Description
Breaking With Tradition In The Insurance Industry Strategies To Insure Operational
BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E 1
Breaking with Tradition in
the Insurance Industry:
Strategies to Insure Operational
Efciency and Future Growth
An Executive Perspective
Authored by Deb Miller
2 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Summary
In the face of challenging economic times, pressing regulatory changes, and increased
competition for market share, insurance companies are struggling to maintain
their balance.
Companies that focus on the traditional business drivers to deal with shrinking revenue
and ?at expenses will continue to weather the ?nancial storm - just as they have in the
past. The competitive landscape is shifting though and will favor those in the insurance
industry who take advantage of today’s market to position for long-term future business.
Capitalizing on the current challenges and turning them into real opportunities will
require new strategies that leverage human capital and increase productivity. Manual
processes, customer retention, underwriter effectiveness, customer service response,
and claims cycle times are all areas within typical insurance companies which are ripe
for transformation. Insurance companies that understand the truly compelling need
for this transformation, and that take advantage of the tools available today to increase
operational ef?ciency and improve critical insurance processes, will be leaders in the
industry for years to come.
This paper describes how Business Process Management (BPM) technologies,
including adaptive case management solutions and business architecture tools,
can help insurance companies apply new strategies to reduce operational cost,
eliminate signi?cant streams of paperwork from their processes, improve the customer
experience and grow their businesses. We will highlight companies with best practices
implementation and proven results.
Challenges
Even before the recent economic crisis, pressure was building for the insurance
industry to be more ?exible and to approach business in a more dynamic fashion.
In particular, keep in mind that while insurance has always been a highly-regulated
industry, new regulations and legislation are proposed and adopted on a regular
basis. Increasing compliance demands from federal, state and other regulatory
bodies demand more agile processes that can evolve and adapt on a continuous
basis, but that also offer varying levels of control over how they are executed.
Insurance companies must ?nd a way to break out of the silo’ed, legacy systems
which perpetuate a limited view of the customer and books of business. New
models of business and enterprise architecture need to arise; where integrating with
newer technology solutions and effecting process improvements that leverage the
capabilities of existing personnel and applications can become the norm.
There is a need for real process improvements in the insurance industry. As
Insurance companies must automate critical business processes with multiple
manual touch points, simplify complex work?ows and hand-offs, get the right
information from disparate data sources for optimum decision-making, and ?ght
patchwork application environments to ease the effects of inef?cient business
processes. With these issues addressed, companies will be prepared to focus
on retaining pro?table customers, attracting new customers through a myriad of
distribution channels, delivering new products, and providing high quality
customer service.
“Insurance companies that understand the compelling
need for transformation, and improve critical insurance
processes, will be leaders in the industry for years
to come.”
3 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Strategies
Insurance company executives are searching for solutions to streamline processes and
deliver improved performance to support pro?table growth strategies.
Four key strategies are ?nding favor with forward-thinking companies:
• Focus on operational ef?ciency and expense control across the value chain,
driving for leverage across silos
• Scale to capture increased demand for select products and support diversi?ed
geographic footprint
• Expand distribution channels while maintaining excellence in customer service
• Remove paper and automate case management support to reduce cost and
settlement timeframes within the claims life cycle
The push to optimize both personnel and systems utilization for these strategies, and
increase ef?ciencies enterprise-wide is on, and pursuit is hotter than ever.
With a number of overlapping, manual processes, companies need to ?nd ways to
effectively manage the people, process and technology aspects of the enterprise to
realize the breakthrough change in operations.
By simplifying internal Information Technology architecture and creating standardized,
repeatable processes, insurance companies can enhance collaboration among key
parties, reduce paperwork, and more effectively manage the overall insurance process
from soup to nuts. The results of these efforts to automate and optimize business
processes include increased pro?tability, superior customer service and a signi?cant
increase in shareholder returns.
Role of Technology
Insurance is a process and paper-oriented industry. So, it stands to reason that
changing the way the insurance industry does business for the better means ?nding
new ways of handling information and revamping manual processes that today push
mountains of paper from place to place and department to department. The key is
managing the process and the paper optimally to achieve the most effective results.
