© copyright strategy meets action 2013 -- claims transformation: positioning for the future karen...

© Copyright Strategy Meets Action 2013

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Claims Transformation:Positioning for the Future

Karen FurtadoPartnerStrategy Meets [email protected] @karenmfurtado

PCS Catastrophe ConferenceApril 29, 2013


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SMA: Strategic Advisory Firm

Our mission is to advise, influence, and keep a finger on the pulse of the insurance industry

Advisory Retained Relationship Project-based Consulting Research – Syndicated and Custom

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Today’s Presentation

• Thinking Strategically about Risk

• Claims Evolution

• Examine the Marketplace – SMA Research

• The State of the Possible

• SMA Call to Action

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Definition - Single View of Risk

The advance capability of real time insights and information of policy level and aggregate level risk exposure and the potential impact of the company’s book of business from a catastrophe, either natural or man made.

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It’s a common view that leverages risk aggregation and risk visualization techniques and is shared across all stakeholders internally and externally.

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To create the single view of the risk, insurers must leverage clean/complete transaction and external data sources, various advance geo/location tools and risk analysis tools.

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SMA Top 10 Imperatives for Insurers Single View of Risk Aligns to 5 SMA Imperatives

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ClaimsAnalysis

ProfitabilityAnalysis

Evolve RATINGwith PRODUCT

CONFIGURATIONCapabilities

ExtendANALYTICSacross theEnterprise

OptimizeCLAIMS

beyond theTransaction

Redefinethe Impactof CORE

AcceleratePaper toDIGITAL

Transformation

INNOVATEfor

ADVANTAGE

Transformthe CUSTOMER

Experience

Committo Dynamic

DISTRIBUTIONCapabilities

TakeUNDERWRITING

Differentiation to theNext Level

Source: Strategy Meets Action 2013


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Big Data – Power of Multiple Data Sources

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Transaction Data

Unstructured Corporate

Data

Embedded Chips and Sensors

ExternalDatasets

Social Media / Web



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Key Lines of Business for Risk Data & Tools

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Percent of Respondents Citing as Key LOBSource: SMA Research 2012


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Most Important Methods of Enhancing Data

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Source: SMA Research, Data and Analytics 2012, n=165


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Innovative Advantage of Surrounding Big Data with Advanced Tools

Geo-coding

Data cleansing

Risk analysis

BusinessIntelligence

Visual mapping


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The Future Claims Value Chain

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Assign-ment.

Investig-ation

CoverageVerificatio

n

Loss Reserving

Negotiation &

Settlement

Litigation

Mgmt

Recovery(Subro & Salvage)

FNOL

Fraud Detection

Case Management

Claim Analytics

CAT Management

Loss Prevention

Loss Mitigation

Loss Restoration

Loss Control (all lines)

Safety Engineering

Programs

WellnessPrograms

Disaster

Preparedness Programs

Real-time Monitoring

& Alerts

Mobile Enablement

Future Emphasis

CurrentEmphasis



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The Future of Claims

Prevention Mitigation

Restoration

• Instrumentation/GPS• Safety Engineering• Enhanced Risk

Selection• Location based data• External risk data• Analytics

• Risk Mgmt. & Loss Control across lines• Social media• External risk data

• Wellness focus

• Instrumentation/GPS• Mobile access

• Claimants• Adjusters• Partners

• Disaster preparedness• Improved CAT

management

• Mobile adjusters• Automated/Self-adjusting• Fully networked providers

• Customer Communications Management discipline

• New technologies

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IT Spending by Capability Area 2013

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Front Office

Middle Office

Back Office

IncreaseIncrease Flat (No Change)Flat (No Change) DecreaseDecrease

IT Spending Moving Out of the Back Office

Source: SMA Research, Insurance Ecosystem 2013, n=157


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Top 5 Business Drivers of Technology Investment

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Percent citing as a key business driver

Source: SMA Research, Claims Transformation 2011, n=337


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Business Capabilities Focus

The focus areas … compliance, efficiency and data



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Technology Capabilities Focus

Efficiency, service and information are the critical areas of focus



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SMA Next-Gen Technologies for 2013

5. Cloud Computing Growth

3. Analytics and Big Data Leverage

1. Mobile Maturity

2. Social Media Momentum

4. Collaboration Expansion

6. Telematics Tipping Point

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Proactive and Reactive Mobile Interactions

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Ad-hocQueries

Dashboards &

Scorecards

Analysis

Business Intelligence

AdvancedStatisticalAnalysis

PredictiveModels

PredictiveAnalytics

AnalyticCollab-oration

Advanced Analytics

Reporting

Spread-sheets

Paper-based

Reports

ClaimHistory

Policy

ExternalRisk Data

CAT Models

Fraud

Vendors

Legal

Operational Results

(Efficiency)

BusinessPlanning

Information(Effectiveness)

ProactiveLoss Control

& Disaster Mgmt(Transformation)

Data & Analytics for Claims

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Telematics Tipping Point

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Leveraging Conjoinment

CCM

BPM Predictive Analytics

ECM

Rules

Data

CRM


WorkflowMobile

Portals

Illustrations and e-Submissions

UXP

Connectivity

Social Media

Rating

Underwriting / New Business

Cloud

Product Management

Policy Administration

Claims

Billing

Front Office

Back Office

Middle Office

Applications Technologies


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Leveraging Conjoinment

CCM

BPM Predictive Analytics

ECM

Rules

Data


WorkflowMobile

Portals

Connectivity

Social Media

Cloud

Claims

Front Office

Back Office

Middle Office

Applications Technologies

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SMA Definition of Innovation

RETHINK REINVENT REIMAGINE RETOOL

idea

ROLES, PRODUCTS, SERVICES, AND/OR PROCESSES

… TRANSFORMS CUSTOMER/EMPLOYEE EXPERIENCE

AND/OR

ACHIEVES GAME-CHANGING RESULTS …27


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Innovation in Action

Travel Industry

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Innovation in Action

Travel Industry

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SMA Business Value Maturity Matrix

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Excellence

Replace+

Maintain

Modernize

Typical End PointEffectiveness

Status Quo

Innovate

Optimize

Competitive AdvantageO

PERATIONAL

COMPETITIVE POSITIONING

Laggard MoverMainstreamer Market LeaderSource: Strategy Meets Action 2013


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SMA Business Value Maturity MatrixClaims Moving Beyond the Transaction

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Excellence

Replace+

Maintain

Modernize

Typical End PointEffectiveness

Status Quo

Innovate

OptimizeOPERATIONAL

COMPETITIVE POSITIONING

Laggard MoverMainstreamer Market Leader

Claims CAT

Capabilities

Competitive Advantage



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Claims Transformation:Positioning for the Future

Karen FurtadoPartnerStrategy Meets [email protected] @karenmfurtado

The content in this deck is the property of Strategy Meets

Action and a copy has been made available to attendees of the PCS

CAT Conference April 2013.

Do not distribute externally.

© copyright strategy meets action 2013 -- claims transformation: positioning for the future karen...

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