Case Studies
Global Insurance Company
Executive Summary:
– Desire to improve the speed and quality of Claims processing;
– Remove human touch points during the process;
– Use advances in technologies to automate steps;
– LEAN the process to make it more efficient;
– Remove unnecessary steps.
Problem Statement:
By applying new technologies an opportunity to deliver a fully automated, straight through processing process was identified.
The end state would allow for a Claim to be submitted by a customer with minimal or no human interaction at speed and with full accuracy/quality.
Current process of Claims was all manual, from FNOL to payment, with many of these taking longer than necessary.
Also, with paper based submissions errors occurred so not only were Claims taking a long time, the accuracy of the process also suffered.
Objectives:
The high level objectives of the project were to:
1. Remove the time spent on Claims processing by 50%, whilst maintaining or improving quality (removal of errors) on these Claims;
2. Reduce human touch points and reduce the FTE count by 25%;
3. Allow for the re-use of solutions to processes for other areas of the business (i.e. Underwriting).
Project Description:
Insurance Claims follow a standard flow of First Notification of Loss (FNOL), Adjudication and Payment.
At this Insurer, this process was all very manual, leading to errors and taking longer than necessary from FNOL to Payment. A project was set up to identify solutions to resolve these pain points with advances in technologies seen as a means to provide better outcomes. This included a ‘self serve’ principle where customers and brokers could submit a Claim through a portal, providing information specific to the type of Claim that had occurred (by Line Of Business, loss etc). This data was to be directly mapped to the Claims system rather than having to be re-keyed. Should a customer/broker not have the facility to use the portal and submit a form another technology was applied (Kofax) to read the form and populate the Claim system fields.
Beyond this further technologies were applied to review the information and a Claims engine was used to triage the Claims into ‘Express’ or ‘Complex’ Claim buckets with Express Claims being paid out by the system (using RPA) without any human action required.
Benefits:
The project delivered fundamental benefits in both speed and accuracy whilst reducing the reliance on manual FTE based resource meaning a lower FTE requirement.
The delivery of the Claims portal and form reading capability took Claims errors (incorrect data) and missing data down significantly (estimated at 75% improvement).
The delivery of the automated straight through processing led to Express Claims taking 9 mins from receipt of a FNOL to Payment compared to 50 mins (worked on time) when manually handled.
FTE resources were not replaced (via natural attrition) meaning the team sizes for carrying out Claims FNOL, Adjudication, Payment were reduced.
Conclusion and Recommendations:
– Advanced technologies are fundamental to improving speed and accuracy of processes in an organisation;
– Human action, especially re-keying risks inaccuracies which are wasted costs for a business;
– Project teams have the right experience to support companies in achieving these improvements;
– Further advances in technologies should allow for continuous improvements and should be applied where necessary.