The ?rst step in overcoming the restrictions placed on insurance by paper ?les and
manual processes is modernizing the legacy systems which drive most insurance
companies in terms of core administration. The sheer number of transactions
handled and paper generated each day makes business process management a
new essential for insurance companies. Since BPM effectively manages complex
processes across multiple systems, it can deliver improved process control and
increased agility. A BPM initiative incorporating industry standards has the inherent
ability to support core business concerns – from legislation and regulation to disaster
recovery and business continuity; from security, privacy, and litigation support to
ef?ciency, productivity, capacity, and customer service.
However, equally important are the tools to monitor and alert based on key
performance indicators (KPIs). They provide insurance company executives an
eagle’s eye view of what is going on inside the business on any given day and the
means to proactively improve processes, fully-manage workloads, and meet or
exceed production and service goals. Without process intelligence, BPM will only
perpetuate bad practices.
Proactive insurance companies can utilize BPM today to gain greater control of
processes, decrease expenses, and streamline operations. By utilizing some of
the best practices de?ned by successful BPM initiatives, insurance companies can
realize a nearly immediate return on investment (ROI).
4 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Best Practices in BPM are Lessons Learned for the Industry
A number of Tier 1 insurance companies worldwide today look to OpenText as an
essential partner in the transformation process. These forward-thinking insurance
companies know OpenText understand the unique needs of the insurance sector
and how business process and case management can help them differentiate
through services and business operations.
Given the industry’s need for immediate improvements, insurance companies are
getting serious about targeting fundamental business processes as key areas where
signi?cant gains can be made in the quest to attract new business and increase
retention, lowering expense ratios, and improve servicing of customers.
These key areas include:
• New Business, Underwriting and Enrollment
• Claims Management
• Customer Service
Automating New Business
The number and type of distribution channels utilized by insurance companies can vary
greatly, ranging from direct transactions taken over the Internet to agent/broker reported
transactions and more. Although the goal in the industry is to automate much of this
processing, a great number of applications are still received in paper format.
As already discussed, the paper format of new applications means insurance
companies face costly and inef?cient processes as they try to underwrite new risks.
The types of problems this leads to include:
• Long underwriting cycles
• High employee to new business counts
• Poor underwriting results
• Lack of underwriting transparency and accountability
• Physical constraints created that inhibit growth
To meet these challenges, forward-thinking insurance companies are realizing the value
of BPM to streamline their new business/enrollment process ?ows. For personal lines
and small commercial policies that means applying straightthrough processing (STP).
For commercial and life products, the new business needs to be presented to the
underwriter in a single view with multiple third party data sources as well.
To compete for this new business and improve the ?nancial performance through
increased productivity, insurers must:
• Conquer the paper avalanche with automation
• Improve underwriting turnaround time on complex risks
• Track all required information electronically
• Reduce new business acquisition costs
A top life insurance company had reached a tipping point in the cost of processing
new applications. The company literally had to hire four people for every 100 new
applications received because the company’s staff had to physically move paper
throughout the organization – ?le it, track it, and retrieve it when requested.
Typical applications for this organization come in the door containing between 10
and 100 pages depending on the complexity of the package, and with the company
receiving between 600 and 900 applications every week, automating processing of
those applications was critical. With OpenText, the company found the functionality,
performance, intelligence and ?exibility they were looking for in a business process
management solution.
Results for New Business Processing:
With OpenText, Insurance companies can replace
paperbased processes with a highly productive BPM
solution, automate documents to reduce errors and
processing time, provide easy access to information
in legacy systems, analyze business performance
and worker queue volumes in real-time, and balance
workload and staf?ng for the humanintensive part of
the process.
“This investment has enabled the company to handle
a 67% increase in applications without
increasing staff.”
5 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
OpenText solutions delivered the ?exibility to handle multiple types of work?ows and the
ability to automate processes so the company could make more informed decisions.
Today, the company is able to handle more applications and is growing the business
with no increase in staff. In fact, case managers are handling 30 percent more cases on
a daily basis than prior to the OpenText initiative and the company’s underwriters have
increased their capacity by 20 percent.
By leveraging the OpenText solution, company employees have instantaneous access
to the status of a ?le, the ability to view documents within the ?le, and can immediately
review any of the reports related to the case, all while the agent is on the phone. This
investment has enabled the company to:
• Handle a 67 percent increase in applications without increasing staff
• Engage an entire new sales channel by marketing its term life policies through
several large ?nancial institutions
• Respond rapidly and ef?ciently to high volumes of new customers
• Enhance the average customer experience in terms of turnaround time
and consistency
• Improve application tracking and compliance monitoring
Improving Claims Management
From a ?nancial viewpoint, it is estimated that insurance companies spend nearly
80 percent of their income on claims. There is a great deal of third party data that is
aggregated during the claim management process in order to determine the settlement
amount. Much of this data is paper-based, making it dif?cult for claims specialists to
obtain a single view of the claims. Studies have found claim settlement times are directly
correlated to the severity of the claim, so ef?cient processes are a must.
