Business Challenges

The actual context and the needs of Insurance Companies
Property and casualty insurers usually provide a wide range of global services: from simple individual policies to complex insurance policies for multinational corporations. Although there are many similarities between claims processes, it is difficult to organize them because of the need of specialized knowledge on each specific line of business segment or expertise. Therefore, insurers try to maintain the quality control of their own organization and to integrate consistent models in order to efficiently administrate claims operations and costs.

Currently, insurance companies are confronting with a series of necessities, such as:

• Maintaining competitiveness in a market founded on price;
• Maintaining permanent alignment to legislative framework and to the national and international system requirements;
• Creating a consistent experience for the company customers in order to retain the existing ones and gaining new ones;
• Promoting high usability interfaces along the lines of business and multiple distribution channels;
• Efficient regulations, fines and penalties management;
• Efficient administration of products and life-cycle components development;
• A more efficient government, given that the support resources are decreasing in number and quantity;
• Increasing labor automation, process efficiency and permanent development opportunities access;
• Building consistent processes which can be extended to the product level and line of business;
• Optimizing the existing systems.

From the operational point of view, advanced insurance organizations have the following strategies:

• Claims processes improvement;
• Reduce claims leakages;
• Reduce claims fraud;
• Cost control;
• Increase customer experience significance.

Description

SmartClaim™, the Enterprise Concept solution, is based on modern technologies of process management in order to help insurers to grow their efficiency in managing property and casualty policies by improving the process management.

Insurers can use  SmartClaim™ solution to administrate the whole claim life-cycle from the first notification until the process is complete. At the same time, this solution empowers a fast delivery of claims managerial elements, creating a fundamental support for all the process components from the claims management and insurance products.

SmartClaim™ offers a life-cycle based claims management that is use by insurers for optimizing processes and systems, according to their business design.

• Claim submission: The speed at which the claim is initiated has a direct impact on the claim’s costs. SmartClaim™ supports the applications and notifications taking over by using detailed processes designed for those who suffered property damage or injuries.
• Creating the claim file: For most of the insurers, creating a claim process is based on a manual mechanism. But SmartClaim™ improves this process efficiency by developing a “Claim Event” that meets the claim right after the notification. During the notification process, it uses consolidated data in order to grow a valuable perspective regarding fraud tracking and service agreement, identify potential risks and adjust the necessary claims processes.
• Reviewing the claims: The insurer’s ability to put an request in the hands of the right person at the right moment can have important implications in terms of loss and coherence.
• Investigation: The insurance investigation is a crucial part of every claim request from the perspective of Claims Management Process – especially when the workflow is consistent and the risks are complicated. The insurer’s ability to effective correlate the investigations can have big impact over the income, reducing expense ratio and excluding fraud risks. SmartClaim™ can help insurance companies to manage the investigation processes from beginning to end.
• Decision making: In every claim operation, there is a person whose experience and organizational knowledge are used to improve more efficient the processing speed of claims.  An claim focused organization can use SmartClaim™ to develop and guide processes and good practices.
• Claims consolidation: A claim has its own life-cycle, which makes it widely used by insurance companies. Insurers have to make provisions, to anticipate the amount of money, to secure the liability with claimants and to follow the agreement. The faster the insurer gets the claimant consent, the smaller the collateral administrative expenditures are. There is the risk that negotiations may be extended, having many aspects to be solved. Property and casualty insurers can atomize simple tasks during the claims process. For example, there can be atomized letters, services, communication etc.
• Recovery: This type of recovery program is full of challenges. Usually, it is a long time process which requires a great dynamics between the parts concerned. Each step the insurer takes during this process adds more costs to claims administration and lowers the company’s benefit. SmartClaim™ allows the insurer to establish his priorities according to his potential opportunities. Administrative costs are minimized by automating parts of the process, and employees can focus on those aspects of the claims management that add value in the company.

Benefits

• Proactive management of more complex cases with real-time visibility across the company using Enterprise Concept’s unique goal-based Business Process Management technology.
• Greater control of the claim supply chain and end-to-end visibility across all those involved in handling a claim.
• Process standardization so that insurers can define and enforce their best practice approaches and achieve more consistent claims outcomes.
• Business rules standardization for more consistent decision-making.
• Process monitoring of the performance of the claims processes against Key Performance Indicators (KPIs).
• Ability to analyze, recognize and act on in real time any claims patterns (regulations, calamities, political or social major events etc.)
• In setting and managing claims strategies, claims managers can use SmartClaim™ to monitor events that may cause claims and prepares the organization for action based on business rules.
• Claims can have a high level of complexity, an insurance can cover many accidents. SmartClaim™ manages every claim like an” individual project “.
• Detection for fraud: there are multiple ways of tracking fraud, from checking fraud databases to exanimate claims statements versus facts etc. Therefore, SmartClaim™ can define anti-fraud processes and also gives power to claims managers to set their own agile claims strategy.

We are here for further information regarding SmartClaim™ solution. You can directly contact us by sending an e-mail us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .