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Challenge

A leading insurance company found its claims management processing was functioning in a highly decentralized manner. In addition to a hyper-localized process, the network was supported by aging technology platforms which were costly as well as straining the company’s ability to deliver consistent experiences for customers.

The company wanted to collaborate with a strategic advisor and managed service provider in order to establish a centralized intelligent operating model for insurance claims management. By creating a model powered by data, intelligent technologies and talent, the insurance company aimed to boost operational agility and efficiencies, accelerate its innovation agenda, redefine the customer experience and drive sustainable growth.

What Accenture did

The insurance company teamed with Accenture to conduct a feasibility assessment to identify the claims services to transition. Two key complex and strategically important areas emerged as critical segments requiring immediate attention: Worker’s Compensation and Auto General Liability.

The move to an intelligent operating model began with the team incorporating standard tools and processes for claims-related customer service inquiries, claims approvals and denials, and the management of medical claims in Worker’s Compensation.

Once these processes were stabilized, the team moved to optimize and continuously improve them by training (and cross-training) agents and assistants. Boosting operational agility and efficiencies, accelerated its innovation agenda, redefined the customer experience and drove sustainable growth.

Identified insurance processes to be automated

  • Introduced a proprietary automation identification diagnostic tool (AIDT)
  • Accomplished tasks with recorded and analyzed claims assistants’ actions
  • Simplified and centralized nearly all claims management

Marked opportunities with new diagnostic tool

  • Automated case assignments
  • Accelerated routing of important documentation
  • Helped boost overall claims management performance

People and culture

This transformation has instilled a new culture of excellence within the insurance company. The workforce, assistants and agents, have now embraced the power of collaboration tools and analytical insights, working closely across the organization. They recognize the value of data-driven insights and optimize its usage.

Value delivered

The insurance company was able to cut operating costs and improve productivity. This burst of productivity is due largely to the combination of data, intelligent technologies and talent that allow the team to work faster and more effectively, with less rework required. Since entering its managed service arrangement, the insurance company has:

20%

Reduced average handling time for all insurance processes by over 20%.

30%

Cut the turn-around time for claims recovery by 30%.

99%

Processed 99.84% claims within specified turn-around time.

99%

Achieved 99.99% payment accuracy.

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