Recently, a leading worldwide insurer needed to unify decentralized claim functions and
improve cycle time. Implementation of the OpenText BPM solution began with a project
in the decentralized multi-site auto claims department in a single country which handles
an overwhelming 230,000 or so new claims per year. Typical auto claim ?les include
approximately 20 pages, and the company employs some 250 claims managers
working in seven regional of?ces to process the hefty claims. To further complicate the
process, more than 10,000 documents a day relating to active claims, such as forms,
letters, and faxes, arrive in a variety of haphazard ways, from different sources, at
different times, and at different of?ces.
The OpenText BPM solution brings all this information together and routes it to the right
desktop, automatically assigning claims, smoothly channeling incoming information,
bundling documents connected to the same claim, and prioritizing the work. At
each auto claims of?ce, incoming documents are sorted by type, scanned into the
OpenText system, indexed, and electronically documents relating to the same claim are
automatically bundled together.
OpenText’s BPM solution improved claims processing for this leading insurer by:
• Automating claims case management
• Optimizing customer service
• Reducing claims settlement timeframes
• Cutting costs in areas of archiving and staff overhead
• Expanding reporting capabilities to proactively manage workload
• Enhancing compliance monitoring and management
Results for Claims Processing:
With OpenText, Insurance companies can bring the
sources of data together for the claims specialist
to obtain a single view of the claim for improved
assessment, enable faster claims settlement times
to decrease the severity of the claim, enable brokers
and claimants to track progress of claims, provide
self-service from ?rst notice of loss (FNOL) to
status inquiry and information provision and support
transparent decisionmaking to minimize the risk of
fraud or manipulation.
6 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Delivering Superior Customer Experience
Many insurance companies differentiate themselves from competitors in today’s market
based on the level of service provided to customers. Call centers are an integral part of
efforts to deliver and maintain high service levels, the veritable front lines of customer
satisfaction and retention.
Developing a high quality call center is in large part about making certain the data
provided to the front line resource is timely and accurate. Keep in mind, call centers and
customer service units are measured not only on average call times, but also on the
quality of the answer provided. The types of issues found in the service area typically
include:
• A lack of metrics to manage the effectiveness of the unit
• No access to an integrated customer view to manage the customer issue
• Numerous legacy systems that need to be interfaced with separately
• Growing pains for existing units attempting to handle business that is increasing
in size and complexity
By allowing insurance companies to automate work?ows and processes, BPM
decreases the time necessary to handle customer and agent issues and ensures a high
level of customer service. That is why following a thorough evaluation of their business
processes and a review of the company’s needs for the future, a large single-line
insurance company recently decided to utilize the OpenText BPM solution to deliver
superior customer results.
With the business growing rapidly, adding four to six new states every year, the volume
of documents was also growing signi?cantly as new customers were added. The
solution was ?rst implemented in the company’s two largest business units, claims and
underwriting. This implementation was executed as a multi-domain installation which
provides the company the ability to support users in multiple locations and push work
items to local domains with optimal performance.
For this insurance company, improving customer service was key, and by leveraging
OpenText’s BPM solution, the company has been able to:
• Decrease customer request response time
• Improve the customer experience in terms of both turnaround time and
consistency
• Remove paper from the process
• Reduce the number of “missing in action” items
Metrics are also available to manage the effectiveness of the customer service unit
– both from a call center perspective as well as written correspondence. Customer
service excellence is achieved while reducing the cost of customer service units – and
thus providing for growth of products without incremental staff.
Next Steps
Insurance companies rely heavily on business process to provide the services that
customers expect. Yet it is the people, the processes, and the data that must work
together to execute those processes and deliver improved customer relations,
reduced costs, and increased pro?ts. OpenText has demonstrated through many
successful installations that it understands industry needs and more importantly how
BPM provides a sustainable and competitive advantage. That is why we invite you to
experience our distinctive viewPoint Assessment service.
