Case Study

Leading insurer transforms claims function to capture $48 million business impact

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Client: A leading P&C insurance carrier

Industry: Insurance

Business need: Build an effective operating model to automate and optimize the claims management process and improve accuracy, efficiency, and lead time.

Genpact solution:
Created a transformation roadmap built on an effective and efficient target operating model and an embedded analytics center of excellence.

Business impact:
Transformation of claims management process will help reduce losses by $40 million and cut costs by $8 million through process efficiency and technological optimization.

A leading P&C insurance carrier required a transformation of its complex claims management processes for greater efficiency and enhanced customer experience. Genpact created a target operating model to increase efficiency, optimize cost, and reduce losses.

Business challenge

The insurer had a complex and sub-optimal claims management process catering to an outdated business model. Key issues included

  • Ineffective organizational structure, lack of clear adjudication guidelines and product specialization
  • Fragmented processes and procedural variations
  • Lack of clear channel strategy and poor input quality
  • Leakage across fraud, towing, subrogation, and car rental management due to highly manual and subjective decisions, which led to errors and increased turnaround time
  • Multiple legacy systems
  • Ineffective sourcing strategy and vendor management

Genpact solution

Genpact was able to develop a transformational strategy with clearly defined targets, ownership, and timelines.

The key solution themes included:

  • Building an effective operating model through hub rationalization, consolidation, and centralization of processes. This includes establishing an operational expenditure (OpEx) framework in a centralized environment, building a specialized team to handle complex work, creating a governance framework and effective communication of processes designed to drive delivery excellence
  • Optimizing first notice of loss (FNOL) through automation and right channel strategy
  • Optimizing assessment channel by creating a channel strategy and segregating internal and external assessments while also integrating an updated estimate tool

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  • Building an integrated procurement and supply chain
  • Building an analytics center of excellence by creating a severity model based on the complexity of the assignment, including predictive analytics for fraud management and subrogation to auto-flag fraudulent claims
  • Modernizing technology to drive efficiency by creating an integrated technology landscape, including the modernizing and automating of business process management functions that leverage robotics and mobility tools

Business results

Resulting from the claims management process transformation, the insurer:

  • Reduced losses by $40 million through improved subrogation recovery, fraud prevention, car rental management, and a better sourcing strategy
  • Reduced cost by $8 million by process efficiency, technology optimization, and an effective operating model
  • Reduced cycle time and improved customer satisfaction scores

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