Operations of Insurance Companies - Insurance Business and Market, Principles of Insurance Video Lecture | Principles of Insurance - B Com

hello everybody and welcome to today's
webcast top ways to simplify insurance
operations and streamline document
workflows we're very excited to have all
of you on board and we appreciate your
taking the time out of your busy
schedules to join us my name is
anne-marie kochiya director of marketing
account is responsive services and I'll
be your moderator for today's webcast
before we get started I do have a few
housekeeping notes to eliminate
background noise all participants have
been muted you will only be able to hear
our presenter speak if you'd like to ask
us a question you may do so at any time
by clicking the chat button on your
WebEx dashboard on the right side of
your screen type your question expands
and we'll try to address your question
before the end of the session today
because we only have a limited time we
do apologize in advance if we are unable
to adjust your question online but we'll
be sure to follow up and any unanswered
questions after the program lastly we
will be sharing an archived version of
today's webcast after the session is
complete okay so we'll get started here
as part of our insurance webcast series
on optimizing work philosophies today
we're talking about simplifying
operations in particular will first
discuss industry trends and then
document process challenges how to go
about simplifying your insurance
operations
streamlining document workflow and then
a short segment on taste management
without further ado I'd like to
introduce you to our esteemed panelists
for today first I'd like to introduce
introduce Vince price from IBM
Vince is a seasoned insurance
professional with more than 20 years of
experience managing and structuring
claims services for fortune 500
companies then set specific claims
handling expertise in all lines with an
emphasis on workers compensation general
liability products liability and auto
second I'd like to introduce Jen
our James is a professional solutions
executive here I counted this responsive
services James has been assisting
clients to order 15 years on the right
mix of Technology process and resources
to improve operations and deliver
savings James has a technical background
and enterprise content management and
business process management Vincent
James are so glad to have you on board
today and we thank you for carving out
this time to share your expertise well
thank you Ann Marie this is Benson price
it from IBM
this gives Alan some Kalen business
process services okay well now that
we've other quick introductions I'd like
to hand it over to you to walk us
through the latest industry turn thank
you from industry perspective we at IBM
and most likely most of you on the
telephone the webcast today probably
recognized there are three distinct
driving forces or focus areas for
insurance companies today obviously
number one is optimizing costs and
profitability with an eye to improving
bottom-line performance and secondly how
do we best understand the portfolio risk
that we employ today whether it's in
workers compensation general liability
overall risk profiles within our
organization and thirdly how does this
help us improve our business performance
so insurance really we're trying to
thank you so there's three industry
shifts we've identified is increasing
industry focus on significant investment
in analytics so three areas were
companies that have been successful we
found in our studies that 63 to 64
percent of insurance executives have
found that investments in analytics are
providing a significant return on a
return on investment for them in better
managing their organizations
obviously this still has a focus on
customer centricity but will also see
increased focused on operational issues
operational topics and thirdly bringing
together integrating all of these
capabilities in a digital enterprise now
there are a number of insurance
initiative or insurer initiatives that
we may think about today so as you think
about your particular company or your
particular department of focus area
there may be various entry points or
pain points if you like that we are
constantly dealing with on a day to day
basis this could be operational issues
such as an underwriting processing new
business processing that could be in
claims claims management management of
discrete or complementary claims
services such as fraud investigation
excess reporting and so forth and also
we may be facing challenge challenges in
our distribution networks the
interaction with agents and brokers and
other intermediaries in delivering our
products effectively and/or managing our
relationships with these third parties
in the most effective fashion and
finally of course we continue to have a
focus on customer service bringing
together if you like multi-channel
experience for our customers today
whether they are in a more direct
engagement fashion or through a mobile
experience and of course dovetailing
into this is managing a new product
development remaining competitive is in
the industry so these are multiple
potential entry points or multiple
potential points of focus for a
insurance company today whether it's
property in casualty or life and annuity
or some a supplemental disability
carries and so forth so think about
these these particular areas as we go
through the webcast today and how James
and I will be talking about resonate
within your organization so that brings
us to our first poll question and we'd
very much like to hear from you for your
organization which of the following are
your biggest challenges today is it
