unlocking the black box of claims management october 2015

Unlocking the Black Box of Claims Management

October 2015

Customer Context

• Research shows that speed of settlement and insurance process transparency are the most important contributors to customer loyalty.

• Both are cited by 94% of policyholders as a key expectation when interacting with insurers during the claims process.

• With an explosion of data and channels, customers’ expectation is for accuracy, responsiveness and effective insurance claims management

© 2015 ClaimLogikGraphics by Squiggle6.com

Omni Channels Multimedia explosion

Managing growth & retention

Improving policyholderexperience

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Insurance Claims Management: The Challenges


No visibilityof process

Black Box toall parties

TimePressure

Anxiety

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5 Phase Process – Best Practice Claim Management

Workflow claim management technology • Transparent & measured performance of all

stakeholders

• Consistent business rule driven process adherence

• Intelligent SLA & non compliance management using never- before-seen data and analytics

• Low cost of ownership model

© 2015 ClaimLogikGraphics by Squiggle6.com4

Opening up Pandora’s box


I want to make a complaint.

I’m not satisfied with the quality

of repairs.

When will my job be finished?

What do I need to do next?

Are the claim variations approved?

Where is my job up to?

When will the trades arrive?Has my claim

been approved?

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Opening up Pandora’s box

So, how do we unlock the Black Box of Claims Management?

• Digitalization•Workflow Management• Process Automation and Robotics


Digitalization


Digitalization

Defining Digitalization:• Creating digital-enabling assets to become more relevant to its

customers and members

• The three D’s:• Digitize• Differentiate• Disrupt

• Traditionally a “push” channel (e.g.phone) now changing to “pull” (bringing information back and ongoing dialogue with the customer)


Digitalization

Defining Digitalization:• All focussed on “convergence”; bringing together digital media,

technology and platforms to improve communication between the relevant parties.

• Why? Because customers virtual lives and physical lives have merged and are much more demanding (Gen Y etc.)

• Large Insurers and System Integrators are setting up Innovation Environments like Labs to experiment and are appointing Digital and Innovation EGM’s


Digitalization

• Predictive analytics (buying behaviour and risk mitigation)

• Customized pricing

• Consumer led demand

• Personalized insurance products is the key differentiator, imperative to understand what the customer wants

• One-click insurance estimates

• Human interaction remains key

• Distribution channels will change as a result of digitalization


Big (Customer) Data is going to be key!!!!!

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Workflow Management


Challenging the Traditional Model

Existing model of insurance industry claims management:Multiple touch points between many stakeholders throughout the lifecycle of a claim mean little or no control over cost, quality, customer service, lifecycle or client management.


Compounding the Chaos in CatastropheCatastrophe impact upon existing model of claims management:Dramatic and immediate surge in claim volumes, overlaid with additional reporting to government, reinsurers, regulators, ICA, APRA etc, multiplies the lack of control and creates communication chaos.


Unlocking Value: A Better Service Delivery Model

ClaimLogik model of claims management:Direct access to our technology platform for all stakeholders through automated communication and analytics tools, plus complete supply chain management, ensure lifecycle reduction, cost reduction and greater control over quality, customer experience and client management.


Analytics & Business Intelligence Creating a modular view of the claims process allows clients to create very powerful analytics across customer experience, claims cost, cycle times & supply panel performance


Analytics & Business Intelligence The key data and analytics captured throughout the property claim workflow enables clients to drill down deeply in the critical performance areas of a property claim:

• Customer & Client Analytics• Cost & Spend Analytics • Cycle Time Performance• Supply Panel Performance


Innovative Stakeholder Management Connecting:• Insurers, Reinsurers & Brokers

• Policyholders

• Third Party Administrators

• Supply Chain Panels

Performance analytics across cost, quality and stakeholder experience


Personalised Connection

Stakeholder management systems• Policyholders, Reinsurers,

Insurers, Brokers, TPA’s communication and reporting platform

• Self Serve Business Intelligence - cost, price, quality and lifecycle reporting


Process Automation and Robotics


Intelligent Process Automation (IPA)

IPA is the next wave of technology. It is enabled by powerful frameworks of technology, methodology, best practices and tools and integrated analytics.


IPA is helping insurance companies achieve results – faster and better.

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Intelligent Process Automation (IPA)

• Transforming business processes

• Reducing error rates, better managing rote activities and standardizing tasks

• Enabling people to drive innovation

• Improving the quality, consistency and “believability” of data


IPA produces results such as:

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Global delivery, automation & analytics working in concert – today and tomorrow Organizations that can master smart robots tethered to smart data will outpace rivals who don’t (or can’t).

• 50% of today’s respondents see automation (and 44% see analytics) as drivers of positive impact to processes in 3-5 years’ time.


Global delivery, automation & analytics working in concert – today and tomorrow


Percent of respondents rating the following four service delivery models as “significant” or “profound/transformational” (4 or 5, on a scale of 1-5) in terms of their overall ability to positively impact business processes.

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Where IPA Can Help


Pre-checks and rules validation for

new business

Addition of new functionality or process module

that requires system rebuild or manual hiring / re-skilling

‘Dirty’ interfaces – data transferred

between applications that

are not integrated

Multiple sources of data input for

business reporting and analytics

Manual checking, decisions and

calculations that follow preset rules with no judgement

involved

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Process Selection Criteria


• Digitized inputs with limited human intervention

• Structured, rules-based, repeatable, computer based tasks

• Prone to error or re-works with limited need for exceptions

• Performing decisions and algorithms

• Need to access multiple systems

• Fluctuating workloads and volumes with long AHTs

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IPA Opportunities and Prioritization in the Insurance Industry

• Policy Service and Contract Administration• Claims Coding and Processing• Claims Administration• Risk, Fraud and Compliance


Percent of decision-makers anticipating greater than 25% FTE reduction as a result of automation in their industry specific processes.

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Remko JacobsHead of Corporate Strategy and M&AClaim Central Consolidated Holdings

M +61 (0) 411 176 707E [email protected]

W claimlogik.com


unlocking the black box of claims management october 2015

Documents

claims process

insurance process transparency

compliance management

customers expectation

stateoftheart technology

claim variations

speed of settlement

communication channelspush