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Claims Transformation: Driving Next-Gen Insurance

Steven Tesler

Principal, Insurance Business Consulting, EPAM

Brian Drimer

Senior Manager, Insurance Business Consulting, EPAM
Blog
  • Healthcare
  • Financial Services
  • Insurance

Claims transformation is a hot topic in the insurance industry.

This area of claims has traditionally been an afterthought in the industry, underfunded and underappreciated. Now, there is a new interest in claims management. In many circles, insurance professionals are acknowledging a shift in mindset to consider claims as the core of the business. Further supporting this shift, carriers are beginning to recognize the benefits of improved customer service and increased retention rates, both of which directly affect the bottom line.

To date, most players in the industry have focused on core platform replacement (i.e., implementation of Guidewire, DuckCreek, Majesco) as their method to claims transformation. As capabilities provided by these core platforms become “table stakes” in the market, it’s imperative for companies to take a more holistic approach.

To focus on and enable transformation, companies should consider the following areas:

Reimagining the claims management experience. Carriers have the opportunity to fundamentally change the claims process by focusing on customer experience (both internal and external). Using existing tools and new technologies, there are many options to streamline the end-to-end process from first notice of loss through resolution. For some claim types, these areas can be part of a Straight Through Process where there is no human intervention necessary. Other areas are ripe for automation that can reduce the level of intervention needed or provide support to the claims professional so they can focus on value-added activities to support the customer.

Powering transformation with enhanced capabilities. Investing in capabilities that will provide differentiated products and services can help companies facilitate a reimagined claims experience. Companies are using artificial intelligence (AI) and machine learning to push intelligence to the beginning of the process to ensure better claims outcomes. Digital connections with clients, agents/brokers, vendors and other stakeholders are expanding to streamline the end-to-end process.

Enabling transformation with an orchestrated ecosystem. By using APIs, microservices and other technologies, companies can develop an ecosystem of best-in-class/fit-for-purpose solutions that enable their reimagined process and enhanced capabilities. Insurance organizations can leverage existing technology assets, and integrate commercially available solutions, using the guiding principle of buying more commoditized/common functionality and building differentiated capabilities.

Empowering talent and managing the change. This shift to a new way of working will require a robust talent enablement program. And change management is also necessary to engage employees, drive adoption support and retain and re-skill the best workforce talent to equip them for the future.

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