01
Stage 1 – Claim Submission
Process
Policyholders or authorized staff submit insurance claims with policy details, incident information, and supporting documents.
Tools
Kong API Gateway
PostgreSQL 14
Implementation
Kong receives the API request, applies authentication and routing rules, and forwards the request to the legacy claims application. Claim information is stored in PostgreSQL.
02
Stage 2 – Policy and Claim Validation
Process
The system verifies the policy, claimant details, coverage, and claim information.
Tools
Kong API Gateway
REST APIs
PostgreSQL 14
Implementation
Kong routes requests to the appropriate claims services. The application retrieves policy and customer information from PostgreSQL and communicates with external insurance systems through REST APIs.
03
Stage 3 – Document and Fraud Verification
Process
Submitted documents and claim information are checked for completeness, inconsistencies, and potential fraud.
Tools
Kong API Gateway
REST APIs
Implementation
The API gateway securely routes verification requests to internal or external verification services. The results are returned to the claims application and recorded in PostgreSQL.
04
Stage 4 – Claim Assessment and Approval
Process
A claims officer reviews the validated claim and approves, rejects, or requests additional information.
Tools
Kong API Gateway
PostgreSQL 14
Implementation
The gateway securely exposes the required claim-management APIs. The application retrieves claim information, updates the decision, and stores the result in PostgreSQL.
05
Stage 5 – Settlement and Claim Tracking
Process
Approved claims are processed for settlement, and policyholders can track their claim status.
Tools
Kong API Gateway
REST APIs
PostgreSQL 14
Implementation
Kong routes settlement and status requests to the appropriate services. Settlement information and claim status are stored in PostgreSQL and exposed through secured APIs.