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Exercise 3.20 Model the following business process. Use pools/lanes where necessary. When a claim is received, a claims officer first verifies whether the claimant is
Exercise 3.20 Model the following business process. Use pools/lanes where necessary. When a claim is received, a claims officer first verifies whether the claimant is insured. Otherwise, the claimant is informed that he must reject the claim by sending an automatic notification through an SAP system. Otherwise, a senior complaints officer assesses the severity of the complaint. Depending on the outcome (simple or complex claims), the corresponding forms are sent to the claimant, again using the SAP system. Once the forms are returned, the claims officer verifies that they are complete. If the forms provide all the relevant details, the claim is recorded in the claim management system and the process is completed. Otherwise, the claimant is informed to update the forms through the SAP system. Upon receiving the updated forms, the claims officer checks them again to see if the details have been provided, and so on.
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