number one customer retention is it
cumbersome underwriting processes
efficient claims processing product
innovation
would you say it's all of the above
please just take a moment we'll wait a
few seconds for you to do you're free to
submit your response and then we'll move
forward
okay way to receptors more I guess we
shouldn't be too surprised okay so
customer retention I'm seeing about 33
percent cumbersome underwriting I'm not
seeing any responses there fishing
claims processing we're at 11 percent
product innovation we're at 11 percent
and all of the above 33 percent so this
what do you think about that I'm seeing
all of the above here as well as that
first response well I guess I guess it's
not extreme surprise in really obviously
some of you may be coming from different
departments so you only the insight into
a particular slice of your organization
but what we're seeing here in this
particular survey again is what we kind
of expected customer retention obviously
it's easier to keep a dollar or should
be easy to keep a dollar to find a new
one so effectively interacting with your
customer base is very critical and
remaining competitive in today's
environment particularly impersonal
lines we see increasing increasing
pressures for many innovative carriers
out there that are all looking for or
delivering different ways of interaction
with the customer so this is important
and again not surprising the other all
of the above yes it makes a lot of sense
and I guess nobody huh nobody has it
underwriting me at this particular point
so let's carry on with the next slide if
we may so essentially just to wrap
insurance companies are focused in three
areas okay continue focus on the
customer delivering and innovative
streamlining their operations and
optimization of risk management by risk
management here and again talking about
understanding the financial risk of the
contracts that you write or underwrite
within your organization so take it one
more step further beyond this we as an
industry need to continue to focus on
capturing the right and relevant
information
we're talking here about structures and
unstructured content understanding
evaluating and acting upon this
information adding to that the component
of collaboration enabling output touch
participants and constituents to
interact with each other to drive the
right decisions and focus on outcomes so
the increased focus going forward is not
just an output but outcomes think about
in this particular example your claims
processing any organization the claims
processing environment is very complexed
multiple interactions with multiple
parties dependent upon multiple streams
of information and data in claims in
particularly whether it's first those
who lost intake or first report of
injury we are having to consume
significant amounts of information
take for example workers compensation
volumes and medical information legal
documents processing rehabilitation and
we can continue adjust as an examiner
for example have to be able to better
manage this information we're talking
about unstructured in a most efficient
fashion the process is further
complicated by unstructured workflows or
in claims as an example depending on a
particularly investigative track or a
piece of information the adjuster
examiner may have to take a different
approach it may change their evaluation
of the exposure and/or impact the
ultimate resolution so again just to
summarize the claims processing is very
complexed we can look at any other parts
of the organization and you would
probably find the same situation and
post a cup ala C servicing and customer
servicing a very similar so just taking
a step back as we talk today about
unstructured content and managing this
information in a form of fashion
hopefully we can give you some ideas how
to improve your organization going
forward so let me just turn this over to
James now James thanks very much Vincent
so one of the first things um we want to
look at
when looking at the complex insurance
environment is really understanding
where you are today and then from there
you can create a plan so something that
we like to talk about is our maturity
model and cannon to help us quickly
assess where companies are so on screen
you see that five pillars done bottom
left and we have chaos level one really
were there's a lot of Kippur in an
organization a lot of emailing taking
place as we move up the maturity level
to use more siloed information and
storage so a lot of shared drives and
different repositories level three we're
coming together where it's a unified
repository with imaging to enable the
digitization of documents level four is
really putting a workflow at layer on
top of your repository to try and drive
process efficiencies and it's finally
what we made some truly enterprise class
that integrated process compliance and
analytics and everything you do so
that's a level five so what do we like
to do and if you take a second to go
over to look at the maturity model where
do you think today you are on this
maturity bond your company your
department we'll take a second for those
results to come in okay so we have our
second poll question here if we'd like
to get again hear from you just take a
moment would you say you're at level one
chaos level two siloed level three
search and discovery level four process
driven or level five integrated process
so would you say you're just not so sure
and that would be number six so we'll
just wait a second or two and get the
responses tallies
you
okay we'll just wait a moment
okay second two more
you
here's as though we have a tie between
the siloed and level 2 and the
process-driven level 4 are you surprised
