A. Frontstage Actions (What Users See & Do)

Before Automation:

<aside> 📃 Policyholder submits a request (e.g., policy update, grievance, e-policy conversion) manually.

</aside>

<aside> 🔍 Moderators manually approve/escalate requests, leading to delays.

</aside>

<aside> 🧑🏽‍💻 Operations Team manually enters and updates data in the system.

</aside>

<aside> 📲 Policyholder receives delayed updates after manual processing.

</aside>

After Automation:

<aside> ✅ Policyholder submits a request via Bima Central, with automated eligibility checks.

</aside>

<aside> ✅ System auto-validates requests (KYC, policy status, document verification).

</aside>

<aside> ✅ Instant approvals for standard cases; complex cases flagged for manual review.

</aside>

<aside> ✅ Automated notifications update policyholders in real-time.

</aside>

B. Backstage Actions (Internal Workflows & System Processes)

Before Automation:

<aside> 📂

Operations Team manually uploads policyholder details and verifies records.

</aside>

<aside> 💻

Service requests assigned manually to the respective teams.

</aside>

<aside> 📝

Policy conversions require manual review and approvals, causing delays.

</aside>

<aside> 📲

No real-time tracking; updates depend on manual follow-ups.

</aside>

After Automation:

<aside> ✅ Policyholder requests auto-sync with backend systems for validation.

</aside>

<aside> ✅ System categorizes requests (policy updates, claims, eIA creation, grievances).

</aside>

<aside> ✅ Standard requests auto-approved; flagged requests routed to the right team.

</aside>

<aside> ✅ Real-time tracking and automated notifications enhance transparency.

</aside>

3. Holistic Process Flow Mapping (Before & After Automation)

A. Policy Conversion Process

Before Automation:

  1. Policyholder submits conversion request via Bima Central.
  2. Operations Team manually uploads policy details.
  3. Moderators verify details and approve request.
  4. Final e-policy is generated manually and updated.
  5. Policyholder receives confirmation after manual processing.

After Automation:

  1. Policyholder submits request via Bima Central →
  2. System auto-validates policy details →
  3. Automated approval for standard cases; flagged requests sent for review →
  4. e-policy is generated instantly →
  5. Policyholder receives instant confirmation.

B. eIA Creation & Verification

Before Automation:

  1. User applies for eIA creation manually.
  2. Operations Team manually checks PAN, KYC, and supporting documents.
  3. Admins approve, escalate, or reject the request.
  4. eIA is created and updated manually in the database.
  5. Policyholder receives a confirmation after manual review.

After Automation:

  1. User applies via Bima Central →
  2. System auto-verifies KYC, PAN, and documents →
  3. If all data is valid, eIA is created instantly →
  4. If discrepancies exist, system flags it for manual review →
  5. Policyholder receives real-time confirmation.

C. Service Request Handling & Grievance Management

Before Automation:

  1. Policyholder raises a service request manually via Bima Central.
  2. Operations Team manually assigns requests to the right department.
  3. Moderators manually verify details and approve requests.
  4. Resolution updates are shared manually via email/SMS.

After Automation:

  1. Policyholder raises request via Bima Central →
  2. System categorizes and assigns priority automatically →
  3. Automated processing for standard cases; manual intervention only when needed →
  4. Status updates sent in real-time via automated notifications.

4. Automation Impact & Future State