Results for Customer Management:
With OpenText, insurers can provide an effective
and ef?cient technology enabled customer
service experience by enabling Customer Service
Representative access to data held in back of?ce
functions, such as policy processing, billing and
claims, in a consolidated view. Critical information
is then available when working a call or performing
research opportunities.
BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E 7
Visit www.opentextbpm.com for more information about OpenText solutions. Corporation is a publicly traded company on both NASDAQ (OTEX) and the TSX (OTC). Copyright © 2011 by Corporation. OpenText,
,
and The
Content Experts are trademarks or registered trademarks of Corporation. This list is not exhaustive. All other trademarks or registered trademarks are the property of their respective owners. All rights reserved. SKU_EN
www.opentextbpm.com
[email protected]
OpenText’s viewPoint Assessment provides a unique role-based approach to identify
and prioritize high-value areas where BPM can generate signi?cant gains in people,
process and business productivity.
The viewPoint Assessment will assist your organization to:
• Discover improvement opportunities for your most critical business processes
• Identify and empower the individuals and roles that participant in and support
your processes
• Establish key process indicators (KPIs) to measure and ensure
desired improvements
About the Author
Deb Miller is Director of Market Development for Business Process Solutions at
OpenText. Her work with the OpenText solutions team focuses on industry strategies
for business process improvement. Her career includes more than 20 years of global
industry experience with GE. Since 2002, she has been a study group contributor
to the President’s National Infrastructure Advisory Council. Ms. Miller is a Phi Beta
Kappa graduate of Syracuse University with a degree in Mathematics and a dual
Masters in Education and Mathematics. She has attended GE’s Management
Development Institute and is a Six Sigma Green Belt. You can follow Deb at
@DebsG360 on Twitter.
About Business Process Solutions
With the focus of BPM shifting from automation to innovation and improved
customer satisfaction, OpenText BPS’s software suite provides the necessary
solutions to retain competitive edge. With over 300 customers and 20 years of
experience, we are recognized by industry analysts as a leading Business Process
and Case Management provider. OpenText solutions provide high impact, high-ROI
solutions for company executives.
doc_453567548.pdf
Breaking With Tradition In The Insurance Industry Strategies To Insure Operational
BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E 1
Breaking with Tradition in
the Insurance Industry:
Strategies to Insure Operational
Efciency and Future Growth
An Executive Perspective
Authored by Deb Miller
2 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Summary
In the face of challenging economic times, pressing regulatory changes, and increased
competition for market share, insurance companies are struggling to maintain
their balance.
Companies that focus on the traditional business drivers to deal with shrinking revenue
and ?at expenses will continue to weather the ?nancial storm - just as they have in the
past. The competitive landscape is shifting though and will favor those in the insurance
industry who take advantage of today’s market to position for long-term future business.
Capitalizing on the current challenges and turning them into real opportunities will
require new strategies that leverage human capital and increase productivity. Manual
processes, customer retention, underwriter effectiveness, customer service response,
and claims cycle times are all areas within typical insurance companies which are ripe
for transformation. Insurance companies that understand the truly compelling need
for this transformation, and that take advantage of the tools available today to increase
operational ef?ciency and improve critical insurance processes, will be leaders in the
industry for years to come.
This paper describes how Business Process Management (BPM) technologies,
including adaptive case management solutions and business architecture tools,
can help insurance companies apply new strategies to reduce operational cost,
eliminate signi?cant streams of paperwork from their processes, improve the customer
experience and grow their businesses. We will highlight companies with best practices
implementation and proven results.
Challenges
Even before the recent economic crisis, pressure was building for the insurance
industry to be more ?exible and to approach business in a more dynamic fashion.
In particular, keep in mind that while insurance has always been a highly-regulated
industry, new regulations and legislation are proposed and adopted on a regular
basis. Increasing compliance demands from federal, state and other regulatory
bodies demand more agile processes that can evolve and adapt on a continuous
basis, but that also offer varying levels of control over how they are executed.
Insurance companies must ?nd a way to break out of the silo’ed, legacy systems
which perpetuate a limited view of the customer and books of business. New
models of business and enterprise architecture need to arise; where integrating with
newer technology solutions and effecting process improvements that leverage the
capabilities of existing personnel and applications can become the norm.
