About Mutual de Seguridad

Mutual de Seguridad is a private, non-profit corporation, created in 1966 that provides full coverage for work accidents and develops risk prevention programs for Chilean workers. The Mutual has own more than 80 health centers, hospitals, clinics and occupational accident care centers located throughout Chile. More than 95,000 companies and 2,000,000 workers receives services from this corporation.

PROJECT OVERVIEW

Tecnova implemented the Mutual Integra Claims Management System for Mutual de Seguridad, a private institution that provides coverage to workers for occupational accidents.

The need for this system emerged in late 2017, when the Superintendence of Social Security (SUSESO) announced a change in how supporting documentation would be requested. This change required insurance claims and medical leave requests to evolve from paper-based, mail-supported processes to fully electronic channels. As a result, Mutual de Seguridad’s Legal Affairs area decided to develop a system to support the management of these requests.

Initially, a component was built to act as a centralized “Inbox”, enabling the unified management of multiple internal workflows. This inbox presents each user with their available and pending tasks across the organization.

Subsequently, tasks were integrated with different forms and actions, streamlining the management and resolution of information requests submitted by SUSESO, while enabling direct integration with the supervisory authority.

Prior to this project, the entire process was handled via email. As a result, response times and processing cycles were significantly extended due to manual interactions and back-and-forth communication.

With the implementation of a fully digital process, workflows are now faster, more transparent, and more efficient. Additionally, the solution introduced advanced capabilities such as escalation management, SLA monitoring, reporting, traceability, and user-level control, among other benefits.
More information is available in the press release: https://bit.ly/2vx01oG

This project is related to the implementation of the Electronic Administrative Procedure System of SUSESO, also delivered by Tecnova.

System Evolution

In a second phase of the project, functionality was added to support the retrieval of official rulings (dictámenes) from SUSESO, completing the end-to-end lifecycle of claims processing.

While Mutual Integra was initially designed as a platform to manage claims originating from SUSESO, it is currently being expanded to support requests from other external entities that require information from Mutual de Seguridad, such as those related to judicial cases.
Unlike SUSESO-related processes, which are fully integrated, requests from other institutions are manually initiated within Mutual Integra, as no direct system integrations exist with those external organizations.