Core Policy Administration (PAS)
End-to-end policy lifecycle management from quote creation, endorsement changes, to automated recurring billing.
INSURANCE & INSURTECH ENGINEERING
Engineering for digital insurance ecosystems and automated claims.
Build and modernize mission-critical insurance platforms with automated policy administration (PAS), real-time claims adjudication, algorithmic actuarial underwriting, and multi-channel agent/bancassurance distribution. Teknalogi delivers secure, highly resilient enterprise architectures for modern insurers.
Discuss your insurance requirements
CONNECTED POLICY & CLAIMS
When policy systems disconnect, claims adjudication stalls.
Operations slow down when policy databases, claims processing, and agent channels operate in silos.
- 01
Legacy policy silos
Scattered policy data across legacy mainframes delays quote issuance and renewals.
- 02
Manual claims bottlenecks
Paper-intensive medical receipts and manual reviews cause month-long claim backlogs.
- 03
Fraud and leakage risks
Lack of automated cross-claim pattern analysis triggers costly fraudulent payouts.
- 04
Strict regulatory audits
Complex OJK compliance and IFRS 17 solvency calculations demand rigid data lineage.
Integrated software solutions engineered for life, general, and insurtech carriers.
System architectures are custom-tailored to your risk governance, spanning core PAS modernization, Straight-Through Processing (STP) claims engines, and cashless hospital integrations.
Automated Claims Adjudication & OCR
Document OCR data extraction, fraud risk scoring, and automated straight-through processing (STP) for minor claims.
Algorithmic Underwriting & Rating Engine
Rule-based and actuarial risk assessment dynamically pricing premiums based on applicant medical and risk profiles.
Agent & Bancassurance Portals
Mobile-ready e-SPA tools for field insurance agents and certified API connectors for banking distribution partners.
e-Policy & Customer Self-Service Portal
Instant digital policy delivery with certified e-signatures, hospital cashless card QR, and online claim submissions.
IFRS 17 Engine & OJK Regulatory Compliance
Automated cash flow modeling, contractual service margin (CSM) calculations, and audited regulatory reporting.
Designed for actuarial precision and rapid customer claims settlement.
01 ACCURACY
Straight-Through Processing & Claims Engine
Automate policy benefit validation and medical receipt OCR to adjudicate routine claims in seconds.
02 SETTLEMENT
Cryptographic e-Policy & Document Integrity
Deploy certified electronic signatures (PSrE) and tamper-evident document seals with full legal standing.
03 ACTUARIAL
Actuarial Valuation & Solvency Modeling
Stream millions of policy events into discounted cash flow models compliant with IFRS 17 and OJK mandates.
Digital Insurance Systems Engineering & Insurtech Architecture
Table of Contents
Policy Administration System (PAS) Modernization
Many insurance enterprises remain constrained by legacy mainframe Policy Administration Systems that are difficult to connect with modern digital touchpoints. This bottleneck delays new micro-insurance product rollouts and partner integrations.
Teknalogi designs event-driven integration middleware and decoupled microservices architectures that isolate legacy ledger cores from high-concurrency digital traffic, enabling sub-second policy issuance.
- Product Factory & Contract Decoupling: Separate insurance coverage rules from core contract ledgers to accelerate rider configuration and new policy launches.
- Sub-Second e-Policy Issuance: Automate premium settlement verification, certified cryptographic digital signing (PSrE), and instant e-policy dispatch.
- Self-Service Endorsements & Alterations: Provide automated workflows for beneficiary updates, sum insured adjustments, and policyholder contact changes.
PAS modernization compresses insurance product time-to-market from months to days while safeguarding core ledger integrity.
Rapid Claims Adjudication & Fraud Anomaly Detection
Claims settlement is the defining moment of truth for policyholder trust. Manual document verification creates extensive backlogs and drives up claims adjustment overhead.
We engineer Straight-Through Processing (STP) claims engines featuring intelligent medical OCR, instantaneous policy limit checks, and automated fraud scoring.
- Medical OCR Receipt & Invoice Ingestion: Extract and standardize hospital receipts, ICD-10 diagnostic codes, and pharmaceutical line items in seconds.
- Straight-Through Processing for Low-Risk Claims: Execute automated payouts for eligible outpatient claims based on strict policy coverage rules with zero manual friction.
- Automated Fraud Risk Scoring: Analyze submission frequencies, tariff anomalies, and multi-insurer cross-claim patterns to flag suspicious claims early.
Automated claims adjudication accelerates legitimate customer payouts while protecting insurer reserve pools from fraudulent loss.
Algorithmic Underwriting & Dynamic Rating Engines
Accurate premium pricing requires transparent, fast, and data-driven risk evaluation across applicant health and lifestyle factors.
We implement algorithmic underwriting decision engines that assess medical questionnaires, lifestyle disclosures, and demographic metrics deterministically.
- Automated Decision Trees: Translate digital proposal forms into instant accept, standard, sub-standard rating, or medical referral decisions.