by that James ah no not entirely I think
in for level 2 silos and storage it's
not a surprise because we have a lot of
class today you're not alone right there
that are struggling to make their way
and get management around their content
lab I know there's some that aren't sure
but really today we work with a lot of
clients that are inside of them in with
a lot of repositories or different
storage areas that they want to
consolidate together and that's all the
first step is really centralizing that
information so thanks for responding
it's always good to get some interaction
from the group so moving on and when we
look at this process in the documents
really think about word is all this
complexity start and a lot of it is when
the physical documents start to come
through your doors into your company
into your departments so here on the
screen we have a best-in-class
imaging workflow which conceive involves
a lot of steps and one of the key wants
to think about is quality control but
also reporting metrics it was an
insurance industry that regulations
compliance you're getting title each
year and really with the reporting
metrics in place we can ensure that
we're meeting turnaround times and
various SOAs and looking to that go to
the next slide so the workflow process
should be very start of the documents
coming into your organization it has a
number of complexities in it itself
typically with insurance documents
there's a significant expense for
separating documents particularly in
high volume operations you can see a
figure on screen here of 50 percent for
document preparation and labor alone
just for sorting documents and inserting
separator sheets and the challenge there
really is that insurance documents come
in all varieties of lengths and types of
structure
but you know the good news is there's
technology to help you with that so
trying to move away from the labor in
the manual interventionist and ring
separator sheets we can start to use
technology to determine structured
semi-structured and even unstructured
documents that helps cut our operational
costs makes a process more automated
sphere on the diagram you can see in the
bottom left that there's at structured
documents they're probably easiest to be
recognized as Stanley structured so and
then finally unstructured which are like
documents such as correspondents and
letters and so forth but the good news
is with all these challenges and
something that we often talk about it as
a digital NT extender and what is that
well it's really combining your mail
room activities where the documents are
coming in and putting under the same
roof you're imaging operations there's a
there's a number of repair advantages or
benefits of doing this firstly it drives
efficiencies you cross them cross
training of staff and you can start to
begin to control operational costs as
well by having books mailroom and
imaging operations under one roof the
other great thing is establishes a
footprint for other digital content that
may be coming into your organization
such as emails so by passing emails
through the digital ntx Center we insure
a centralized and standardized approach
to high all documents are handled
whether it's physical or electronic so
we talked about technology and how it
can help well you know in a recent
survey Canon market survey we passed by
the top challenges that insurance
companies have today and you can see the
results on screen and not surprisingly a
technology of 44.2% is one of the major
challenges companies have today so even
though technology can be seen as the
answer to automate and streamline prop
prop M tasks and activities within your
organization there's also the challenge
of implementing it and then continuing
to run it and make sure it is up to date
so one of the things that we like to add
to talk about is our managed service
offerings
really today who's better to manage your
capture service than a capture company
and what does a managed service look
like well today we have a support
keeping the services up keeping the
lights on addressing any issues from day
to day in combat combining that we
bundle a number of development dollars
not really allows to maximize investment
in your technology so a lot of
organizations implement a large
technology systems or platforms but then
there's an ongoing need to keep them up
to date
develop them add new document types look
for further efficiencies and this is
where the bundle doors come in and
together with the proactive monitoring
and the bundle development ours we can
really enhance capture service and then
provide that business agility that may
be internal and resources may struggle
with so just a finalize a few points of
amazing capture process where documents
come into the organization is complex in
itself you know really you want to focus
on what you do best which is insurance
so with some of the challenges that come
along there's also transactional volumes
during times the year may be seasonal or
due to a natural disaster there may be
spot volume spikes complexity documents
we've always already touched on the
varying lengths the difference of
structured and unstructured tribal
knowledge this key area because a little
technology can help us a lot in the
automating and streamline the process
and directing and writing documents
there's also an element of tribal
knowledge is needed to interpret
documents and context particularly those
on structured documents like
correspondence process control we
mentioned this already high reporting
and monitoring the SLA is getting more
important in this regulatory environment
and then finally hand writing a lot of
the documents today may be type or FL
