Risk Assessment and Compliance Checking of Business Rules in insurance by using of Process Mining Technique: Case study on Third-Party claim  process

Khadivar, A.; Frouzi, F.; Niakan, L.

doi:10.22056/ijir.2020.02.02

Document Type : Original Research Paper

Authors

¹ Department of Business Management, Faculty of Social and Economic Sciences, Al-Zahra University (S), Tehran, Iran

² Research Institute of Insurance affiliated to the Central Insurance of the Islamic Republic of Iran

https://doi.org/10.22056/ijir.2020.02.02

Abstract

Objective: Today, organizations have turned to process-oriented approaches to improve their activities. Knowing and correcting processes in organizations is necessary to save time and reduce costs. Process management and enterprise risk management and checking compliance with rules are among the main challenges of today's process-oriented organizations, especially insurance companies. Today, insurance has made tremendous progress in our society. In the meantime, the process analysis technique helps insurance companies in identifying the existing process and timely understanding the degree of non-compliance of operational processes with the rules of the organization.
Methodology: This research aims to identify the existing process and timely understand the level of non-compliance with the rules of the organization by using process mining techniques through the structured methodology of implementing process mining projects. This study has been implemented in one of the active insurance companies of the country for the selection processes of that group.
Findings: In this research, an image of the process has been obtained by using the events recorded in the organization's information systems. Then, using PRAM software, organizational processes have been analyzed, the sequence of activities related to the process, taking into account the selected business rules, have been examined, and finally, suggestions have been made to improve the processes.
Conclusion: In this case study, new insights have been provided that can be useful for other professionals in the application of process analysis in the financial field. This approach can be used along with control layer approaches to monitor and improve information system performance and reduce operational risk. Because it can provide useful insight for the organization by providing timely process analysis based on rules.

Keywords

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Iranian Journal of Insurance Research

Risk Assessment and Compliance Checking of Business Rules in insurance by using of Process Mining Technique: Case study on Third-Party claim process

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Volume 9, Issue 2 - Serial Number 32
April 2020
Pages 144-158

Risk Assessment and Compliance Checking of Business Rules in insurance by using of Process Mining Technique: Case study on Third-Party claim process

References

References

Letters to Editor

Send comment about this article

Volume 9, Issue 2 - Serial Number 32April 2020Pages 144-158

Volume 9, Issue 2 - Serial Number 32
April 2020
Pages 144-158