traditional to customer-centric claims organization
DESCRIPTION
Traditional to Customer-Centric Claims Organization. Ayhan Dayoglu 03.10.2013. The cost of claims pay ments and expenses is the largest spending category . - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/1.jpg)
Traditional to Customer-Centric
Claims Organization
Ayhan Dayoglu03.10.2013
![Page 2: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/2.jpg)
2
The cost of claims payments and expenses is the largest spending category
• In order to maintain “Profitable and Sustainable Growth”, Business As Usual Gaps with Budgeted Targets should be closed through improved claims operations and organization
SUSTAINABLE GROWTH
INCREASING THE PROFIT
1
2
Almost 80 percent of each earned premium amount is “claimed by claims” as pay-out and related
expenses
![Page 3: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/3.jpg)
Claim Process: Moment of truth
3
Company Strategic Approach Vision
A Direct Focus, Retention is key to success
Differentiate by claims service and focus on customer satisfaction
B Focus on Agency; service the agent
Provide claims service that meets industry standard
C Speed up settlement Focus on efficiency and accelerate handling time
D Low cost provider Focus on efficiency and effective cost ingredents
Source: Deloitte
![Page 4: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/4.jpg)
Claims management is highly challenging
4
Multiple processes
and platforms.
Complex, duplicative functions
Often with outdated
technology
top-down commitment to operational excellence
right claim with the right resource at the right time
• More stable and predictable loss costs
• More efficient and predictable operating expenses
• Improved loss and expense costs
• Higher overall claim service ratings
• Higher policyholder retention• Improved employee
productivity• More reserve stability• Improved regulatory
compliance
• Leveraging advanced analytics
• Supplier management
• Legal cost management
• Technology enablement
• Fraud detection
![Page 5: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/5.jpg)
Alarming Situation
5
Claim SystemsManuel
& Paper Based
25%
25%Resolve at the First Contact
14%
Resolve
Non-Core Activities56% of an average claims professionals’ day is focused on non-core activities
Source: Accenture Research
![Page 6: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/6.jpg)
New channels are changing the game
6
use of mobile devices for first notice of loss
proliferation of the use of social media
![Page 7: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/7.jpg)
Today’s problems for insurance companies
7
Pressure to reduce costs
Stretch targetsBacklogs
IT issues
Increased workloads
Disengaged employees
High customer expectations
![Page 8: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/8.jpg)
Today’s problems for insurance companies
8
![Page 9: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/9.jpg)
Delivering a resonant customer experience proposition
9
• How do customers perceive the quality of insurance interactions, taking into account the customer’s specific values and standards ?
• How do I track a customer’s journey along entirely the her lifecycle (from an initial quote to a claim), across product categories, and across channels ?
![Page 10: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/10.jpg)
Factors influencing customers’ decision to choose and leave an insurer (%)
10
Source: Cap Gemini
![Page 11: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/11.jpg)
There is a gap between what customers expect of insurers and what they believe they receive
11
Source : Accenture
![Page 12: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/12.jpg)
Most insurerer struggle to achieve the differentiation which is crucial to growth
12
Source : Accenture
![Page 13: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/13.jpg)
The job of management : manage people and budgets
13
Henry Ford’s mass production system
Board
Managers
Workers
Top-Down Approach
Seperating decisions from work
What is Fordism (Taylorism)
Work lacks intellectual content Mechanization Routinization & simplification of tasks Fragmentation Specializations Coercion outweighs consent Work speeds up Liberation of brain to think other things:
this led industrialists to form educational institutes for workers
Americanism & Fordism
![Page 14: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/14.jpg)
The consequences of a top-down fear culture : unhappy customers & higher costs;
14
command and control design spoils the delivery of service to customers.
Breaking work down into low-cost functional operations fragments the flow of work.
Customers experience difficulty in getting through to someone who can solve their problem,
They find they have to repeat their problem, call back again and it takes time to get problems solved.
Many customers give up. Bad service is not only bad for customers; it also costs more
![Page 15: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/15.jpg)
Mass production demoralises workers
15
WHENEVER THERE IS A PROBLEM
85% OF THE TIME IT WILL BE IN THE
SYSTEM 15% OF THE TIME
IT WILL BE THE WORKER
![Page 16: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/16.jpg)
The job of manager has changed
16
THE JOB OF THE MANAGER IS TO WORK ON THE SYSTEM TO IMPROVE IT, WITH THEIR HELP.
Thinking
System
Performance
To change performance, we need to change the system. To change the system we need to change our thinking.
There are two steps to changing management thinking: * understanding what is wrong with the current assumptions – the harder part – and * learning to operate with different assumptions.
![Page 17: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/17.jpg)
If you want people to do a good job, design a good job to do
17
To design a good job to do, change the system. To change the system, change the way you think
If you design a system where the people who do the work, have control of the work, people change
Traditional Assumptions Systems Thinking View
All incoming work is treated as “work to be done’’
Identify & eliminate non-value / failure demand work
Functional specialization reduces unit costs Functional specialization increases end to end costs
Targets work Targets make performance Worse
Process standardization reduces costs andimproves service
Standardization of processes increases end toend costs and makes service worse
Outsourcing saves money Outsourcing failure / waste is not a sensible way to
![Page 18: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/18.jpg)
Change based on knowledge
18
Check
PlanDo
Understand current performance –“what and why”
Use front line staff to study the work
Identify levers for changeExperiment to get to perfect
Implement thechanges
![Page 19: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/19.jpg)
Change in the approach
19
FROM
Functional teams
Targets / Rules
Competition
What’s in it for me ?
Managers behind desk
TO
Multi-skilled teams trained to resolve high frequency customer demands
Purpose, Principles, Measures
Collaboration
What matters to the customer ?
Leaders “in the work”
![Page 20: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/20.jpg)
Culture change is free
20
When you change the system, your people become your asset
![Page 21: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/21.jpg)
What about suppliers
21
Work Providers(Insurers)
Battlefield
Supplier Resistance
Clients/Customers
CommonInterests
Supplier Desire
![Page 22: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/22.jpg)
Understanding & meeting real needs
22
Insurance Company • Fulfil liabilities – policy & compliance• Cost reduction• Retention/satisfaction• Competitive advantage
Policyholder • Restoration• Satisfaction• Perceived value
Supplier Provide solutions to physical, emotional, liability and management needs for all parties
![Page 23: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/23.jpg)
Cost reduction causes customer dissatisfaction
23
Source : Insurance Association of Turkey / Accenture
![Page 24: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/24.jpg)
Basic standards are needed to structure system thinking
24
Source : Insurance Assosiation of Turkey / Accenture
![Page 25: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/25.jpg)
Summary
25
Organizations are complex systems – a change in one part of the system can have unplanned and unintended consequences on another part of the system
Management thinking is still rooted in 19th Century factories
A new way of management thinking is required if businesses are to succeed in the 21st Century
Start by understanding why your customers are displeased
![Page 26: Traditional to Customer-Centric Claims Organization](https://reader036.vdocument.in/reader036/viewer/2022081520/568168a2550346895ddf38ee/html5/thumbnails/26.jpg)
THANK YOU
26