The Next Frontier: Straight-Through Claims Processing

In today's economy, insurance companies are looking for ways to do more with less. However, gone are the days when companies could reduce staff by 10 to 20 percent across the board and still effectively run their claim organisations.

To lower operating costs, companies must first improve processes and then capture the efficiencies achieved within day-to-day operations. Opportunities abound. Start with dusting off all that data you've been collecting and turn it into actionable insight. You can leverage that information to roll out new capabilities such as straight-through processing and customer self-service to achieve breakthrough results.

Accelerate Straightforward Claims

The place to start is with straight-through processing for straightforward claims. How do you know which claims are straightforward? Just look at your claim data. Use analytics to identify the types of claims that have the least variability in outcomes.

In other words, it doesn't make sense to insert an adjuster into the process on claims where an adjuster seldom influences the outcome, such as replacing a windshield or processing an ambulance or towing bill. Calculate the related costs and benefits to determine where to draw the line when selecting claims for straight-through processing.

For example, if an adjuster adds 40 percent to the claim-handling cost but saves only 20 percent in loss costs, then evaluate other aspects. The adjuster's involvement could provide other less tangible benefits, such as creating a sentinel effect to deter fraud or abuse. Customers expect that the process will be fast, easy, and fair. However, regardless of the adeptness of an adjuster, a claim resolved by a computer will always be faster.

Create Seamless Electronic Processes

Straight-through processing allows claimants to upload photos, receipts, police reports, and other required proofs.

In a straight-through process, if an inspection, repair, or rental vehicle is required, then claimants schedule their own appointments or reservations. Emergency room bills can be uploaded and auto adjudicated, which allows them to be reviewed, authorised, and immediately paid, all by the system. Within a single claim, some components may qualify for straight-through processing while other components could take the traditional path and be reviewed by an adjuster.