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Transforming Claims Management

Overview

Claims is one of the most critical service components for an insurer, that plays a big role in driving customer satisfaction and increasing share of wallet. It is a key differentiator in customer experience and helps attracts new customers and deliver healthy underwriting profits. Yet this process faces many inefficiencies. Despite years of efforts to improve claims processes and systems, claims teams are still challenged to optimize operations and remain competitive. The need today is a unique value proposition that provides a superior claims experience not just for the customer, but everyone associated with the claims value chain. Insurers should be able to position claims performance as a growth leverage in alignment with their strategic business vision and technology optimization.

Claims Transformation Offerings from Infosys

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Macro and Micro Environment

Internal & External Stakeholders

Critical Enablers

Strategy

  • Claims core process transformation
  • Strategic alignment of claims with technology & business vision
  • Redesigning claims value chain and operating models
  • Develop transformation blueprints

Process

  • Claims process innovation and redesign
  • Improve claims efficiencies leveraging digital
  • Elevate customer experience, reduce fraud losses
  • Train claims workforce, boost governance

Technology

  • Claims data and process integration with enterprise technology
  • Redesign claims architecture for agility and future proofing
  • Leverage latest technology to deliver superior experience
  • Data-driven decisions

Success Pillars

Infosys offers digitally driven end-to-end claims transformation services that help insurers achieve competitive differentiation arising out of reduced claim cycle times and total cost of ownership. Our bouquet of services enables insurers transform core claims processes and systems harnessing the power of digital technologies, leading to better brand image and higher customer satisfaction.

Leveraging our claims solutions and service offerings, we can deliver a holistic claims experience across all touchpoints in the claims value chain. We enable decision making purely driven by data that helps integrate enterprise systems and technology, leveraging industry leading tools and frameworks as well as our in-house offerings and expertise.

Despite years of efforts to optimize claims function and minimize redundancies, challenges still remain in the form of legacy systems, outdated claims processes and policies, disparate systems that lack integration amongst themselves and third party software, gaps in the claims value chain that lead to longer settlement times and higher costs. Insures need to take customer experience to a whole new level leveraging digital technologies, modernizing claims capabilities, and effectively managing claims resources that would eventually earn customer loyalty.

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Challenges & Solutions

Guided Claims processing is our mobile application for claims adjuster on tablets that shows adjusters necessary information about claims, allows to register required data during claims inspection and then forward it to client claims systems. It is an IoT-based solution powered with analytics that helps in potential loss control and prevent equipment breakdown losses. The solution has additional features of collaboration (chat, document sharing, audio and video), speech recognition, photo capture and upload, GPS/map integration, and knowledge base. It provides interactive claims analytics dashboard and KPI reporting for complete spectrum of claims operation. Textual and graphical reports with real-time information for decision support in easy to read format.

Losses from equipment breakdown insurance can be huge considering the exposure of the risk cover like damage to the equipment, loss of business income, extra expense, and other consequential losses. Our IoT and analytics-enabled solution for claims helps the insured as well as the insurer to prevent equipment breakdown losses. This helps loss control through preventive and predictive monitoring, risk profiling of equipment, faster claim settlement, reduced fraudulent claims and superior customer experience, self-care assistance through alerts, and reduction in service disruptions.

Interactive Claims Analytics and KPI reporting dashboard is our out-of-the-box solution to suit the needs of CXOs, claims directors, managers, and adjusters. It covers the complete spectrum of claims operations including claims-specific dashboards, KPIs, and metrics. The textual and graphical reports provide instant information on claims. It provides a 360-degree view of end-to-end claims operations, insights from historical claims, and critical claims data that can improve pricing of risks in future. The solution also has advance analysis options such as trend lines, claim forecast depending on historical data and improved efficiency based on real-time information and help make decisions faster.

Infosys' blockchain-based application for claims provides a secure and transparent way of handling claims process. Typical claims process involves multiple entities like lead insurers, secondary insurers, and third parties and can lead to multiple iterations to capture data and getting required clarifications. Legacy claims process has data quality issues due to disparate legacy systems and higher percentage of manual hand-offs. Blockchain-based claims application enables capturing FNOL, related data, and documents using Distributed Ledger Technology. This solution provides capabilities like straight through processing, instantaneous updates to all entities that are part of the claims process, easy integration to existing systems through ACORD messages, and transparent workflow management. The benefits derived are faster turnaround time of claims processing, transparency in claims settlement and transaction accounting, data integrity, and single source of truth for auditing.