Real World Process Examples: BPM For Insurance – Claims Management

Business Problem: Our Lotus Notes-based system for managing our contractor network was inflexible, provided little visibility into claims management processes, and lacked an interface to our AS 400 financial system. Contractor enrollment and KPI management was difficult to monitor. Client satisfaction was negatively impacted by claims completion process delays.

Process Players: Customers, contractors, Claims Management department, Finance department

Process Steps: Claims are now entered into a BPM-based extranet and routed to appropriate stakeholders for review. When approved, the claim goes through the extranet to our contractor network. The right contractor for the work is assigned, and throughout the repair process, they organize audits to check workflow, quality, and resources to ensure standards are maintained. Contractor reporting from the field is done through mobile Tablet PCs, with information going directly into the BPM system, which sends appropriate status alerts to our internal departments and to customers. Upon job completion, all data is sent to Finance for invoicing and to close out the claim.

Process Benefits: With BPM, we now have the process visibility and control needed to guarantee that the right contractor is assigned, that the repair workflow proceeds smoothly, that service quality meets our high standards, and that proper internal and customer reporting occurs at every stage. Because our BPM solution is web-based, it is integrated with the mobile devices used by contractors in the field, and interfaces to our backend AS 400 financial systems, increasing overall efficiency and profitability.

Sources & References:

*Appian

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Using BPMS to Pass Insurance Industry Hurdles [Video]

Insurance companies often deal with siloed legacy underwriting and claims platforms, making it difficult to share data efficiently. However, through the introduction of Appian’s business process management software, the status quo can transform into a unified insurance platform ready for the industry’s challenges. To start, modern BPM can provide the framework for more effective collaboration between underwriters and insurance agents. Appian’s BPM platform can transform ad hoc conversations between different parties into more effective social business collaborations. In the end, those collaborations speed processes and save time and money. Appian BPM can also give underwriters greater visibility into the information they need to make the best decisions, instead of being forced to make approval decisions without a complete picture of the situation. Poor information invites unnecessary risks and losses into the equation. Creating a custom set of guidelines and easy data access for underwriters can help ensure they are making the best decisions, which translates into fewer losses. Insurance business process management software can also be used to revamp claims processing systems and avoid situations where claims take too long to settle. Appian’s BPM software can help deploy adjusters to review claims, and create a place for all parties involved to efficiently communicate on the best course of action for the claim. In addition, its mobile capabilities allow for effective collaboration between all involved – regardless of where they are. When dealing with an insurance marketplace where new products or concepts are introduced regularly, a rigid system can become obsolete in the span of a few months. Appian’s BPM software allows companies to introduce the flexibility and collaboration capabilities of the most modern technology without requiring a full “rip and replace” of existing legacy systems. That promotes increased productivity throughout the company while continuing the mission of constant self-improvement.

* Sources and References:
http://www.appian.com

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