right and to be scanned there's still a
large portion statistically those that
we see in the Accord forms that are
handwritten and that brings another set
of challenges for recognition
so with that in mind on the operation
side you can see the chart on screen on
the Left we have reduced operational
costs on the vertical access and then
maturity over time on the bottom already
just to touching these points you know a
level one organization can often be am
remote sites utilizing MFDs or
multifunctional devices to capture their
information so it's a distributed model
level two that the benefits of
consolidation standardization can come
with an onsite centralized approach to
scanning and imaging level three is
starting to look at that outsourcing to
try and drive some of the efficiencies
and reduce the operational costs so
we're a band or is actually running the
operations on-site with your technology
taking that a novel further and we look
at a hybrid model which we're seeing
more and more common as the documents
come in the door we're actually scanning
those but then sending them up to
off-site or to a processing center
that's off-site or offshore to and
utilize the technology and get economies
of scale in there as well and then
finally the truly vast in class that's a
real mixture of off-site and offshore so
the technology investment is all with
the vendor and the benefits of the
resources that are complement that and
no high off the technology to operate it
efficiently so Jaso actually I just see
we have a write-in question I believe it
relates to what we're talking about here
what is the best way to assess the
improvement opportunities for my
departments by outsourcing that's it
that's a great question on Murray and I
actually have a slide that can help us
with that so if we jump forward just one
more slide please
on screen you can see the business value
assessment and this is something that we
work with in Canton to help understand
where you are today on the maturity
model and you know balance it off it is
we really brain as a Vandor product
technology the main client expertise
into your operation through the value
assessment we
to view the different department leads
as VPS as well as understand what's
happening within the day-to-day tasks
and speak to IT about your technology
capabilities and also security so our
business value assessment really helps
to get things started
and put together some estimates or
values against war outsourcing could
potentially help in your organization
and lead to actual value and operational
reductions cost and controlling those
costs as well listen we step back
together
I prefer so with that once you
understand where you are and what needs
to be done and we can look at the
organization and try and simplify it so
on the left-hand side we have a complex
organization this may be familiar to
some of you or you know information in
volute style departments for business
agility unclear accountability
this could common in large or insurance
organizations but really become a
world-class insurance company you want
to focus on your core services core
services all right so they from a
complex after organization that's
generally slow to respond if we look at
simplifying that organizational
structure that can be enabled through
outsourcing with workforce process
organization even offshore labor and
Technology rationalization to enable
business growth allowing you to focus on
what you do best
so when we've evaluated it we came up
with a plan but who do you really want
to help you through this process as you
try to simplify your organizational
structure we're really you're looking
for a strategic partner an on screen we
see a recent our courses resources
outsourcing research results and up in
the top blue bar in the middle of the
screen we can see that a lot of clients
I source purely before the operational
cost reduction and avoidance and but
what also is key and is becoming more
common is really having a strategic
partner that helps with digital
transformation re-engineering processes
so it's not a one-stop-shop there's a
continual transformation certainly the
insurance copy state want access to this
technology you want a strategic partner
who can bring that to the table and then
finally the industry specialists and
talent and when an insurance industry
you want to be speaking with a partner
who understands your industry and knows
it well too so a few things to consider
on the slide really think of like
digital transformation leaders
technology and access to industrial
specialists as part of our strategic
partnership as you move forward so
finally and from me we heard some ways
to basically simplify your insurance
operations we talked about a digital
intake center we mentioned managed
services as well you better to the
gaster your your capture platform and
capture specialists and then we also
talked about or outsourcing and how that
little complexity work could be taken
and moved off-site offshore in the
maturity model really done and then
finally at the business value assessment
really the starting step to help you
write that business case to understand
the value and added value that a partner
can bring so just for me to finish in
the slide before I hand the packed
events I wanted to show you a short case
study that we have one of our examples
of high cannon business process services
helped an insurance plan really want you
to focus or than the results done in the
bottom corner either the gear we were
able
to enable and reduce operational costs
or mitigate our risks as well through
our outsourcing model using offshore and
at the same time we're able to take on
