Workflow management at an insurer

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By Peter Hilton

Insurance industry examples

Workflow management is understandably popular in the insurance industry, because it’s such a good fit for a number of key business processes. An insurer’s work is information rich, fast moving and involves multiple people in both high-volume and diverse cases. This article introduces some examples.

The insurance industry applies workflow automation to both key customer-facing processes, such as on-boarding new customers and processing claims, as well as business critical back-office processes, such as claims handling and fraud investigation.

On 24 November 2015, Signavio Workflow (Effektif) will be at the IT für Versicherungen (in German) insurance industry event in Leipzig.

Optimising claims processing

The goal of optimised claims processing is to deliver a positive customer experience and turn an existing customer into a long-term loyal customer.

Challenge

A customer making an insurance claim may be stressed by a difficult situation, and is likely to respond to a negative experience by getting back at the insurance provider. Reduced switching costs and easier online comparisons between insurance providers increase the likelihood that dissatisfied customers will switch provider.

Opportunity

Policyholders have low expectations for friendly, timely and detailed ongoing information about their insurance claim. Also, but supporting a variety of communication channels – from telephone and email to social media and web-based forms – you can improve the customer experience by making the process more convenient.

How workflow management can help

Workflow management can help with claims processing in two ways. First, an overview of open insurance claims, such as Effektif’s cases view, helps you manage the team’s workload. Team members can use task views like Effektif’s tasks inbox to see what they have to work on – what’s due today, and managers can see which tasks are unassigned.

This kind of collaborative task management functionality helps you ensure a prompt response to claims from policyholders, which is the first step in a positive customer experience.

You can also use workflow management to keep the policyholder up-to-date as claims processing progresses, by providing status updates. In Effektif, you can use the Send email task to automatically send updates, using standard email templates.

Coordinating new product introduction

The goal of coordinating new product introduction is to introduce a high-quality insurance product quickly and efficiently, and be responsive to market opportunities.

Challenge

Introducing a new product requires involving a variety of internal stakeholders in a series of feedback and approval iterations. This process risks dragging on for months, resulting in high administrative costs and reducing your ability to respond to market changes with a flexible product line. Saving time by cutting corners increases the risk of launching a flawed product.

Opportunity

Successfully involving all parts of the business in product development – from claims adjusters to customer service – can improve both product innovation and employee engagement. At the same time, making it faster and easier to launch new products will encourage you to do this more often, so you get better at it, resulting in even better quality and efficiency.

How workflow management can help

Developing and launching a new product includes elements of project management workflows and approval workflows. You can use a workflow to coordinate how different stakeholders in your organisation contribute to the project, by capturing a sequence of tasks, such as preparing proposals and scheduling review meetings.

At key milestones, you can use approval workflows to involve stakeholders and capture management sign-offs. Then you can automatically send email to distribute documentation to stakeholders to keep them informed.

This kind project coordination makes it simpler to involve different members of your organisation in the process without introducing delays. What’s more, when you use Effektif cases for projects, each case’s participants become an ad-hoc virtual project team that can use Effektif to collaborate.

Investigating fraudulent claims

The goal of investigating fraudulent claims is to reduce fraud, to ensure profitability.

Challenge

Even if you have an efficient way to flag potentially fraudulent claims, you still need to prioritise and investigate. Claims investigation is time-sensitive, because a successful investigation may depend on evidence still being available, so it is important to avoid delays in assigning staff to the most important cases.

Opportunity

By systematically identifying and dealing with fraudulent claims, you can increase profitability. At the same time, you can develop an investigation protocol that reduces investigation costs by capturing knowledge about how to investigate suspicious claims.

How workflow management can help

Workflow management can help avoid delays in fraud investigation by making task assignment and handovers work smoothly. Effektif helps you avoid delays by sending automatic notifications when tasks are created and assigned.

You can also use workflow management to create standard procedures that increase efficiency by building checklists and guidance into workflows, to make sure that the right things are checked first and that nothing is forgotten. At the same time, case management features such as ad hoc tasks give investigators the flexibility to provide visibility of their work without being constrained by a fixed process.

Photo: Jumilla / CC BY 2.0