1. Unlocking the Black Box of Claims Management
October 2015
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2. Improving policyholder Managing growth & retention
Customer Context
Research shows that speed of settlement and insurance process transparency are the most important contributors to customer loyalty.
Both are cited by 94% of policyholders as a key expectation when interacting with insurers during the claims process.
With an explosion of data and channels, customers’ expectation is for accuracy, responsiveness and effective insurance claims management
Omni Channels
Multimedia explosion
Improving policyholder
experience
Managing growth & retention
Speed of settlement and process transparency is 94% key expectation of customers
Improving NPS
Omni Channels; gen Y, mobility, I want it now, no loyalty 2

3. Insurance Claims Management: The Challenges
No visibility of process
Black Box to all parties
Anxiety
Time Pressure
* Issues right now; money involved, exposure, anxiety, time is money 3

4. 5 Phase Process – Best Practice Claim Management
Workflow claim management technology
Transparent & measured performance of all stakeholders
Consistent business rule driven process adherence
Intelligent SLA & non compliance management using never- before-seen data and analytics
Low cost of ownership model
World Best practice measurements, state-of-the-art technology, analytics, high expectations
One streamlined process with lsot of automated communication channels ( SMS, ) 4

5. Opening up Pandora’s box
I’m not satisfied with the quality of repairs.
Are the claim variations approved?
When will the trades arrive?
Has my claim been approved?
When will my job be finished?
Where is my job up to?
I want to make a complaint.
What do I need to do next?
* Technology now allows us to open up the box and give full transparency by a push of a button
* Customer calls broker first who has full visibility now
* Claimlogik for Brokers, across multiple lines P&C ,Motor etc.
* OPEX versus CAPEX cost,hosted etc. 5

6. Opening up Pandora’s box
So, how do we unlock the Black Box of Claims Management?
Digitalization
Workflow Management
Process Automation and Robotics
* 3 key focus items in full visibility of the process. 6

7. Digitalization 7

8. Digitalization Defining Digitalization:
Creating digital-enabling assets to become more relevant to its customers and members
The three D’s:
Digitize
Differentiate
Disrupt
Traditionally a “push” channel (e.g.phone) now changing to “pull” (bringing information back and ongoing dialogue with the customer)
* Optimizing communication channels
Push versus pull ( scripts)
Disrupt;very consdervative industry ( e.g. direct, 40 year old processes) 8

9. Digitalization Defining Digitalization:
All focussed on “convergence”; bringing together digital media, technology and platforms to improve communication between the relevant parties.
Why? Because customers virtual lives and physical lives have merged and are much more demanding (Gen Y etc.)
Large Insurers and System Integrators are setting up Innovation Environments like Labs to experiment and are appointing Digital and Innovation EGM’s
* Merged private and business lives, multiple devices, IAG Labs, what happened in Banking long time ago is now starting in Insurance 9

10. Digitalization Big (Customer) Data is going to be key!!!!!
Predictive analytics (buying behaviour and risk mitigation)
One-click insurance estimates
Human interaction remains key
Customized pricing
Distribution channels will change as a result of digitalization
Consumer led demand
Personalized insurance products is the key differentiator, imperative to understand what the customer wants
Woolworths example of face recognition , push technology on the phone, cross selling new products, plug and play, new channels coming up all the time
Insurance pricing and claims estimates now based upon analytics of benchmark data , incredibly accurate! 10

11. Workflow Management 11

12. Challenging the Traditional Model
Existing model of insurance industry claims management:
Multiple touch points between many stakeholders throughout the lifecycle of a claim mean little or no control over cost, quality, customer service, lifecycle or client management.
Lots of interaction, too many touch points, lack of communication, labour intensive, lack of automation 12

13. Compounding the Chaos in Catastrophe
Catastrophe impact upon existing model of claims management:
Dramatic and immediate surge in claim volumes, overlaid with additional reporting to government, reinsurers, regulators, ICA, APRA etc, multiplies the lack of control and creates communication chaos.
Dealing with Corporate regulators, Media, Government 13

14. Unlocking Value: A Better Service Delivery Model
ClaimLogik model of claims management:
Direct access to our technology platform for all stakeholders through automated communication and analytics tools, plus complete supply chain management, ensure lifecycle reduction, cost reduction and greater control over quality, customer experience and client management.
Technology brings it altogether based upon automated communicated and analytics.
To find the money “go with the (work) flow” 14

15. Analytics & Business Intelligence
Creating a modular view of the claims process allows clients to create very powerful analytics across customer experience, claims cost, cycle times & supply panel performance
Instead of only vertical views now a complete horizontal view of what stage the process is 15

