Claims Services

Claims represents a major opportunity for insurers to improve their profitability and achieve meaningful differentiation. This has always been true; in these difficult times it is more of a priority than ever.

Claims handling has a critical impact on the business—both financially and operationally—making it central to the organization’s strategic objectives. It is key to customer satisfaction, and so to growth. And as it accounts for more than 70 percent of the insurer’s expense base, it is a vital determinant of profitability.

Yet in most companies the claims department is significantly underperforming. This is due to cumbersome processes, poor allocation of tasks to skilled personnel, an inability to deal effectively with intricate, diverse insurance products, the growing burden of regulatory compliance, and an overly complex and therefore inefficient processing platform. Many initiatives intended to address these shortcomings have been “quick-hit” interventions and isolated point solutions – and have yielded disappointing results.

Accenture’s research and experience shows that claims handling represents the single greatest opportunity for property & casualty / general insurers to drive significant gains in business performance and customer service.

"A reputation for settling claims fairly and efficiently can give you an unassailable marketing advantage." — Michael Costonis

Accenture has abundant experience helping insurers unlock hidden value by optimizing and industrializing their claims operations: reducing their complexity and maintenance requirements, and improving their functionality and efficiency. New processes and services are introduced, automation is extended, world-class operating metrics and capabilities are implemented, and a workforce is developed that uses the new capabilities to their best effect. The focus of these initiatives is on three key areas—loss cost containment, expense control and service enhancement—to ensure customers' expectations are met, growth is supported and costs are minimized.

The benefits of this service can include:

• Improved claims outcomes and settlement costs.
• Reduced unit cost per claim.
• Lower IT costs.
• Dramatically improved service to customers.

Related Research

Rethinking Claims: The only way to ensure a durable competitive advantage and high claims performance is to rethink the organization, embracing a new vision that is built on a foundation of human performance, information access and management, claims segmentation and organizational agility.

How World-Class Business Information Drives High Performance in Insurance.
Insurance companies need to manage enterprise information, since they face rigorous regulation and complex, information-rich value chains. Information management is central to their competitiveness and license to operate, and yet many insurers lack adequate insight to operate as high performers. What is needed is an approach to business intelligence (BI) that takes into account the challenges of the insurance industry.

Claims Masters: Achieving top-flight claims performance requires a high level of IT/business alignment to deliver high-tech, high-touch service in the customer’s hour of need, Insurance & Technology.

Get The Point. Today's financial services topics—summarized quickly but well-explored by Accenture Industry experts.

Accenture has an impressive track record of helping insurers improve their overall performance by enhancing their claims operations. There are six good reasons for partnering with Accenture:

• Our deep understanding of claims. For more than 30 years Accenture has worked with leading insurers to transform their systems and processes. We serve 34 of the world’s top 40 carriers and half of all those based in North America, including the 10 largest in the US. In addition to providing claims services to some 40 insurers we have, for many years, intensively researched and analyzed the claims function.
• Our holistic approach to claims. We offer not only a claims management system that is widely acknowledged as a leader in its field, but also a comprehensive set of skills and services – from consulting, implementation and systems integration through to business process outsourcing and ongoing support – that together represent a total claims solution.
• Our commitment to innovation. Accenture doesn’t simply strive for innovation – we plan for it, invest in it, and embed it into our training, our tools and methodologies, our Technology Labs and claims-specific innovation centers, and even the specially tailored contracts we offer our clients.
• Our global capability. Few service providers can give their clients the assurance of round-the-clock, worldwide support which Accenture’s Global Delivery Network affords. In addition to these 50 centers, with 83,000 professionals, we have insurance BPO centers in nine countries, with 4,500 insurance specialists supporting 57 carriers.
• Our market-leading software. The Accenture Claim Components Solution is a core claims system that brings automation and configurable business rules to the claims process. It is a robust, scalable system that is currently being used by 65,000 claims professionals at 19 leading insurers to process as many as 40 million claims a year.
• Our financial strength and stability. In these times, more than ever, insurers need to know their business partner will be with them for the long haul. Accenture has the financial strength, the track record of enduring client relationships, and the willingness to share clients’ risk and reward, that are the hallmarks of a real partnership.

Read how Accenture helped Royal & SunAlliance transform its claims operations.

Accenture research shows that claims optimization pays off for P&C Companies.

Claims strategy and management consulting: Accenture has extensive experience in analyzing claims business processes, performance metrics and operating models, developing a transformation business case and roadmap, and planning an optimization strategy.

Process enhancement and organizational design: This includes Lean Six Sigma and process redesign; activity-based costing, claims data analysis and claims segmentation; and organization structure, job redesign, footprint analysis and migration planning.

Custom build / technology: .NET/J2EE development of claims-specific functions.

Accenture Claim Components Solution: An end-to-end claims solution that supports claim handler efficiency and effectiveness in a buy / build model.

Accenture and SAP Add-Ons and Accelerators: For those who prefer an SAP-based claims solution, we have developed implementation accelerators for SAP Claims Management that draw on our industry knowledge and our experience in implementing SAP solutions.

Managed services / application outsourcing: Accenture’s insurance clients outsource their application development and maintenance, as well as the hosting of their applications – from individual systems to entire portfolios.

Claims business process outsourcing: Accenture’s Global Delivery Network provides support for first notice of loss, end-to-end adjudication, claims business processing, and specific functions such as subrogation and actuarial analysis.

Claims Learning: Accenture offers several toolkits, which can help carriers develop specific claims curricula and deliver their learning programs to their claims professionals.