with time the actual non each services
off the IT platform to further drive in
efficiencies over and above what and
clients IT group today so I've talked a
little bit about and the intake of
documents often the process and the
challenges around that in some ways to
help simplify it and make it better and
but what do you do once the documents
digitized and again to pass further off
the workflow I'd like to turn a fact
events at this point it does help a
little bit more of an advanced case
management thank you James
let me first we'll just kind of help
define what we mean by case think of the
business operations within your
organization if it's claims you may have
a physical electronic file which we
collect all the information in order to
make a decision
maybe it's in contract compliance you
may have a physical file electronic file
where you gather the information apply
workflows and decisions to drive
outcomes so we talk about case we're
actually thinking about if you like
consolidating all of that unstructured
content and all that data in a
manageable format so the industry
insurance industry today is when you
think it is combined with this best
growth of data
James has talked about how one can
effectively manage the intake congestion
storage of documents and content
now of course content can can be much
more than paper informational forms it
could be as I said earlier video or
audio or it could be blueprints it could
be extensive file formats in many many
situations our case manager from IBM is
designed to make this more consumable so
given all this the vast amounts of
structured unstructured data which we
can affect the capture today I would
imagine that most of the effectively
managing content repositories within you
organize a
case manager is designed to make it much
more consumable accessible to your
organization parties in insurance or any
industry actually and deliver at the
right point in time and when you can
combine this with the work that we do
and think about all of the unpredictable
and complex processes that are driven
unstructured content interpretation
application of that knowledge bring your
knowledge workers quite often results in
having to drive flexible workflows so we
have managing the data plus managing and
delivering workflows to contend with it
in our organization today this is an
extract from a Forrester report ask one
can we share with you and Forrest
elected insurance customer needs from a
high level they concluded that yes we
need a 360-degree view of what is
happening within our organization again
in the case level Pacific there is
technology to help improve the process
and if we can consolidate all of our
systems and automate the data gathering
we can be much more effective IBM case
manager is designed to bring together
the people the content apply the
workflows and analytics to make the best
decisions and of course can be delivered
on via cloud or and of course with
mobile capabilities you so you think
about not just think about claims but
there are many parts of your
organization's I mentioned earlier
contract management compliance issues
vendor management policy servicing audit
compliance audit processing these are
many ways a lot of our customers today
are employing IBM case manager to manage
these processes that are dependent upon
unstructured content if you think of
business content today exed can mean
video audio podcasts social media blogs
podcasts email chat and listen go on
how can we effectively manage this you
know in our organization imagine if you
workflow decision and complex
transactions or business processes
required of all these types of business
content can help support a knowledge
worker so if there was a platform
available to help you be more effective
then hopefully this could be one idea
IBM case-knives brings all this together
in a 360-degree view giving the the
employee or the adjuster the examiner
the under-eyes the customer service rep
the ability to interact and view the
entire view of the case in this case as
they could be claims it could be policy
servicing and so forth so knowledge
workers can now make decisions based on
the right date at the right time
IBM conducted a a recent Institute for
business value assessment for the
industry across all industries and
executives found in our report that 65%
of them felt that investing further into
analytics was critical to their
organization but thirty percent of the
respondents also indicated that the
quality of the data they capture the
completeness of the data they capture
was insufficient to meet their needs so
possibly as you think about managing
unstructured content in the case format
this could be one approach for you so
just a summarized IBM case manager
brings together workflows rules and
processes think about three key areas it
helps you activate through workflow
process and rules we can help engage you
through improved collaboration between
the people and processes and finally
with embedded analytics
provide you better insight into your
organization or in this particular case
a case or a series of case across your
organization
as quickly just to recap on the
analytics are three real components here
the obviously content analytics deep
ingestion understanding of the
information and structured document case
analytics if you like the real-time
metric of where we are in this organize
where we are in the progression of this
particular case again think of case as
any physical electronic file that we
manage with this knowledge worker within
our organization to make the right
decisions and finally if one can add
some it's of intelligence investigative
analysis predictive analysis we can take
