Claims Processing (for Insurance)
Expedite Property & Casualty claims processing
Claims Processing presents complexities and added overhead to every insurance company in the market. With Loss Adjustment Expense (LAE) continuing to rise, claims costs continue to be a black hole for insurers. Time to decision has a direct correlation to claims leakage and increased costs, impacting reserves. Insurers must evaluate new and innovative approaches to claims handling. Improving transactional processing is at a critical stage, and resisting the use of work management technology in its claims divisions is no longer an option for insurers.
OnBase Insurance customers are ahead of the pack as they deploy OnBase workflow and OnBase case management solutions, and they have found that, in many cases, automating just one step saved 30 minutes of work in claims.
The OnBase Insurance Solution brings relief to a long-time challenge within claims departments and offers the ability to provide access to documents and information surrounding a claim, providing a single interface for all claims content, regardless of where it originated or of its format. Managing the First Notice of Loss (FNOL) can be managed from paper, fax, email, eNotice, phone call or any method, then streamlined into one process that can kick off the automation process from assignment of work, generation of acknowledgement letters, to Special Investigation through to settlement. OnBase customers who manage the FNOL tasks in OnBase have found staggering results in reducing the process which previously took days. Now new claims (submitted via web) are resolved in 24 hours.
To properly adjust a claim, adjusters must have access to all of the information pertaining to the incident. Quite often, the information required must be requested as part of the investigation. As such, the creation of correspondence and documentation of phone records, and so forth, becomes an integral part of the claims process. It also becomes increasingly difficult to manage whether the replies are received. Often information must be gathered from various sources, making a considerable amount of the process “task related”.
The OnBase Insurance Solution provides the ability to easily access information and identify when required information is missing. Document creation allows for the automated or ad hoc generation of correspondence requiring specific legal wording or criteria-based generation. Pending task-related actions can be managed directly in OnBase with automated notifications built into the workflow to manage follow-up requests and diary alerts. Work distribution can be easily managed by authority levels, skill sets, type of claim or other business rules. Approval requirements can be managed throughout the process to ensure that internal controls are maintained. OnBase provides the ability to automate a significant number of manual repetitive tasks, freeing up adjusters to focus on high value tasks. OnBase Insurance customers who use OnBase Workflow have seen claims adjuster productivity increase by 150 percent.
It is imperative that the adjuster has all the information pertinent to the claim in order to make timely, accurate decisions. This type of accuracy takes years of experience, so insurance companies must manage employees and various levels of authority. Claims handling procedures often detail what authority level and approvals are required to pay claims, especially those high-dollar or complex claims. OnBase solutions provide this type of flexibility and rules based distribution.
OnBase provides the ability to integrate with Claims Handling Systems such as Guidewire Claim Center, CSC, Accenture, and home grown AS400 Mainframe solutions, providing the ability to bring together data and content improving expediency and efficiency. The OnBase Case Manager is integrated with document management which brings the added value of allowing task management at the case level throughout the claims process. Additionally, providing documented audit trails of claim procedures for reinsurance auditors and internal quality control is standard functionality available to claims personnel.
OnBase provides Claim departments with the flexibility they require to overcome their reluctance to move to an automated environment. Claims handlers must have visibility into the current state of the process and be able to change authority levels or processing rules on a whim as needed. Claim volumes fluctuate on a daily basis and workflows need to be adjusted, reassigned and handled appropriately to ensure accurate, timely setting of reserves and to maintain service level standards. Claim processes are heavily regulated and hefty fines can be applied when processes are not accurately followed and payments are not made on time. Insurers using OnBase have reduced the administration of claims appeals by 2,000 hours per month, resulting in a significant reduction in claims expenses.