Case Study

Insurer transforms claims process to boost capacity by 20%

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Client: A leading auto insurance carrier, with over 2 million policyholders and a sales channel interface with over 850 agents, brokers,and auto dealerships

Business need addressed: Optimized claims management process by combining advanced operating models and technology to improve efficiency, lower costs, and reduce lead time

Genpact solution: Developed an efficient target operatingmodel for the insurer's initial contact team (ICT) and leveraged technology best practices to redesign their automated claims lodgement process

Business impact: Optimizing claims management process will help the insurer cut down expenses by $12.5 million, boost capacity by 20%, and improve cycle time by shaving 12 days off the end-to-end cycle

A leading auto insurance carrier needed to improve the operational efficiency of its complex claims management system by building an operating model capable of improving productivity, delighting customers, and eliminate unnecessary expenses associated with claims handling. Genpact created a target operating model addressing these goals while also increasing efficiency, optimizing cost,and reducing losses.

Business challenge

The insurer had a siloed and highly complex claim organization with disparate system infrastructures and processes catering to an outdated business model. The inefficient process steps were being replicated, leading to costly redundancies and longer lead time. Key issues included:

  • High end-to-end cycle time for auto claims (~84 days) leading to low customer satisfaction, high call volume, and decreased employee efficiency
  • Low percentage of “straight-through" processing(23% average across branches)
  • Ineffective responsibility metrics andlack of proactive claims management andcommunication, resulting in poor customersatisfaction and high call volume, with 75% callsrelated to queries on open claims
  • Loss and revenue leakage due to incorrect liabilitydecision, inadequate recovery flagging, andineffective subrogation processes
  • Ineffective First Notice of Loss (FNOL)processes leading to internal delays, frequently requiring up to 14 days for submission of “Proof of loss" for recovery

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Genpact solution

Genpact developed an efficient target operating model for the insurer's initial contact team (ICT) and leveraged technology best practices to redesign their automated claims lodgement process.

The key themes in the solution included:

Organizational realignment:

  • Analyzed initial contact team (ICT), brokerage claim lodging, broker/agent portfolio, dealer portfolio, motor assessment process, and third party settlements and recovery to identify the gaps in processes
  • Conducted employee-level interactions across the office branches to spot the challenges and gather primary information
  • Led value-stream mapping exercise involving key stakeholders, from line of business (LoB)managers to branch managers and front desk staff
  • An effective operation matrix was designed to address the identified challenges, plug the service gaps, centralize administrative tasks, and realign roles and responsibilities for accelerated claim closures
  • The FNOL team was consolidated and baseline was revised for the service level agreement (SLA)on average handle time (AHT)

Leveraging technology to drive efficiency:

  • Enhanced the claims workflow for proactive claims management which enabled a superior customer experience
  • Devised structural changes to ensure single file ownership, one contact person per customer,proactive claims management and communication,and enhanced customer experience

Optimizing processes and measurement

  • Re-scripted questions asked during FNOL to capture accurate loss description for liability decisions and subrogation flagging 
  • Established rigorous process metrics across claims function to improve information access 
  • Initiated 30+ quick-hit projects to identify various processes and system issues impacting productivity and data quality, and provided easy-to-implement solutions—improving these processes helped enhance productivity, reduce cycle time, and reduce non-value-add activities 
  • Implemented robust metrics framework that linked metrics to business outcomes, giving management an integrated view through which to monitor performance and realign resources and activities as/when required for rapid turnaround

Business impact 

The claims management process transformation and technology optimization will realize the following benefits for the insurer: 

  • Potential business impact of $15 million over a three-year period through process re-engineering

Business impact

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  • Loss reduction of $ 2.5 million and cost benefits of $12.5 million over a three-year period
  • Capacity enhanced by 20% through process efficiency, technology optimization, and a more effective operating model 
  • Reduced cycle time, shaving 12 days off endto-end cycle time through optimization and realignment
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