this a step further and I'll be remiss
not to acknowledge the fact that
managing a case within your office is
ideal but in today's environment
managing merely management access case
information mobile is very critical for
example many of our customers using IBM
case manager to complement some of the
core operations of core systems in this
particular example they're using case
manager to support the SIU fraud
capability for activities capabilities
within their organization many insurance
companies particular larger ones have
separate SIU units that work in tandem
with and parallel to the claims
organization this particular customer
needed to develop and employ much more
effective supplemental solution to
manage claims fraud sa involves case
management and this component we also
added predictive analytics which helps
predict likelihood of fraud and outcome
and just to summarize arm again IBM we
are a leader than the enterprise content
management field discussion today James
and I would say she focused on content
enterprise content a case manager is not
your repository of content but think of
case manager as your solution tool to
effectively manage all that unstructured
data from violet workflows business
rules analytics to drive the right
outcome so let me just turn this back
over to James with some final comments
thanks Vincent so M we talked to to
start around imaging and then take and
how to simplify operations done but that
can continue as Vincent the same further
up into the different departments in the
workflow whether that be new business
policy changes or claims processing by
using Kalen businesses process services
you can actually help bring down and
reduce operational costs just the finish
and current business process service
deserts of surgery of Canon USA if you
don't notice as the services that we
offer today range from Business Process
Outsourcing
document processing office services
facilities management and even discovery
services as well we are one add top 100
i I
a opie global outsourcing leader for the
last nine years and that's you can also
see on screen some of the other services
specific to the insurance industry that
we offer our our clients today with that
I'd like the hand of dr. Ann Marie
to see if we have any questions but
that's our program for today we are
interested in any questions from the
audience just go ahead and write them in
the chat box there and we'd like to
address them for you okay well I do see
we have one question of sitting there
first let's say is IBM case manager a
BPM tool that's I imagine that's for you
must be well that we get that question
quite up quite often I'm going to answer
that with the question
so what is it you're trying to
accomplish a manager in your
organization other processes the
workflows and outcomes driven primarily
by unstructured content such as
documents other decisions and outcomes
determined by knowledge work is based on
that information and how they interpret
it are some of those decisions and
outcomes different in other words are
they unpredictable as I mentioned
earlier let's take a claims example an
examiner or adjuster may be working
through a claim and based on new
information now let's take a different
workflow path to resolve that issue it
could be an underwriting situation and
you piece of business comes into
submission and although everything may
be aligned if you like and
straightforward and structured there may
be a piece of information that an
underrated uncovers that may take him or
her down different paths if the point of
saying is if it's unstructured if its
content centric and then an IBM case
manager most likely is the solution for
you
now how does this differ from BPM a BPM
focuses on obviously process improvement
structured data and governance the two
are complementary but the real answer to
the question is what is it that I'm
trying to accomplish in my organization
and what is the best tool to do that
hopefully that answers the question if
not just pop back in with another
question we'll see if we tackle it okay
well thank you guys I just do we have a
second one here
I imagine this one is for Karen how how
long does a typical implementation take
good question and it varies from site
site there the number of offices that
may be involved in it if it's a national
rule 8 but it can be as short as 4-6
weeks to take on operations for our
clients today one of the things I would
like to say is that the job just doesn't
finish there as a true outsourcing
provider if you're doing our job right
there's
continuous transition through the
relationship as that partner
so even when operations are up and
running early in the relationship even
after that there's a continuum focus
from the isolate provider to transform
to digitize to enhance where the
operations on-site and off-site so it's
a never-ending cycle for us okay well
thank you thank you James Thank You
Vince that concludes today's
presentation thank you everyone for
joining us we hope you found today's
insights helpful if you have any
additional questions for Vince or James
or would like to learn more about
cannabis responsive services and how we
are helping other companies develop and
implement and optimize document workflow
please contact us directly at the email
address on your screen if you're
interested in the work IBM is doing
please see Vince's contact information
there and one other note as you leave us
today you will see a three-question
survey we would like to hear from you
and get your feedback so please take a
moment to complete that survey and thank
you again thank you my presenters and
and thank you our audience today and
have a wonderful afternoon
thank you we do