insurance industry trends: claims · pdf fileglobal insurance . industry trends —...
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Claims transformationEY claims capability
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According to the market point of view, claims transformation will be the focus of innovation and investment in the coming years. Investments will be primarily in the field of IT solutions to buy and customize. The potential complexity in claims will result in more sophisticated management systems than in the past and will require integrated, multichannel, flexible and rules-based processes. EY has studied numerous claims management models across various countries and types of business to develop a leading practice model.
Global insurance industry trends — claims transformation
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Maximizing performance in claims management can drive value for the entire company.
Broader implicationsfor claims transformation
Quality and speed of response
Satisfaction levels and retention
Customer service
Data analytics Effective decision-making
Data management
Incident coding Asset leverage
Reinsurance recoveries
Commercial awareness
Control of operational risk
Resource capabilities
Management of case reserves
Accuracy of“ultimate” projections
Incurred management
Leakage Unnecessary costs hitting bottom line
Control of indemnity costs and ALAE*
Correct case estimates
Capital efficiency
Claims portfolio management
Optimal supplier management
Cost optimization
Supply chain
* Allocated Loss Adjustment Expense
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EY’s insurancecapabilities matrix
Claims processing
Initial reporting
Segmentation and assignment
Claim administration
Litigation and medical management
Recovery
Financials
Vendor management
Other services
Underwriting and pricing
Policy processing
Billing, collections anddisbursements
Product developmentand management
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EY’s structured approach to address claims management issues
Claims effectivenessPaying the appropriate amount on the claim through accurate adjustment and reduction in the costs of the goods and services supplied in the settlement.
• Improve decision quality and reduce claims costs
• Improve reserving• Reduce supplier or
repairer costs• Improve claimant experience
Claims efficiencyAchieving and maintaining operational efficiency through lowering the processing and operating costs associated with claims.
• Reduce process cycle time and hence processing cost
• Improve process quality• Increase productivity
Focus
Offerings
Claimsstrategy
Claims health check and leakage
Claims operating model
Claims transformation
Areas to lead and how to get there
Evaluate the current claims operation and identify opportunities to improve
Define how required capabilities will be delivered through people, processes, governance and technology
Execute detailed implementation plan design, package selection (if required), implementation and risk management
• Customer proposition• Process and organization• Sourcing and supply chain• Technology• Management information• Finance and actuarial
Impact areas
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Utilizing the Agile methodology, the following diagram illustrates the typical way in which EY coordinates and delivers work.
Functional requirements
Management, communicationand coordination
Our capabilities: claims transformation delivery model
Onsite or onshore team
Project management officer
Offshore delivery team
Team manager
Components for redesign
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Technical design specifications
Workpacket
Completed work packet
Development
Demonstration and sign-off of work packet
Support
Integration into onsite team’s deliverable
Unit testing and quality assurance
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BenefitsResponsive services to enhance claims productivity through automation and reduction of cost of settling claims.
Client situation
The client intended to have a one-stop claims management solution and reduce manual process overheads.
EY provided an end-to-end claims solution for different lines of business across different releases. In some cases, we integrated legacy systems for comprehensive claims management. Our teams customized out-of-the-box solutions to suit the client’s requirements.
EY action+
Claims transformation services delivered globally
EY credentials
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• We were Guidewire’s Partner of the Year 2012.
• Our resources have successfully supported over 40 Guidewire systems implementations to date.
• We have a global workforce of over 750 trained Guidewire practitioners on change management, technical architecture, data management, configuration, functional and testing.
• We bring leading claims practices to make the most of implementation.
• We have a successful track record in program delivery of Guidewire.
• We bring specific Guidewire accelerators that will help de-risk a program.
UnrivaledGuidewireknowledge
Solution design
Program delivery and change management
Businesscase and deployment
Design and implementation process
Americas
UK
Italy
India
Japan
Australia
• We have dedicated Guidewire Centers of Excellence around the globe supporting our onsite teams, allowing us to mobilize these teams quickly.
• Our program management and change management experience helps to deliver on time.
• We are currently engaged in implementing Guidewire for a number of organizations in the Americas, Europe and Asia-Pacific.
Our Guidewire qualification
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Americas
Chris [email protected]+1 513 460 0112
Chris is a principal in the FSO Advisory Insurance Operations practice and leads the North American Property & Casualty (P&C) claims transformation team. In addition to leading US- and Canada-based insurance clients through large-scale claims transformation programs, he has been involved as a business architect and program advisor in insurance operational and technology transformation programs across Europe, Asia-Pacific and Australia.
William [email protected]+1 213 240 7027
William Smith is the partner responsible for technical delivery on our Guidewire projects. With over 22 years’ experience in large program management, systems integration, systems conversion, operational design, process design, technical requirements definition and business requirements analysis, he is a seasoned delivery executive program manager.
Key contacts
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Europe, Middle East, India and Africa (EMEIA)
Stefano [email protected]+39 028 066 9782
Stefano is a partner and leads the Insurance Center of Excellence in the EMEIA Region. He has extensive experience working with insurers in southern Europe while managing important online IT projects in the Italian market. He managed the merger of four insurance companies, and also a large channel composed of more than 800 agencies. He participated in the start-up of insurance companies in Italy and Spain. He has also helped to develop internet direct channels.
Preetham [email protected]+44 20 795 16979
Preetham is a director within our Performance Improvement practice in the UK. He has over 10 years’ consulting experience, predominantly in the financial services market, with specific emphasis on the insurance industry, including claims transformation, strategy and business case development.
Asia-Pacific
Clifford [email protected]+61 400 923 440
Clifford is a partner in the Asia-Pacific Financial Services Organization. He has extensive experience of working with insurers in Australia, South Africa, the United Kingdom and China. He focuses on the transformation of insurance capabilities (including claims management), from inception to delivery and benefits realization.
Offshore unit, India
Sriman [email protected]+91 80 660 86346
Sriman Naarayan is an executive director in our offshore IT Advisory practice. He has extensive experience in service delivery using the global distributed delivery model, large-scale program management, custom systems development, packaged application implementation and quality assurance reviews. He has played an instrumental role in the growth of our offshore IT Advisory practice since its inception.
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