GWIS Insurance TPA ERP
Powered by OptiFlowProject overview
An ERP system for Gulf Warranties (GWIS), a leading Third Party Administrator licensed by the Saudi Insurance Authority, operating from offices in Riyadh and Jeddah. GWIS provides quality claims management services with a personalised, customer-oriented approach, delivered transparently through tools and procedures that support transparency and communication. Developed as part of my work at OptiFlow, contributing to the system's development, customization, and implementation.
My role
ERP Developer — development, customization, and implementation
Key responsibilities
- Modelled the administration hierarchy — insurer clients, schemes, policies, and covered beneficiaries — as structured, linked records
- Implemented the full claims lifecycle from intake and registration through verification, assessment, approval, settlement, and closure
- Built tiered adjudication workflows where approval authority is determined by claim value and claim type
- Implemented structured rejection and pending reasons so declined claims carry an auditable justification
- Configured the service provider and repair network, linking claims to approved providers and their agreed rates
- Implemented document handling so supporting evidence attaches to each claim and is retained for audit
- Built turnaround time and SLA monitoring with claim ageing so delays surface before breaching client commitments
- Implemented settlement and reimbursement processing with posting into financial accounting
- Configured multi-office operation across Riyadh and Jeddah with role-scoped visibility
- Delivered client-facing and regulatory reporting covering claim volumes, settlement ratios, and processing times
- Supported implementation, user acceptance testing, staff training, and go-live
Technical contributions
- Designed custom DocTypes for claims, schemes, beneficiaries, and provider agreements with enforced referential links
- Implemented a state machine over the claims lifecycle, with Python server-side rules controlling every permitted transition
- Built value-based approval routing so claims escalate automatically past defined authority thresholds
- Automated turnaround time calculation and ageing buckets from lifecycle timestamps
- Implemented an immutable audit trail capturing who changed a claim status, when, and why
- Developed dashboards and reports on claim volume, settlement ratio, average processing time, and outstanding liability
- Configured granular role-based permissions separating intake, assessment, approval, and finance functions
- Automated notification triggers on status changes to support proactive customer communication
Business impact
Gave the administrator procedure-driven, auditable claims handling with measurable turnaround times across its Riyadh and Jeddah operations, supporting the transparency its clients are promised.
Completed while working at OptiFlow. Presented as professional experience — not a MaveriKode project, and all intellectual property remains with OptiFlow and Gulf Warranties (GWIS).