Declaration of Non-existence of Claim in Insurance Companies

Tabla de contenidos

What is the Declaration of No Claim and when is it requested?

The Declaration of No Claims (DIS) is a critical process for insurers that impacts customer experience, operational efficiency and regulatory compliance. While it may seem like a simple process (the insured needs a document confirming that no claims have been reported in a period), in practice it often involves multiple departments (customer service, operations, legal/compliance), multiple data sources, and communication channels that, if not automated and mapped, lead to friction, costs and legal exposure.

The DIS accredits through a certificate issued by the insurer that, during a given period, the policyholder or insured has not registered claims in a policy or in a set of policies, it can be requested in scenarios such as:

  • Clarifying situations and preventing improper claims from being made
  • Change of insurer or policy
  • Banking or leasing operations
  • Regulatory processes or internal audits
  • B2B relationships (fleets, collectives)

The “as is” process: where are the areas for improvement?

In many insurance companies, the “as is” flow, i.e. the current status of the process as it is currently executed, usually has these characteristics:

Client request through different channels (email, web, phone, app).
2. Manual or semi-manual identity verification.
3. Data consultation in claims/policy systems (core and/or data mart).
4. Generation of the document (template + data), generally in PDF.
5. Internal review and approval.
6. Sending to the client (non-certified e-mail or portal).
7. Filing of proof in the file.

Common bottlenecks during the DIS process

  • Identification/consent: insufficient or slow validations.
  • Dispersed integrations (CRM, core, DWH): manual work and duplications.
  • Variable response times (non-standardized SLAs).
  • Weak proof of delivery: sending by email with no guarantee of receipt, integrity or identity of the addressee.
  • Incomplete auditing: fragmented records that make it difficult to comply with inspections.

Why standardize and automate?

From a business and technology perspective, standardizing the DIS process brings:

– Reduction of mean time to resolution (TTR) and compliance with
service level agreement (SLA) in situations of peak demand.
– Brand consistency: homogeneous messages and documents across all channels.
– Reduction of errors due to manual intervention and resubmissions.
– Scalability: capacity to handle more requests with the same team.
– Improved traceability from request to delivery and archiving.
– Mitigation of regulatory and reputational risks.

Mitigating Risk with Certified Electronic Delivery of a QTSP

Certified Electronic Delivery (EEC) through a Qualified Trust Service Provider (QTSP) guarantees, with legal validity, the sending, integrity, identity, date and content of electronic communications, generating evidence that can be opposed against third parties. When integrated into the DIS process, it provides:

a) Robust evidence of the entire cycle
– Proof of sending and receiving including traceability of openings or rejections.
– Qualified time stamp on each critical event.
– End-to-end traceability: from document generation to acceptance.

b) Identity and consent
– Mechanisms for strong identification of the recipient.
– Management of consent and proof of reading/downloading of the document.

c) Document integrity
– Hash and seal certifying that the document has not been altered.
– Versioning and archiving with legally relevant metadata.

d) Compliance and audit
– Secure evidence register accessible for internal and external audits.
– Reduced risk of challenges due to lack of evidence or informal channels.

Reference architecture with a CRM and the EEC from a QTSP

A typical design with a CRM and EEC (Electronic Certified Delivery) from a QTSP (Qualified Trusted Service Provider) supported policy/claims systems might include:

Request capture (portal, app, phone, email – routed to CRM).
2. Automation: rules and flows in CRM (cases, approval, tagging).
3. Document generation with dynamic templates.
4. EEC orchestration with an integrated QTSP via API or native connector.
5. Communication to the client (certified email/SMS certified/portal with evidence).
6. Archiving and governance: evidence + final PDF on file, with defined retention.
7. Analytics and reporting: times, delivery rates, processes, costs.

Key benefits

  • Legal certainty: evidence of high probative value.
  • Operational efficiency: less manual tasks, less rework.
  • Customer experience: faster responses, clear and reliable communication.
  • Interoperability: integration via API/native connector with CRM and core systems.
  • Data control and governance: life cycle and access under defined policies.
  • Scalability: capacity to absorb peak requests without degrading the service.

Conclusion

In the Declaration of No Claim (DIS) process, integrating Certified Electronic Delivery through a QTSP within the CRM ecosystem and core systems, in addition to improving the customer experience, is an opportunity to optimize operational efficiency and mitigate risks by ensuring regulatory compliance.