16. Analytics & Business Intelligence
The key data and analytics captured throughout the property claim workflow enables clients to drill down deeply in the critical performance areas of a property claim:
Customer & Client Analytics
Cost & Spend Analytics
Cycle Time Performance
Supply Panel Performance
Using technology to get better “insights” and speeding up processes and increase overall performance of the business. 16

17. Innovative Stakeholder Management
Connecting:
Insurers, Reinsurers & Brokers
Policyholders
Third Party Administrators
Supply Chain Panels
Performance analytics across cost, quality and stakeholder experience
* Technology connects everyone, hub and spoke model , runs on mobile technology as well.
* The more we move towards mobile work, the more time we have.
* We want see automation of allt he very timeconsuming , little tiresome things 17

18. Personalised Connection
Stakeholder management systems
Policyholders, Reinsurers, Insurers, Brokers, TPA’s communication and reporting platform
Self Serve Business Intelligence - cost, price, quality and lifecycle reporting
Tailored insight, tailored communication, as a customer it feels that they actually know you. 18

19. Process Automation and Robotics19

20. Intelligent Process Automation (IPA)
IPA is helping insurance companies achieve results – faster and better.
IPA is the next wave of technology. It is enabled by powerful frameworks of technology, methodology, best practices and tools and integrated analytics.
New wave of cost optimization and efficiency improvements 20

21. Intelligent Process Automation (IPA)
IPA produces results such as:
Transforming business processes
Reducing error rates, better managing rote activities and standardizing tasks
Enabling people to drive innovation
Improving the quality, consistency and “believability” of data
Better quality work delivered, stimulating staff, far more accurate way of doing business 21

22. Global delivery, automation & analytics working in concert – today and tomorrow
Organizations that can master smart robots tethered to smart data will outpace rivals who don’t (or can’t).
50% of today’s respondents see automation (and 44% see analytics) as drivers of positive impact to processes in 3-5 years’ time.
ANZ example robots deployed by end of Payments, Standard processes like Ar and AP
Not replacing FTE’s but re-allocation of FTE’s onto the smarter work, better for carreers etc.
Cost savings, better processes 22

23. Global delivery, automation & analytics working in concert – today and tomorrow
* Huge change in focus on Process automation and Analytics/big data
* Virtual payments as part of optimization of payment processes,w e are working closely with a partner in this area.
* Global delivery, Analytics and Automation working in Tandem- Today and Tomorrow.
Percent of respondents rating the following four service delivery models as “significant” or “profound/transformational” (4 or 5, on a scale of 1-5) in terms of their overall ability to positively impact business processes. 23

24. Where IPA Can Help Pre-checks and rules validation for new business
Addition of new functionality or process module that requires system rebuild or manual hiring / re-skilling
‘Dirty’ interfaces – data transferred between applications that are not integrated
Multiple sources of data input for business reporting and analytics
Manual checking, decisions and calculations that follow preset rules with no judgement involved
Replace new functionality and skills by robots
The time of throwing more bodies at it is over and done.
Capabilities ofpeople are magnified by Robots now
* Replaces a lot of interfacing work to be done
* Immediately linked to reporting and analytics purposes
* No subjectiveness by people involved. It is what it is. 24

25. Process Selection Criteria
Digitized inputs with limited human intervention
Structured, rules-based, repeatable, computer based tasks
Prone to error or re-works with limited need for exceptions
Performing decisions and algorithms
Need to access multiple systems
Fluctuating workloads and volumes with long AHTs
Dull, non-attractive work can be done much better by Robots. EG payments.
No mistakes made
Better planning core/flex, amp-up, onsite/offshore, captives 25

26. IPA Opportunities and Prioritization in the Insurance Industry
Policy Service and Contract Administration
Claims Coding and Processing
Claims Administration
Risk, Fraud and Compliance
Work smarter with fewer people doing the process
It is not about cutting costs, but increasing sales, speed up sales cycles and customer satisfaction
Percent of decision-makers anticipating greater than 25% FTE reduction as a result of automation in their industry specific processes. 26

27. Look at area’s in Insurance where this can be applied to
* Look at area’s in Insurance where this can be applied to. This is the future.
* Robots can make a money-saving assembly line of processes.
Compared to other Industries this Insurance industry is now ripe for it. Captives eg QBE. 27

28. Remko Jacobs Head of Corporate Strategy and M&A
Claim Central Consolidated Holdings
M +61 (0) E
W claimlogik.com