There is a need for real process improvements in the insurance industry. As
Insurance companies must automate critical business processes with multiple
manual touch points, simplify complex work?ows and hand-offs, get the right
information from disparate data sources for optimum decision-making, and ?ght
patchwork application environments to ease the effects of inef?cient business
processes. With these issues addressed, companies will be prepared to focus
on retaining pro?table customers, attracting new customers through a myriad of
distribution channels, delivering new products, and providing high quality
customer service.
“Insurance companies that understand the compelling
need for transformation, and improve critical insurance
processes, will be leaders in the industry for years
to come.”
3 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Strategies
Insurance company executives are searching for solutions to streamline processes and
deliver improved performance to support pro?table growth strategies.
Four key strategies are ?nding favor with forward-thinking companies:
• Focus on operational ef?ciency and expense control across the value chain,
driving for leverage across silos
• Scale to capture increased demand for select products and support diversi?ed
geographic footprint
• Expand distribution channels while maintaining excellence in customer service
• Remove paper and automate case management support to reduce cost and
settlement timeframes within the claims life cycle
The push to optimize both personnel and systems utilization for these strategies, and
increase ef?ciencies enterprise-wide is on, and pursuit is hotter than ever.
With a number of overlapping, manual processes, companies need to ?nd ways to
effectively manage the people, process and technology aspects of the enterprise to
realize the breakthrough change in operations.
By simplifying internal Information Technology architecture and creating standardized,
repeatable processes, insurance companies can enhance collaboration among key
parties, reduce paperwork, and more effectively manage the overall insurance process
from soup to nuts. The results of these efforts to automate and optimize business
processes include increased pro?tability, superior customer service and a signi?cant
increase in shareholder returns.
Role of Technology
Insurance is a process and paper-oriented industry. So, it stands to reason that
changing the way the insurance industry does business for the better means ?nding
new ways of handling information and revamping manual processes that today push
mountains of paper from place to place and department to department. The key is
managing the process and the paper optimally to achieve the most effective results.
The ?rst step in overcoming the restrictions placed on insurance by paper ?les and
manual processes is modernizing the legacy systems which drive most insurance
companies in terms of core administration. The sheer number of transactions
handled and paper generated each day makes business process management a
new essential for insurance companies. Since BPM effectively manages complex
processes across multiple systems, it can deliver improved process control and
increased agility. A BPM initiative incorporating industry standards has the inherent
ability to support core business concerns – from legislation and regulation to disaster
recovery and business continuity; from security, privacy, and litigation support to
ef?ciency, productivity, capacity, and customer service.
However, equally important are the tools to monitor and alert based on key
performance indicators (KPIs). They provide insurance company executives an
eagle’s eye view of what is going on inside the business on any given day and the
means to proactively improve processes, fully-manage workloads, and meet or
exceed production and service goals. Without process intelligence, BPM will only
perpetuate bad practices.
Proactive insurance companies can utilize BPM today to gain greater control of
processes, decrease expenses, and streamline operations. By utilizing some of
the best practices de?ned by successful BPM initiatives, insurance companies can
realize a nearly immediate return on investment (ROI).
4 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Best Practices in BPM are Lessons Learned for the Industry
A number of Tier 1 insurance companies worldwide today look to OpenText as an
essential partner in the transformation process. These forward-thinking insurance
companies know OpenText understand the unique needs of the insurance sector
and how business process and case management can help them differentiate
through services and business operations.
Given the industry’s need for immediate improvements, insurance companies are
getting serious about targeting fundamental business processes as key areas where
signi?cant gains can be made in the quest to attract new business and increase
retention, lowering expense ratios, and improve servicing of customers.
These key areas include:
• New Business, Underwriting and Enrollment
• Claims Management
• Customer Service
Automating New Business
The number and type of distribution channels utilized by insurance companies can vary
greatly, ranging from direct transactions taken over the Internet to agent/broker reported
transactions and more. Although the goal in the industry is to automate much of this
processing, a great number of applications are still received in paper format.
As already discussed, the paper format of new applications means insurance
companies face costly and inef?cient processes as they try to underwrite new risks.
The types of problems this leads to include:
• Long underwriting cycles
• High employee to new business counts
• Poor underwriting results
• Lack of underwriting transparency and accountability
• Physical constraints created that inhibit growth
To meet these challenges, forward-thinking insurance companies are realizing the value
of BPM to streamline their new business/enrollment process ?ows. For personal lines
and small commercial policies that means applying straightthrough processing (STP).
