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Deena M. Amato-McCoy
Deena M. Amato-McCoy
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Claiming the Future

In the next stage of claims automation, insurers are looking to improve information sharing -- with internal claims specialists and external partners and policyholders.

The concept of claims automation isn't new. In fact, insurance companies already are feeling the positive effects of automating their claims management processes. But as insurers prepare to tap new technologies and further leverage their electronic, end-to-end systems, they are focused on providing end users -- from internal claims specialists to external partners and consumers -- with insight into the claims life cycle.

By integrating claims management solutions with new delivery methods, carriers are giving internal and external users access to the status of claims. As a result, companies simultaneously are streamlining claims processing and building customer loyalty -- especially among younger tech-savvy policyholders.

The move toward automation has clearly added new efficiencies within claims processing operations. Electronic, paperless systems increase productivity and save carriers time and money. But automating processes for operating efficiency is just the beginning.

Improving Decision Making

As carriers embark on the next phase of their claims management investment, beyond processing efficiencies, companies are looking at how they can further exploit claims systems to improve decision making and workflow. "One of the biggest trends is to use existing software and internal data to take the guesswork out of handling a claim," says Vincent Cialdella, vice president, ISO Claims Solutions. The Jersey City, N.J.-based company provides integrated tools to manage the claims process.

"By leveraging their software and existing data, for example, carriers can route claims more effectively so the right people have information at the right time," Cialdella explains. This can reduce cycle times and improve customer satisfaction, he notes.

However, there are steps involved in leveraging claims data. First, carriers need to break down the silos that exist between departments and create a single data warehouse that stores claims data. Next, carriers are adding data-mining solutions to discover trends and conduct data modeling or forecasting. "Gathering, analyzing and monitoring data is one method that insurers are using to provide better answers and ensure ongoing claims customer satisfaction," says David West, global insurance strategist for SAS, a Cary, N.C.-based provider of business intelligence software.

Working to Improve Workflow

The final piece of the claims management makeover is to add workflow capabilities. Workflow software typically creates a list of administrative actions based on user criteria, and specifies the procedure associated with each action. These tasks may include alerting associates to a particular trend, or prompting a manager or underwriter to complete a claim. Documents can be physically moved over the network or maintained in a single, shared database. The appropriate users can securely access the data at required times.

Eager to make its claims management process more reliable and efficient, New York-based American International Group (AIG) created its own streamlined workflow process. "Our challenge is to manage all of our resources and develop the right strategies to achieve optimal claim resolution, time and time again," says Michael W. Smith, president of AIG Domestic Claims, AIG's claims division.

AIG ($108.9 billion in total revenue) expects to overcome that challenge with its c-Claim project, which stands for "centralized-Customer Link and Information Management." Building off of its ongoing commitment "to optimize the claims handling process and provide the highest standard of service to our clients," Smith says, the company launched c-Claim in December.

The c-Claim platform provides a single point of entry for all directors and officers (D&O), errors and omissions (E&O), financial institutions, and fidelity claims, according to Smith. Upon receipt of a notice of loss or a claim, a simplified workflow process directs each document to the appropriate claim professional, he explains. By electronically alerting each involved internal division to their task, c-Claim ensures that the staff facilitates efficient claims resolution, Smith adds.

"We developed c-Claim to enhance the speed at which communication flows and to move toward a paperless environment," Smith continues. "C-Claim is designed to facilitate our management of information, from handling the claims and the relationship with customers and brokers, to the sharing of loss trends and results with actuaries and underwriters."

Though the system has been live for less than three months, AIG already is receiving positive feedback, Smith notes. In fact, "The simplified reporting method of a single e-mail address instead of multiple physical addresses and fax numbers has been particularly well received," he says.

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