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Published byGiles Pearson Modified over 9 years ago
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Page 1 Recording of this session via any media type is strictly prohibited. Page 1 Technology: A Risk Professional’s Best Friend Using Technology to Enhance Claims Management
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Page 2 Recording of this session via any media type is strictly prohibited. Session Presenters: Matt Thomson | Wells Fargo Insurance | Risk Consulting Leader Since 1903, Wells Fargo Insurance Services USA, Inc. has been providing its clients with innovative and insightful insurance solutions that help protect assets and strengthen businesses Frank Lott | FirstGroup America | Corporate Claims Director FirstGroup America owns and/or operates thousands of school bus, transit, and maintenance locations in the United States and Canada, with over $5 billion in annual revenue from North American operations Aaron Shapiro | Origami Risk | Executive Director Origami Risk has emerged as innovator and leader in the marketplace for RMIS solutions : #1 RMIS by the 2013 RMIS Review
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Page 3 Recording of this session via any media type is strictly prohibited. What to Expect After attending this session, you will: Learn about the current trends in technology- related claims program consulting Learn ideas for the practical application of technology to enhance your claims and risk management efforts
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Page 4 Recording of this session via any media type is strictly prohibited. ENVIRONMENTAL ASSESSMENT Exploring the history and pace of technology advancement
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Page 5 Recording of this session via any media type is strictly prohibited. A Few Warm Up Stats 2.4 billion Internet users Google: 100 billion searches every month YouTube: 24 hours of video uploaded every minute FaceBook: 175 million connected every moment 3.500.000.000.000.000.000.000 3.5 Zetabytes of unique new information will be created worldwide this year Source: Did You Know 2014
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Page 6 Recording of this session via any media type is strictly prohibited. Past 5-10 years ago Present What technical capability exists today that is ‘new’ Future Where are we headed & how to prepare Claims Technology Evolution
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Page 7 Recording of this session via any media type is strictly prohibited. Easy Button?
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Page 8 Recording of this session via any media type is strictly prohibited. Big Data – but is it Good data? Unstructured v. structured Carrier systems designed for underwriting/internal use Claim characteristic code standardization Lowest common denominator Point in time valuation / lack of development factors Location hierarchy Acquisitions & divestitures Departmental naming conventions
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Page 9 Recording of this session via any media type is strictly prohibited. Today’s Technology Memory is cheaper Processing is faster Analytical programs are more sophisticated Are you equipped to take advantage?
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Page 10 Recording of this session via any media type is strictly prohibited. Analytics Platform Source: AllAnalytics.com
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Page 11 Recording of this session via any media type is strictly prohibited. SaaS/Cloud Computing Data capacity implications Data conversion Psycho/social elements Privacy/security Speed
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Page 12 Recording of this session via any media type is strictly prohibited. CLAIM PROGRAM TRANSFORMATION Exploring practical ideas to transform your claims management efforts
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Page 13 Recording of this session via any media type is strictly prohibited. Claim Lifecycle + Technology Notice of Loss Investigation Decision & Reserves Cost Containment Disposition 13
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Page 14 Recording of this session via any media type is strictly prohibited. ‘Similar’ Claim Characteristics
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Page 15 Recording of this session via any media type is strictly prohibited. Dashboard Management
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Page 16 Recording of this session via any media type is strictly prohibited. Need for claims professionals communication speed
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Page 17 Recording of this session via any media type is strictly prohibited. Claim Vendor Partner Connectivity Sharing information to improve efficiency and outcomes MSA vendor having access to RX program Nurse case management Minor damage photos coded to trigger IME assignments Alert when PT is over guidelines (take action) Alert when 12 PT visits that have not had a diagnostic test RX utilization sharing with medical bill re-pricing to flag contra-indications and over-use Early refill and/or if more than one MD is prescribing Adjuster accountability
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Page 18 Recording of this session via any media type is strictly prohibited. Claims Key Performance Indicators (KPIs) 2 Important Points: #1 : It has a direct, bottom line impact on the success of the business; and #2: It is analyzable and actionable.
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Page 19 Recording of this session via any media type is strictly prohibited. Leading Indicators Focus on Risk Management Quality Leading Indicators (Culture, engineering, training, etc.) to drive down trailing indicators (incidents, losses, etc.) Choose Leading Indicators Carefully Thorough causal analysis of past losses and potential exposures Choose indicators that will drive positive behaviors and improvements Make sure they correlate to the trailing indicators Be comprehensive in approach (training w/out commitment is worthless) Be Practical Must choose approach that fits with culture and needs of organization Measure the “big ticket” items – the ones that will cause the most change in trailing indicators Be outcome focused Measures should promote problem reporting and drive action
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Page 20 Recording of this session via any media type is strictly prohibited. Benchmarking
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Page 21 Recording of this session via any media type is strictly prohibited. Internal Benchmarking
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Page 22 Recording of this session via any media type is strictly prohibited. Balanced Scorecard Key Performance Indicators YTDTargetPrior Year Based on Claim Type Definition ACPC$18,000$23,000$25,000 Pending Duration 650640650 Pending Attorney Rep 50%42%40% Pending Litigated 21.7%22%25% Pending $250K+ 4850 Pending $500k+ 65 Cash Spendin thousands$xx Pending Begin 4,8505,000 New 9,80010,000 Closed 10,00010,250 Reopened 150100 Pending End 4,8004.850 Subrogation YTD RecoveryIn thousands$xx Duration 307355423 Based on Unit Group Number of Pending Files4,800 4,850 Number of Active Staff 3031 Average Pending Per Staff160 156 Quality Assurance InternalTotal83.8%85% 80% ExternalTotal90.8%90% 88%
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Page 23 Recording of this session via any media type is strictly prohibited. Top Tech Priorities of Carriers & TPAs
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Page 24 Recording of this session via any media type is strictly prohibited. CONCLUSIONS & Q&A Final thoughts and recommendations
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Page 25 Recording of this session via any media type is strictly prohibited. Critical to your ROI Data Analytics Resources Skills/expertise of internal/external partners Balancing Claims Quality & Efficiency Are claim adjusters critical thinkers, or adjusting to activity-based ‘tech driven’ metrics?
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Page 26 Recording of this session via any media type is strictly prohibited. THANK YOU
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