pyramid
Technology and Architecture
Key Performance Indicators
Claim KPI Definitions
Key Reporting Metrics
Claims Ratios
Claims Measures
Claims Metrics
Dashboards
Overview
Claims Financial Focus
Claims Metric Focus
Claims Historical Focus
Claims Graphical Reports
Overview
Claim Metrics
Claim Timeliness
Incurred Losses
Estimated Loss Trend
Paid vs. Denied
Paid vs. Recovered
Loss History
Timeliness
Claims Register Reports
Report Definitions

17. Claims Graphical Reports - Overview
The graphical reports are designed to provide a summary roll up of key claims reporting areas at a glance, the reports allow for filtering :
Report Name
Insurer
Distributor
Adjuster
Product
Underwriting Year
Assured
Claim Metrics Y
Incurred Losses
Estimated Loss Trends
Paid Versus
Loss History

18. Claims Graphical Reports – Claim Metrics
Live metrics report, providing the number of claims in each status
Stacked column chart
Reporting by Adjuster, by Product

19. Claims Graphical Reports – Claim Timeliness
Illustrating the claim case processing performance in days to closed
Stacked column chart
Reporting by Product, by Adjuster

20. Claims Graphical Reports – Incurred Losses
Reports the break down of total losses by type and distribution over products
Stacked bar chart
Reporting by Product, by Loss Type. Additional filtering for Losses Report by Date

21. Claims Graphical Reports – Estimated Loss Trend
Reports total estimated losses historically against the target set for the product
Stacked line chart
Reporting by month, quarter, year

22. Claims Graphical Reports – Paid Versus
Illustrating the ratio of payments to denials and recoveries
100% stacked bar chart
Reporting Paid vs. Denied, Paid vs. Recovered, by Product, by Underwriting Year

23. Claims Graphical Reports – Loss History
Reports the historical loss including payments, reserves and incurred amounts
Stacked line chart
Reporting by month, quarter, year

24. Agenda Methodology Key Performance Indicators Key Reporting Metrics
Reporting Pyramid
Technology and Architecture
Key Performance Indicators
Claim KPI Definitions
Key Reporting Metrics
Claims Ratios
Claims Measures
Claims Metrics
Dashboards
Overview
Claims Financial Focus
Claims Metric Focus
Claims Historical Focus
Claims Graphical Reports
Overview
Claim Metrics
Claim Timeliness
Incurred Losses
Estimated Loss Trend
Paid vs. Denied
Paid vs. Recovered
Loss History
Timeliness
Claims Register Reports
Report Definitions

25. Claims Register Reports - Overview
The register reports are designed to provide in depth detailed reporting, providing filtering options for targeted granular reporting, the standard filtering options are:
Policy Details
Product
Underwriting Year
Coverages
Claim Details
Insurer
Distributor
Assured
Adjuster

26. Claims Register Reports – Report Definitions
The following register reports are offered:
Claims Summary
Summary details of claims, including claim participants, reported loss amounts, loss types, reserve amount and payment amount roll ups
Claims Detail
Expanded details of claims, including coverage individual reserve amounts
Claims Ageing
Detailed report of claims ageing allowing granular filtering to provide claim processing performance by product, adjuster, assured, insurer, distributor
Claims Lag Analysis
Detailed report of claims processing performance tracked between key claim statuses, e.g. FNol to In Progress.

27. Claims Register Reports - Report Definitions
Claims Metrics
Detailed report of number of claims in each status
Claims Payment summary
Detailed report of all claim payments provided in descending chronological order
Recovery Summary
Summary of all recovery payments for claims
Salvage Summary
Summary of all salvage payments for claims
Bordereaux Summary
Summary of claims included in a bordereaux

28. Claims Register Reports - Report Definitions
Catastrophe Summary
Summary of claims included in a catastrophe
Incident Summary
Summary of claims included in an incident