For commercial and life products, the new business needs to be presented to the
underwriter in a single view with multiple third party data sources as well.
To compete for this new business and improve the ?nancial performance through
increased productivity, insurers must:
• Conquer the paper avalanche with automation
• Improve underwriting turnaround time on complex risks
• Track all required information electronically
• Reduce new business acquisition costs
A top life insurance company had reached a tipping point in the cost of processing
new applications. The company literally had to hire four people for every 100 new
applications received because the company’s staff had to physically move paper
throughout the organization – ?le it, track it, and retrieve it when requested.
Typical applications for this organization come in the door containing between 10
and 100 pages depending on the complexity of the package, and with the company
receiving between 600 and 900 applications every week, automating processing of
those applications was critical. With OpenText, the company found the functionality,
performance, intelligence and ?exibility they were looking for in a business process
management solution.
Results for New Business Processing:
With OpenText, Insurance companies can replace
paperbased processes with a highly productive BPM
solution, automate documents to reduce errors and
processing time, provide easy access to information
in legacy systems, analyze business performance
and worker queue volumes in real-time, and balance
workload and staf?ng for the humanintensive part of
the process.
“This investment has enabled the company to handle
a 67% increase in applications without
increasing staff.”
5 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
OpenText solutions delivered the ?exibility to handle multiple types of work?ows and the
ability to automate processes so the company could make more informed decisions.
Today, the company is able to handle more applications and is growing the business
with no increase in staff. In fact, case managers are handling 30 percent more cases on
a daily basis than prior to the OpenText initiative and the company’s underwriters have
increased their capacity by 20 percent.
By leveraging the OpenText solution, company employees have instantaneous access
to the status of a ?le, the ability to view documents within the ?le, and can immediately
review any of the reports related to the case, all while the agent is on the phone. This
investment has enabled the company to:
• Handle a 67 percent increase in applications without increasing staff
• Engage an entire new sales channel by marketing its term life policies through
several large ?nancial institutions
• Respond rapidly and ef?ciently to high volumes of new customers
• Enhance the average customer experience in terms of turnaround time
and consistency
• Improve application tracking and compliance monitoring
Improving Claims Management
From a ?nancial viewpoint, it is estimated that insurance companies spend nearly
80 percent of their income on claims. There is a great deal of third party data that is
aggregated during the claim management process in order to determine the settlement
amount. Much of this data is paper-based, making it dif?cult for claims specialists to
obtain a single view of the claims. Studies have found claim settlement times are directly
correlated to the severity of the claim, so ef?cient processes are a must.
Recently, a leading worldwide insurer needed to unify decentralized claim functions and
improve cycle time. Implementation of the OpenText BPM solution began with a project
in the decentralized multi-site auto claims department in a single country which handles
an overwhelming 230,000 or so new claims per year. Typical auto claim ?les include
approximately 20 pages, and the company employs some 250 claims managers
working in seven regional of?ces to process the hefty claims. To further complicate the
process, more than 10,000 documents a day relating to active claims, such as forms,
letters, and faxes, arrive in a variety of haphazard ways, from different sources, at
different times, and at different of?ces.
The OpenText BPM solution brings all this information together and routes it to the right
desktop, automatically assigning claims, smoothly channeling incoming information,
bundling documents connected to the same claim, and prioritizing the work. At
each auto claims of?ce, incoming documents are sorted by type, scanned into the
OpenText system, indexed, and electronically documents relating to the same claim are
automatically bundled together.
OpenText’s BPM solution improved claims processing for this leading insurer by:
• Automating claims case management
• Optimizing customer service
• Reducing claims settlement timeframes
• Cutting costs in areas of archiving and staff overhead
• Expanding reporting capabilities to proactively manage workload
• Enhancing compliance monitoring and management
Results for Claims Processing:
With OpenText, Insurance companies can bring the
sources of data together for the claims specialist
to obtain a single view of the claim for improved
assessment, enable faster claims settlement times
to decrease the severity of the claim, enable brokers
and claimants to track progress of claims, provide
self-service from ?rst notice of loss (FNOL) to
status inquiry and information provision and support
transparent decisionmaking to minimize the risk of
fraud or manipulation.
