Choosing the Right Path to Improving Claims Systems

Claims management is a priority issue for property and casualty (P&C) insurers. Many P&C insurers, however, operate with claims systems that are less than optimal. Key functions often prove inadequate in facilitating faster loss reporting, improving adjuster efficiency, increasing customer satisfaction, quickly adapting to market changes and providing actionable management information.

In quantitative survey research with C-level claims executives conducted in mid-2012, Accenture found that most insurers agree on the lack of modernity and flexibility of their claims management systems, especially in terms of allowing change in system behaviors and business processes and in addressing consumers’ evolving needs. American P&C insurers plan to invest an average of $17.5 million in their claims functions over the next three years, and more than one in five plans to invest more than $20 million.

Accenture is a pioneer of advanced claims capabilities–built on more than a decade of experience working closely with the industry’s most recognized and respected insurers. Accenture Claim Components, a comprehensive approach to claims modernization and optimization, is designed to support insurers’ business imperatives and provide maximum flexibility, agility and efficiency. Insurers can choose the components and an implementation approach designed to reduce disruption and minimize the resources needed for implementation.

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Consumers want the ability to report a claim and then track the progress of their claims using the channels they prefer. To meet customer needs, insurers must be positioned to service each customer in the manner–and according to the need–that they want to be served.

Modern, flexible claims systems need to be nimble enough to support online customer self-service as well as provide access using a mobile device. Accenture Claim Components provides support for call center loss reporting, service portals for agents and consumers who want to handle questions themselves and a powerful claims management solution for adjusters, all buttressed by a single point of configuration and maintenance.

Ultimately, claims systems should be able to support three key business imperatives:

1. Respond to changes in business process. Sophisticated insurers move rapidly to adjust to market conditions and to bring new products and services to consumers. Dome insurers have invested in configuration consoles that allow them to set up their claims system quickly for new product opportunities, letting the business owners define system processing requirements.

2. Integrate with other internal and external systems. Claims systems should be configured to deal with a host of third party service offerings. New systems should, for example, integrate automatically with predetermined vendors based on business rules. These might include rental companies for customers who require transportation while their vehicle is being repaired, field adjusters or appraisers’ assignments, body shops for vehicle repairs, and many others.

3. Allow changes in system behavior and business processes without IT intervention. Our survey research indicates that most insurers feel their claims systems lack the modernity and flexibility to allow changes in systems behavior and business processes, and to address the evolving needs of consumers.

Priority #1: Core Replacement

Too often companies want to replace their core system but the IT department is backlogged or not in a position to take on another project. Accenture offers Claim Components in a software-as-a-service (SaaS) implementation model as a way to have your claims department take advantage of the capabilities of Claim Components without the need to implement and maintain the system in house.

Priority #2: Developing Analytics

Advanced analytics can be harnessed to great advantage by claims professionals, but only if the claims systems can handle vast quantities of data from structured and unstructured sources.

The application of analytics in fraud prevention and identification has been well documented. Properly configured rules and automated review of experience, based on years of past claims data can improve the quality of fraud referrals and a higher likelihood of fraud prevention.

Subrogation is another area where analytics can be exploited by carriers. Accenture Claim Components can help uncover areas to reduce claims settlement expenses and increase recoveries, improving the organization’s loss ratio.

Priority #3: Investing in the workforce

As every P&C insurer knows, attracting and retaining good claims adjusters is increasingly difficult. While the profession can be interesting and fulfilling, many claims systems seem to make it harder rather than easier for claims professionals to make the most of their abilities.

One of the key requisites of a good claims system is an intuitive, easy-to-use user interface (UI). In addition to a well-designed UI, the claims system should automate the routine, manual tasks of the claims process to allow the adjuster to focus on the key elements of investigation and settlement.

Accenture Claim Components offers a well-designed and intuitive interface that can be easily learned by claims professionals of any skill or background.