A versatile solution for employment injury insurance schemes, powered by openIMIS

openIMIS offers a range of functional modules which can be combined into tailored solutions for the delivery of specific social protection schemes. The employment injury insurance solution powered by openIMIS allows scheme operators to manage beneficiaries, employers/employees, contracts, products, contributions, providers, claims and accounting in a single software. Its easy-to-use accident reporting system and efficient claims procedures can help to ensure that workers or their survivors receive benefits promptly.

Supported processes

openIMIS supports the following business processes for employment injury insurance:

• Enrolment
• Employer/employee management
• Accident reporting
• Health service utilisation
• Health service claims generation and submission
• Claims review process
• Salary compensation calculation
• Processing and payment of claims

Benefits

For employees, openIMIS simplifies enrolment procedures, makes it easy to verify one’s coverage status at point of care and ensures prompt receipt of benefits in case of injury. For employers it provides a one-stop solution for managing both enrolment and accident reporting, with seamless links to information from hospitals about treatment and rehabilitation. For health facilities, it streamlines the processes associated with a health financing scheme and makes it easy for them to receive reimbursements. For scheme operators it reduces operational costs, allows for better monitoring and analysis of the scheme’s overall performance, and enables information to be shared between different health and social protection schemes.

Example workflow

Current implementations

Nepal

Further information

Visit the wiki page or download the factsheet for this openIMIS use case: