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Auto Audit Odds & Ends

 

By Rajani Mahadevan, Rhode Island's Beacon Mutual Insurance Company

In the worker's compensation industry, premium is based on payroll of the insured. In order to accurately estimate premium, the insured's financial and business records are surveyed to determine true premium based on expenses and conditions stated in the policy. At the Beacon Mutual Insurance Company the auditing staff performs audits annually after the policy in question has expired or at predetermined intervals. If the audit determines that an insured's initial premium was too low, the audit will result in additional premium due to the Beacon. If the audit shows that the initial premium was too high, the insured will receive a refund.

Key goals to automate the auditing process were:

  • To provide the auditors with the capability of working on their laptops, with the same visual user interface whether connected or disconnected from the network.
  • To use the Internet environment to provide a minimal footprint thin client which will facilitate development and transparent deployment of the application.
  • To maintain data integrity and security.
  • To eliminate the need for auditors to come in off the road to sign files or obtain software upgrades.
  • To eliminate manual pre-audit and post-audit activities.
  • To allow auditors to view historical policy and claims information.

The Beacon developed a Java-based web application, 'Audit Lynx'. This application checks the mainframe Policy/Claims to determine on a daily basis the policies that are due for an audit. In addition, it automatically assigns the auditor based on the previous years' audit assignment. The associated policy and claims data are downloaded through Oracle's Transparent Gateway into the central Audit Lynx database repository.

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Online Server Side 'Administrative' Component

The administrative component is accessible through the browser by the user from anywhere on the network as long as they have been granted access privileges. The audit administrator manages downloaded audits through this component and moves the audit through the different stages of its lifecycle.

In addition, the application provides the following functionality:

  • View status of all downloaded audits, through the 'View All' screen.
  • View audit details for a specific audit through a hyper link.
  • Assign or Reassign auditors.
  • Release Audits to the auditors.
  • Receive Completed audits from the auditors.
  • Preview reports through the browser.

Offline Client Side 'Auditing' Component

Deployment of this component to an auditor is done through a browser on the client side. Any auditor can connect to the network and complete the installation via a specified address on the web page.

After installation, auditors can log in through the browser using their ID and password and 'Go Online' to receive their audit assignments. They have the flexibility to disconnect from the network to work offline at any time during the auditing process. This is extremely significant since this feature allows the auditors to work at the insured site on their laptops independent of the network.

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When the auditor goes offline:

  • Oracle's Internet Mobile component, Web-To-Go, synchronizes the auditor's database on the client side with the central Oracle8i database.
  • The auditor has the advantage of working with the same graphical user interface, running the same Java servelets, except that it is accessing the local Oracle8i Lite data and the results are delivered by HTML through the local version of the Web-To-Go web server.
  • Upgrades to data, database schemas or application logic are transparently distributed to clients when they synchronize.
  • Only one set of code is written for both online and offline modes of the application.

The 'Offline' Client Side 'Auditing' component offers the auditors the following functionality:

  • Receive assignments and schedule audits.
  • Capture all detail data elements required to complete audits at the insured site.
  • Generate audited results based on payroll and adjustment calculations.
  • Generate summary results to review with the insured's on location.
  • View previous audited results and related policy/claim information.

Once the auditors complete the audit, they return them back to the audit administrator by going online. The synchronization process updates the data on the main Oracle Lite database and the audit administrator reviews the completed audit through the administrative component of Audit Lynx. Once the audit is verified, the administrator releases the completed audits to our Underwriting staff. On approval, audit data is uploaded back to the mainframe Policy/Claims system. Information is now made available to create endorsements for additional or return premiums, hence completing the audit life cycle.

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Quick Links
Online Server Side 'Administrative' Component
Offline Client Side 'Auditing' Component

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