The system prevents inappropriate access to the claims administrative system by segregating the following functions:
Certain individuals have the ability to enter and modify claim data in the claims administrative system;
Certain individuals have the ability to enter and adjust case reserves for individual claims in the claims administrative system;
Certain individuals make claim payments;
Certain individuals reconcile the claims administrative system and general ledger.
Individuals cannot access any combination of above duties that is inappropriate.
The control operates continuously."