- Dynamic Risk-Based Premium Calculations: Compute mortality and morbidity loadings in real time based on entry age, smoking history, and occupational risk tiers.
- Partner Diagnostic Clinic Gateways: Directly ingest electronic medical examination results from partner laboratories to accelerate medical underwriting approvals.
Automated underwriting elevates policy conversion rates while maintaining rigorous actuarial discipline.
Bancassurance & Open Insurance Partner Ecosystems
Distributing insurance through banking channels and e-commerce platforms requires secure, low-latency, and standardized enterprise API interfaces.
Teknalogi builds Open Insurance Gateways featuring industry-standard authentication (OAuth 2.0 / mTLS), end-to-end payload encryption, and real-time SLA telemetry.
- B2B Product Illustration & Quote APIs: Deliver premium simulation endpoints ready for embedding directly inside partner mobile banking applications.
- Automated Recurring Premium Debit & VA: Automate scheduled premium deductions through standing instructions and dynamic bank Virtual Accounts with instant reconciliation.
- Unified Agency Portal & Commission Ledger: Equip insurance agents with mobile digital proposal tools, e-signatures, and real-time commission tracking.
Reliable API connectivity expands insurance distribution to millions of banking customers and digital ecosystem users.
IFRS 17 Financial Reporting & Actuarial Solvency Engines
Implementing IFRS 17 demands precise separation of insurance revenue from investment components, alongside rigorous Contractual Service Margin (CSM) amortization.
We build actuarial data marts and historical transaction pipelines that project policy cash flows into discounted valuation models compliant with IFRS 17 standards.
- CSM & Cash Flow Liability Valuation: Calculate Present Value of Future Cash Flows (PVFCF) and non-financial risk adjustments across partitioned policy cohorts.
- Complete Transaction Lineage for Audits: Trace financial report line items directly back to underlying individual policy events for external auditor validation.
- Risk-Based Capital (RBC) Solvency Dashboards: Track capital adequacy ratios continuously to fulfill statutory financial solvency requirements mandated by regulators.
Integrated reporting architectures ensure total compliance with international accounting standards and regulatory mandates without manual spreadsheet dependencies.
Digital e-Policy & Cashless Hospital Integration
Modern policyholders expect instant digital policy access and cashless hospital admissions without the burden of physical plastic cards.
We deliver customer self-service mobile portals featuring QR-based membership cards, Third-Party Administrator (TPA) bridging, and real-time claims tracking.
- Digital Membership Card & QR Hospital Check-In: Enable cashless hospital admissions by scanning dynamic digital membership barcodes at admission desks.
- Real-Time Claims Tracking Timeline: Provide total milestone visibility from claim submission, medical review, to bank disbursement.
- Paperless Outpatient Reimbursement: Allow policyholders to upload clinic receipts and medical summaries directly from their smartphones for rapid reimbursement.
Seamless digital policyholder touchpoints drive customer retention and streamline hospital administrative handoffs.
What teams usually discuss before an insurance project starts.
Product portfolio structures, legacy core systems, and distribution channels vary. Technical discovery maps core PAS integrations, OJK regulatory audits, and claims architecture.
Can Teknalogi interface with legacy core PAS platforms like AS/400 or mainframe systems?
Yes. We engineer event-driven API middleware layers that communicate safely with legacy cores, allowing modern digital applications to operate at high speed without overloading backend ledgers.
How does the OCR engine parse irregular or semi-structured hospital medical receipts?
Our medical OCR pipeline pairs computer vision with healthcare domain language models to accurately extract clinic names, receipt totals, ICD-10 diagnostic codes, and pharmacy line items.
Does the claims system connect directly with Third-Party Administrators (TPAs) and hospitals?
Yes. We provide electronic gateway connectors for pre-authorization requests, guarantee letter (GL) generation, and final hospital discharge billing data exchange.
How does the platform ensure compliance with IFRS 17 Contractual Service Margin (CSM) calculations?
Our actuarial data mart captures granular policy transactions, groups them into defined cohort portfolios, and computes CSM amortizations deterministically under rigorous audit trails.
Are issued e-policies signed using legally recognized digital certification authorities?
Yes. Digital policy issuance connects natively with licensed Electronic Certification Authorities (PSrE compliant under Kominfo/OJK), applying cryptographic anti-tamper seals.
Can non-technical product teams configure new insurance riders without custom code changes?
Yes. Our visual Product Factory engine enables actuarial and product teams to define premium rate tables, coverage limits, waiting periods, and rider rules independently.
What is the typical timeframe for deploying a new agency portal or claims adjudication platform?
Modular implementations typically span 8 to 16 weeks, covering core data synchronization, field agent training, comprehensive User Acceptance Testing (UAT), and staged rollout.
Does Teknalogi provide 24/7 system monitoring and high-availability support?
Yes. We provide 24/7 managed infrastructure support covering bancassurance API latency monitoring, security patching, database optimization, and rapid incident resolution.
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