April 26, 2011 – Improving claims management is at the top of many insurance CIOs’ priority lists. The benefits are many – increased efficiency, reduced costs, and improved customer and agent service.

But the question is: How do we improve claims management? Deloitte’s new report, “Driving Operational Excellence in Claims Management,” details some steps for P&C insurers.

Claims management is highly challenging, with multiple processes and platforms, according to the report. Complex, duplicative functions are performed, often with outdated technology. The consulting firm suggests a top-down commitment to operational excellence, which can provide a competitive advantage in a soft market.

To help achieve this objective, insurers should leverage data to provide actionable information about what drives loss and expense, and then put in place the business processes and supporting infrastructure needed to take advantage of these insights, Deloitte says.

Based on its experience and work with P&C insurers in the claims marketplace, Deloitte suggests:

  1. Leveraging advanced analytics – Using data acquired at “First Notice of Loss” to effectively forecast outcomes for individual claimants and to segment claims can transform claim management by improving the allocation of claim resources, increasing efficiency, improving the estimates of claim severity and reduce claim cycles.
  2. Supplier management – As insurers rely more heavily on third-party suppliers, a supplier management strategy cannot only contain costs, but also can enhance the customer and agent experience
  3. Legal cost management – A performance-based approach uses data-driven analysis to help develop a streamlined, reusable process for organization selection, case governance and traditional cost management. This can be combined with predictive modeling for litigation management to help create a disciplined process that assigns cases to the most appropriate resources for the specified resolution, reducing the total cost of the claim
  4. Technology enablement – Developing an overarching approach to how and where to invest in new capabilities can improve efficiency and increase the likelihood that the technology infrastructure effectively supports the organization’s initiatives to enhance operations
  5. Fraud detection – Insurers that adopt advanced fraud detection tools and techniques that promptly identify claims with a high propensity for fraud can reduce losses and may gain a reputation in the industry of being hard on fraud

“As P&C insurers continue to face uncertain market and economic conditions, claims management is sure to have a central place in their strategies. The cost of pay-outs and expenses is the largest spending category, often accounting for up to 80 percent of premium revenues,” says Rebecca Amoroso, vice chairman, Deloitte LLP and U.S. insurance leader.
“Insurers need to leverage claims data to provide actionable information about what drives loss and expense, and put in place the business processes and supporting infrastructure to address these findings. The goal is to align the ‘right claim with the right resource at the right time.”

This story originally appeared on Insurance Networking News.


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