Thursday, April 16, 2015

Process & Insurance Claims: A Case Study

This organization handles claims for multiple insurance companies and must be accountable for results even when disaster strikes. There are specific SLAs that are in force and must be delivered under all circumstances by this organization for each company they serve. 

The Challenge:

For each insurance company this organization must handle commissioned appraisals, taking into account not only contractual conditions and expectations for satisfaction of those being insured but also the average time lapse for processing. Finally, during the disaster and up until its closure, the employees must be able to provide relevant answers on demand and comply with commitments for each insurance company client.

The Solution:
To achieve the desired expertise for this sphere of activity, automation and process control become paramount. This organization has decided to rely on different software components, including a BPM platform to entrust the management of workflows, an indispensable element for best management and business expertise. Over 150 processes including many variations have been automated. More than 800 employees now use the system daily.
Among the major contributions of BPM are found:
  • Real-time monitoring of the progress of activities at the individual level as well as collective, to meet the compliance expected by customers.
  • Reduction of supervision and training costs for experts and administrative staff, thanks to the support of the workflow management allocating and linking all tasks and decisions regarding each case
  • Traceability of all business activity increasing individual awareness and reducing errors.

The Results:

This organization was able to meet compliance expectations while delivering 15 - 20 percent productivity gain on claims management for loss adjusters and clerks 

Net; Net: 

Meeting SLAs while increasing productivity is a traditional benefit for BPM, but it good to see that BPM is still delivering basic benefits to many organizations that attempt BPM projects. 

This is a highly summarized and anonymous case study provided by W4

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