O processo de gestão de sinistros

: projecto no departamento de sinistros

Abstract

As organizations seek solutions to reduce its service costs without losses in efficiency, operations management gains on increased meaning regarding process optimization. As to this matter, we have been witnessing the spread of management systems such as Lean Thinking, which have their effectiveness proven in managing and reducing waste in processes. AXA Portugal, an insurance company belonging to the international AXA group, facing changes in its internal structure and the decline of the insurance sector in Portugal, sought to analyze the efficiency and effectiveness of the operation in the worker’s compensation branch. The project that is now presented in this report had as main objective the study of the operational model of AXA’s Worker’s Compensation department. Regarding this, we were placed in the organization for a six months internship to witness, register and analyze the whole claim handling process. Initially we were introduced to the Worker’s Compensation branch and the several areas that make up the department. Afterwards, a broad, but deep, study was made of the processes, procedures and actions that engineer the entire worker’s compensation claim handling circuit. The study’s findings are concrete in their justification for the department’s low yield. A wide lack of procedure standardization was perceived, that, together with the excessive individualization of the claims handling, resulted in a inefficient service with high variability. With the aim of stabilizing the operation, several improvement proposals were developed. They’re main objective was to standardize the claims handling processes, to increase control over the claim’s status and the department’s capacity to work, as well as to create a hybrid structure, that is more efficient and less likely to propagate errors in the following stages of the the claim’s handling.

Date of Award	17 Dec 2014
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Sofia Pinto (Supervisor) & Sofia Parente (Co-Supervisor)