Operational Claims General Insurance Procedure in PT XYZ

Operational Claims General Insurance Procedure in PT XYZ
By: Imanugrahtama

I. Introduction
Life is full of unexpected risks or unexpected, because of that we need to understand about insurance. Some natural events that occurred recently, such as an earthquake in West Java, an earthquake in Padang and Jambi, such as reminding us will need insurance. For every member of society including the business world, the risk for experiencing disadvantage (misfortune) are always there (Kamaluddin: 2003). In order to minimize losses, human beings developed a mechanism which we now know as insurance.
The primary function of insurance is as a mechanism to transfer risk (risk-transfer mechanism), which transfer risk from one party (the insured) to another party (the insurer). Risk transfer is by no means eliminates the possibility of misfortune, but the insurer to provide financial security (financial security) and tranquility (peace of mind) for the insured. In return, the insured pays a premium in a very small number when compared with potential losses that may be suffered. (Morton: 1999).
The insurance company is the kind of company that runs an insurance business. Business insurance is a financial services business with public funds through the collection of insurance premiums to provide protection to members of the public service users insurance against potential losses because of an uncertain event or for life or death.
In the Book of Law Trade Law (to businesses) of article 246, "Insurance is an arrangement whereby a person binds himself to a person insured by receiving a premium to provide reimbursement to him for any loss, damage, or loss of expected benefits that may be suffered as a indeterminate event ". Can be taken a conclusion that insurance is an agreement between the insured and the insurer (insurance company) where the insurer guarantees all insured losses from the insured object.
Basically, the insurance policy is a contract that is a legal agreement between the insurer (in this case the insurance company) with the insured, whereby the insurer willing to cover some losses that may arise in the future in return for payment (premium), some of the insured. In the insurance policy there are some parts that is the scheduling policy, and the wording of the policy. Scheduling policy includes details about ikhitisar responsibility, among others; name insured, object responsibility, policy period, and the amount of premium paid. Policy wording contains about ketentuan-ketentuan/pasal-pasal insurance policy agreement.
Vehicle insurance is insurance with a guarantee that ensures vehicle collisions, slip, evil deeds of others rather than families, theft, and fires with a pay premium in a period of coverage. Vehicle insurance to help vehicle owners feel financially protected if the vehicle experienced an unexpected risk.
Initially vehicle insurance claims handling in PT XYZ takes a long time. Procedures that are too long cause customers often complain of vehicle spending long hours in the garage so that customers can not use his vehicle.

II. Theory basis
Competition has never stopped and even always in the market, it is necessary for reorganization of the company's operations to provide better service to customers. Competitive advantage does not always obtained from the basic price per unit is lower, but more on the ability to deliver timely quality products in a sustainable, these capabilities are highly regarded by customers, and therefore customers are willing to pay more for it. Competition began to be developed through excellence in operations, which support product development and customer sensitivity that is targeted. (Johns and Harding, 2001)
Management operations such as that expressed by Jay Heizer and Barry Render (2009) was a series of activities that create value in the form of goods and services by transforming inputs into outputs. Activities to create goods and services is available at any company or organization.
Services can be interpreted as an economic activity that does not create a tangible product. Goods can be interpreted as a tangible product. The factors that distinguish goods and services (Heizer and Render, 2009), among others:
1. Services do not usually have the form of tangible goods while
2. Services are usually produced and consumed simultaneously and do not need storage while the goods are produced and consumed in isolation and need storage.
3. While the goods are usually unique services have common characteristics and are not unique.
4. Service levels with high customer interaction while the level of interaction with customers goods is low, customers who had complaints filed complaints.
5. Services have inconsistent definitions of the product. Defini products carefully as possible contained in the vehicle insurance policy, but inkonsistent for policyholders to replace their vehicles.
According to Heizer and Render (2009), Pure Service can be defined as services that do not include a tangible product. As an example of a pure services company (puree of service) are insurance companies, both life insurance and general insurance. The services sector is a segment of the economy including trade, finance, lodging, education, legal and other professional medical work.
Service sector productivity is very hard to develop this is because the service sector:
1. Typical is more use of labor
2. Often focused on the individual's unique attributes.
3. Often an intellectual task performed by a professional
4. Often difficult to mechanize and automate
5. Often difficult to evaluate the quality of
Creating services is a challenge because services have unique characteristics. One reason for the increase of productivity improvement in services is very low this is because the design process and distribute it to customers requiring customer interaction. In the early stages when the company will make or design a product and services received inputs from the customer or the company gets feedback from customers through the transmission and can also advise customers whether it is in the design process or distribution process.
Quality, as adopted from the American Society for Quality can be defined "The totality of features and services or Characteristics That bears on its ABILITY to satisfy stated or implied needs". From the definition above can be interpreted that the quality has the features and characteristics of goods and services that can satisfy customers' needs.
Manpower planning is to determine staffing policies related to job stability, work schedules and work rules. Stability of labor associated with the number of employees who are managed by an organization at a particular time. There are two policies relating to the stability of labor:
1. Following a request, follow the demand to keep direct labor costs but remain attached to the other charges. Other costs include: costs to appoint and dismiss, the guarantee of unemployment, and the cost to entice employees to work is not fixed. This policy of treating employees as a cost variable.
2. Maintain the number of permanent employees. Maintaining the level of permanent employees with memperhankan trained manpower and equipment hire, dismiss and not working a minimum cost. With labor remains constant, the employee may not be fully utilized when demand is low, and the company may not have the necessary human resources when demand is high. This policy of treating employees as fixed costs.

