Insurance claim

Consider the following business process using a BPMN diagram: When a claim is received, a claims officer first checks if the claimant is insured. If not, the claimant is informed that the claim must be rejected by sending an automatic notification via an SAP system. Otherwise, a senior claims officer evaluates the severity of the claim. Based on the outcome (simple or complex claims), the relevant forms are sent to the claimant, again using the SAP system. Once the forms are returned, they are checked for completeness by the claims officer. If the forms provide all relevant details, the claim is registered in the claims management system, and the process ends. Otherwise, the claimant is informed to update the forms via the SAP system. Upon reception of the updated forms, they are checked again by the claims officer to see if the details have been provided.

3. Which actors can be considered as customers in this process?

4. What value does the process deliver to its customers?

5. What are the possible outcomes of this process? 6. Model the process using a BPMN diagram