6 BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E
Delivering Superior Customer Experience
Many insurance companies differentiate themselves from competitors in today’s market
based on the level of service provided to customers. Call centers are an integral part of
efforts to deliver and maintain high service levels, the veritable front lines of customer
satisfaction and retention.
Developing a high quality call center is in large part about making certain the data
provided to the front line resource is timely and accurate. Keep in mind, call centers and
customer service units are measured not only on average call times, but also on the
quality of the answer provided. The types of issues found in the service area typically
include:
• A lack of metrics to manage the effectiveness of the unit
• No access to an integrated customer view to manage the customer issue
• Numerous legacy systems that need to be interfaced with separately
• Growing pains for existing units attempting to handle business that is increasing
in size and complexity
By allowing insurance companies to automate work?ows and processes, BPM
decreases the time necessary to handle customer and agent issues and ensures a high
level of customer service. That is why following a thorough evaluation of their business
processes and a review of the company’s needs for the future, a large single-line
insurance company recently decided to utilize the OpenText BPM solution to deliver
superior customer results.
With the business growing rapidly, adding four to six new states every year, the volume
of documents was also growing signi?cantly as new customers were added. The
solution was ?rst implemented in the company’s two largest business units, claims and
underwriting. This implementation was executed as a multi-domain installation which
provides the company the ability to support users in multiple locations and push work
items to local domains with optimal performance.
For this insurance company, improving customer service was key, and by leveraging
OpenText’s BPM solution, the company has been able to:
• Decrease customer request response time
• Improve the customer experience in terms of both turnaround time and
consistency
• Remove paper from the process
• Reduce the number of “missing in action” items
Metrics are also available to manage the effectiveness of the customer service unit
– both from a call center perspective as well as written correspondence. Customer
service excellence is achieved while reducing the cost of customer service units – and
thus providing for growth of products without incremental staff.
Next Steps
Insurance companies rely heavily on business process to provide the services that
customers expect. Yet it is the people, the processes, and the data that must work
together to execute those processes and deliver improved customer relations,
reduced costs, and increased pro?ts. OpenText has demonstrated through many
successful installations that it understands industry needs and more importantly how
BPM provides a sustainable and competitive advantage. That is why we invite you to
experience our distinctive viewPoint Assessment service.
Results for Customer Management:
With OpenText, insurers can provide an effective
and ef?cient technology enabled customer
service experience by enabling Customer Service
Representative access to data held in back of?ce
functions, such as policy processing, billing and
claims, in a consolidated view. Critical information
is then available when working a call or performing
research opportunities.
BUSI NESS PROCESS SOLUTI ONS E X E CU T I V E P E RS P E C T I V E 7
Visit www.opentextbpm.com for more information about OpenText solutions. Corporation is a publicly traded company on both NASDAQ (OTEX) and the TSX (OTC). Copyright © 2011 by Corporation. OpenText,
,
and The
Content Experts are trademarks or registered trademarks of Corporation. This list is not exhaustive. All other trademarks or registered trademarks are the property of their respective owners. All rights reserved. SKU_EN
www.opentextbpm.com
[email protected]
OpenText’s viewPoint Assessment provides a unique role-based approach to identify
and prioritize high-value areas where BPM can generate signi?cant gains in people,
process and business productivity.
The viewPoint Assessment will assist your organization to:
• Discover improvement opportunities for your most critical business processes
• Identify and empower the individuals and roles that participant in and support
your processes
• Establish key process indicators (KPIs) to measure and ensure
desired improvements
About the Author
Deb Miller is Director of Market Development for Business Process Solutions at
OpenText. Her work with the OpenText solutions team focuses on industry strategies
for business process improvement. Her career includes more than 20 years of global
industry experience with GE. Since 2002, she has been a study group contributor
to the President’s National Infrastructure Advisory Council. Ms. Miller is a Phi Beta
Kappa graduate of Syracuse University with a degree in Mathematics and a dual
Masters in Education and Mathematics. She has attended GE’s Management
Development Institute and is a Six Sigma Green Belt. You can follow Deb at
@DebsG360 on Twitter.
About Business Process Solutions
With the focus of BPM shifting from automation to innovation and improved
customer satisfaction, OpenText BPS’s software suite provides the necessary
solutions to retain competitive edge. With over 300 customers and 20 years of
experience, we are recognized by industry analysts as a leading Business Process
and Case Management provider. OpenText solutions provide high impact, high-ROI
solutions for company executives.
doc_453567548.pdf