Indonesia's standard work schedule is 8 hours. Variety of popular work schedule currently is flextime. According to Heizer and Render, 2009, within the limits of Flextime allows employees to set their own schedule. This policy provides one of the freedoms granted to employees of the company.
Job rotation is that employee turnover occurs when employees are allowed to move from jobs that they have learned into a new job. Companies sometimes require rotation benefits when employees have been hired experts in the field and to move them to other divisions / areas of work that others can add to the employee experience.
Arrangement reflects the operating strategy of the view out the decision-making operations, focusing on market needs and customers, with the aim of improving the competitive position of companies selected in the present and future. Prepare the operating capacity of the operating strategy that can be exploited for commercial profit. Operating strategy to prepare the operating capacity that can be used for commercial profit.




III. Case Studies
XYZ Company is one of the 20 largest insurance companies in Indonesia. These companies are subsidiaries of one company group. The company was founded in 1968 and began to go public in 2002. XYZ has a superior product that is vehicle insurance, fire insurance, and insurance carriers.
Competition strategy of low prices, PT XYZ in this period lies in vehicle insurance. Ease during the process of vehicle insurance coverage who did not take long to make this product can capture market share. Ease, among others; Marketing can conduct surveys cover photo, Marketing can quickly create a cover note stating the vehicle had been assured by the insurance without waiting for the submission by the officer of XYZ. Coffee cover note is given to Officer PT XYZ to immediately created a vehicle insurance policy. This strategy
At the beginning of Going Public, XYZ management has many partners workshop. Workshop for partners that is owned by XYZ ± 20 units. Claims payment system is still reimbursement. Claims process in PT XYZ starts from the insured to report claims XYZ, the claims department advised the insured to bring his car, officers claim the vehicle and the physical survey collected information both chronological events, photo survey and notes sections of damaged cars and also bring claim forms have been signed by the insured, claims Officer requested approval to your supervisor or claims manager to get SPK (work orders), so the workshop can directly do. The process of reporting to the DSS out ± 1-week time-consuming and time-consuming process of ± 1 week of making the insured waited long enough to use the car.
The duration of the process of insurance claims and closure process is inversely proportional. Claims process long enough to make the customer disappointed and move to other insurers. Apart from the duration of construction period by the workshop, fraud also occurs from some of the workshops that often do cheating in the process so that the cost of claims become swollen. The ratio of claims to be as high as 100% ±. The claim ratio is a calculation of the cost of claims divided by premiums. The ideal ratio is the ratio of claims that are under 100%.

