Make the Right Decisions Quickly in Claims Management

Latest Analytics Technology Helps Reduce Claims Costs and Improve Service

In today’s economy, claims departments have to do more with less. And with operations already running as lean as possible, reducing staff is no longer an option. Instead, claims departments need to improve their processes and capture those efficiencies in day-to-day operations. They need to find new ways to do the one thing that lets them run most effectively – make the right decisions quickly.

Turn Data into Actionable Insight
“Claims divisions are starting to accelerate the adoption of data analytics,” said Ed Charlton, vice president of Claims and Legal Solutions at CSC. “By taking a closer look at their data, claims departments will uncover many opportunities to lower costs and improve service.”

When used properly, analytics are not just about analysis; they’re about action – right where insurers need it most. Unfortunately, at most companies, a big obstacle to getting good analytics is the claims administration system.

Collecting data, writing queries and running reports often depend on the support of an already-backlogged IT department. Modern, configurable systems allow organizations to track data and modify processes to improve results.

“What claims organizations need is agility,” Charlton said. “So we’ve pre-integrated our claims systems with analytics and made them easy to integrate with other systems and data sources.”

CSC’s claims administration systems and tools are used by more than 20,000 claims professionals at 750 organizations. This community has provided CSC with a wealth of feedback on areas where insurers can make gains in streamlining processes.

Customer Service
The obvious starting point for increasing efficiency is to quickly process straightforward claims.

“Look at your claims data,” Charlton said. “Identify the types of claims with the least variability in outcomes. Why insert adjusters into claims where they seldom influence the results, such as windshield replacement?”

Insurers might be surprised at the number of claims that are candidates for self-service. If a company can analyze why customers are calling so much, it can adjust its processes to address their needs.

CSC is helping claims organizations take advantage of the growing mobile channel. In fact, CSC’s mobile first notice of loss app, downloaded to a Smartphone, enables customers to file their claim on a mobile device and even become part of the investigation.

CSC is also leveraging mobile technology’s location and time awareness, video and audio capturing capabilities, and powerful processing capabilities to provide opportunities for adjusters to investigate and settle claims faster.

Performance Evaluation
Organizations can use analytics to evaluate — and improve — performance. They can capture metrics on their adjusters and call centers, then look at individual performance, or specific offices, regions or claim types.

Analytics can also be useful in evaluating distributers — which agencies are writing the least profitable business and why? For that matter, which underwriters are writing the best business? Are your pricing assumptions holding up?

Vendor Management
Analytics can also help insurers focus on vendors, such as independent adjusters, law firms and repair shops. Analyses of charges, performance and guideline compliance can help in controlling costs and renegotiating rates. Supported by systems with automated bill review that highlights errors, claims professionals are free to spend more time closing claims.

Make Your Software Work Harder
Insurers can use analytics to improve their processes – or they can incorporate software that has already internalized those same processes.

“CSC’s systems give adjusters rules-driven tools,” said Charlton. “This provides more consistency and fairness, whether it’s bodily injury evaluation, accident fault determination or vendor management. Our systems become even more valuable when companies integrate their own data and tune the processes to fit their best practices.”

With CSC’s Fraud Analytics Suite, for example, a combination of predictive analytics, identity search technologies and fraud indicator business rules helps flag suspicious claims early. With integration to third-party claims tools, CSC’s solutions have helped customers increase their fraud referral rate by 25 percent and reduce legal spending by 6 to 8 percent.

Lock In Your Efficiencies
Once insurers capture the metrics they need, they can create automated workflows that not only manage workloads, but also recognize the complexity of the transaction and deploy it to the right person, place or process. Because automated claims can be processed by lower skilled adjusters, there are inherent opportunities for reducing processing costs.

Discover and Analyze Trends
When claims costs rise, it’s imperative to find the cause. Creating a dashboard view of your data can quickly pinpoint out-of-pattern areas. Is the problem due to increased parts prices, or is it body shop labor rates?  Drilling deeper into the data can reveal the answer.

“You can’t manage the issue until you know what the issue is,” said Charlton. “Companies that can take full advantage of data analytics are much more successful at managing their program and measuring its success.”