Case Study

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


A leading P&C insurance carrier

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The insurer had a complex and sub-optimal claims management process catering to an outdated business model.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

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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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