IV. Analysis
Create price competition strategies PT XYZ emphasis on shortening the closure of only 1 day. XYZ less attention to accuracy of the data so that cause underwriting result to be down. Some marketing has a low utmost good faith, and lead to better prioritize the interests of customer marketing. Customers want the condition of any car can be accepted by the insurer while choosing car insurance is more smooth in a state that can be covered. This difference can be explained by marketing in offering car insurance products to prospective customers.
High claims ratio causes insurance companies do not benefit from insurance premium vehicle. Besides the high claims ratio can result in a decline in the financial balance sheet of XYZ. Payment of an expense claim in the financial balance sheets of insurance companies and also makes the underwriting result to be down. This will adversely affect the financial performance of XYZ.
Number of workshops to become a partner PT XYZ is selling to the public. Society will have a perception of more and more partners workshop owned by a company that will allow them to process claims. This strategy is an initial strategy for the company to be able to win the general insurance market. This strategy must be supported by good supervision.
XYZ Management evaluates the product of their vehicle insurance. A significant change is to reduce the number of workshops for regional partners Jabotadebek, from the original 20 partners to six garage workshop partners. Besides reducing the number of workshops partnership, XYZ Management and workshop partners agreed to use part of garage space to establish a claim center.
Claim Center is a place for insureds to report claims, to wait for the repair process, and can also be used as containers for the marketing of insurance products such as fire insurance. Claim Center does not require such a vast room, spacious 4x5 m room equipped with air conditioning, 1 table, 1 fruit cabinet shelves, 5 chairs, and equipped with banners, brochures and claim forms. Claim Center manned by 1 or 2 person staff of XYZ. SPK-making increasingly shortened by claims supervisors conduct regular schedule every day to approve the claim and sign the DSS and can not be separated from other activities. Acceptance Limit Supervisor should have charged to supervisor of ± five million rupiah, the limit above five million rupiah should be submitted to the claims manager by the claim center staff and the responsibility of the claim center staff to follow up the process of acceptance. After the acceptance of claims approved by the DSS will be followed up by the workshop partners. This had a positive impact on customer satisfaction.
Ordering procedures regarding vehicle insurance claim process in PT XYZ, as follows: Page
1. Report loss within 5 days after the loss.
2. Prepare all reporting documents in accordance with the type of loss suffered. Immediately submit the claim documents are complete, so that claims can be processed immediately.
3. Some types of claims require a survey to the insured object. This is intended to identify clearly the cause of the loss estimation process and as a total loss suffered by the customer
4. After all the documents and complete claim data, XYZ team will further analyze the existing claims. This is intended to determine the value of compensation and compensation process to be traversed.
5. The process of compensation made in accordance with the type of loss suffered.
Changes in internal party procedure XYZ bring meaningful change to the claims processing cycle, a process which was originally more than one week to less than one week. This increase is expected to increase production amount of vehicle insurance.
Page 6 XYZ has a partner in regional workshops across Greater Jakarta area, Pondok Indah (South Jakarta), Kalimalang (East Jakarta), Yos Sudarso (North Jakarta), Jelambar (West Jakarta), Bogor and Tangerang. Into six regions have been represented Jabotadebek and capable of satisfying the customer.

IV. Conclusions and Suggestions
IV.1. Conclusion
As an insurance company XYZ will increase customer satisfaction by understanding customer needs. What are the customer's desire can be described as follows:
1. Rapid procedure of insurance coverage, including survey process, the policy-making to the process of policy delivery.
2. Rapid claims procedures, including the survey process claim, the decline in DSS, to the working process in the workshop.
3. Workshop for partners that have good quality and sufficient quantity so that customers can more easily find the garage when it will make the claim.
XYZ has the right step when the customer feels dissatisfied with the process of vehicle insurance claims, PT XYZ conduct an internal evaluation of its claims division and repair of vehicle insurance claims handling procedures. Repair procedures for handling these claims is expected to increase revenue XYZ company because the power of word of mouth from customers is key in marketing the products of a company.

IV.2. Suggestion

As for suggestions for XYZ as follows:
1. XYZ should conduct routine evaluation of the procedures that have been executed. It aims PT XYZ may correct errors and mistakes to motivate employees.
2. XYZ must monitor competitor. It aims PT XYZ can continue to innovate and have the advantage of competitors.
3. XYZ must monitor the quality of the workshop partners, and conduct workshops reprimand to the owner if the quality of the workshop can not meet customer satisfaction.
4. Kaizen strategy should be the motto for the management to continuously improve the quality in terms of service.


Biliografi

Heizer, J and Render, B., 2009. Operation Management, 9th ed. New Jersey: Prentice Hall,Inc.
Johns, D.T. and Harding, H.A., 2001. Manajemen Operasi: Untuk Meraih Keunggulan Kompetitif, Seri Manajemen Operasi No.9. Jakarta: Penerbit PPM
Juran, J.M., 1974. Quality Control Handbook. New York: McGraw Hill
Vollmann,T.E., Berry, W.L., and Whybark,D.C., 1984. Manufacturing Planning and Control System, Illinois: Irwin
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