Insurance Claims Management
Every insurance claim — from first log to insurer submission — on one auditable workflow.
Log the claim, authorise treatment, generate the guarantee of payment, confirm admission and submit to the insurer — each step captured, timed and defensible. Built for multi-site operators and their insurers.
The problem
Claims admin lives in email, spreadsheets and phone calls.
Scattered and slow
Authorisations, documents and insurer correspondence sit across inboxes and folders. Nobody can see a claim’s real status.
Delays cost money
A slow guarantee of payment or a missed insurer deadline turns a routine claim into a dispute and a write-off.
No defensible record
When the insurer or auditor asks who did what and when, an email trail is not an answer.
How it works
One guided workflow, from log to close.
The EMS/medical path shown below — motor, glass and public-liability claims follow their own typed steps on the same engine.
Log the claim. Capture the incident, member and claim type — a reference is issued automatically.
Authorise. Place the call and record the authorisation (e.g. the emergency-services / hospital confirmation).
Generate the GOP. Produce the guarantee of payment from the claim’s data, ready to send.
Confirm admission. Record admission and any documents received, keeping the claim current.
Submit & close. Submit to the insurer, track the outcome and close on the record — reject or reopen if needed.
Capabilities
Everything a claim needs, in one place.
Typed claims & guided steps
EMS/medical, motor, glass and public-liability claims, each with its own workflow and status stepper.
Guarantee of Payment (GOP)
Generate the GOP straight from the claim, with a consistent, managed layout — no re-keying.
Insurer portal
Give insurers a read-only view of the claims that concern them — scoped, safe and always current.
Documents, NCs & comments
Attach every document, raise non-conformances where a claim exposes a gap, and keep the conversation on the record.
OCR survey import
Import survey and audit reports by OCR, turning a PDF into reviewable, trackable findings.
Audit trail & exports
Every action time-stamped and attributed, with Excel/CSV exports and dashboards for the whole book.
On the data spine
Claims connect to the rest of the operation.
A claim rarely stands alone. On the MiMs data spine, the incident behind a claim, the audit that flagged the risk and the corrective action that follows are the same story — captured once and accountable to the end.
What it connects to
- Incidents that give rise to a claim
- Non-conformances & CAPA raised from a claim
- Audits & inspections that surface exposure
- A single audit trail across all of it
Built around your team
A role for everyone who touches a claim.
Initiators
Log claims from the site the moment they happen — on any device, scoped to their branch.
Processors
Drive the workflow — authorise, generate the GOP, submit and close — with a clear view of every open claim.
Insurers
See the claims that matter to them through a read-only portal — no email back-and-forth.
Questions
Insurance claims FAQ
Which claim types are supported?
EMS/medical, motor, glass and public liability today, each with its own guided workflow on one shared engine. New types can be added as your operation needs them.
What is the Guarantee of Payment (GOP)?
The GOP is generated from the claim’s own data so it is consistent and quick to issue — the format is managed centrally, not re-typed per claim.
Can our insurers see their claims directly?
Yes — a read-only insurer portal gives each insurer a scoped, always-current view of the claims that concern them, without granting access to anything else.
Is it POPIA-aligned and audited?
Yes. Data is hosted in South Africa, access is role-based and branch-scoped, and every action on a claim is recorded to a full audit trail. See the Security & Trust Centre.
See claims run on one workflow.
45 minutes, shaped around your claim types and your insurers. No slides.