Success Stories

Transforming Claims Processing With Improved Quality and Reduced Cycle Times

The Client

A leading US-based insurance company offers insurance products, investment products and advisory services that address client needs for financial security and protection, capital accumulation, asset distribution and estate preservation. This company and its affiliates have a huge customer base of policy owners and clients for financial advisory services. A large team of financial representatives services this customer base through the company network.

Business Need

The client's benefits division catering to Disability Income products wanted to improve claim analysts' effectiveness and efficiency, reduce claim decision cycle times and thereby improve customer service. The client also wanted to simplify, integrate and streamline the claims processes and supporting applications, integrate them with the enterprise data and systems and move to newer technologies as per the enterprise technology direction. In order to achieve their business goals, the client partnered with UML to develop a comprehensive Vision and implement a three-year program for transforming their operations.

Challenges and Requirements

UML experts addressed the following key challenges during this Program:

  • Developing a clearly articulated vision to improve business operations and enhance claims processing capabilities to meet future needs. The Vision needed to provide clear direction on business and technology goals and enable a common understanding across a wide spectrum of stakeholders within the client organization
  • Outdated systems and technology supporting existing processes. The implementation roadmap needed to define a cost-effective way to achieve the technology strategy as replacing existing systems was prohibitively expensive
  • Determination of optimal implementation choice between custom-built and package options
  • Introduction of new technologies for document management and imaging to reduce reliance on paper-based processes

Our Role

UML leveraged its insurance claims consultants to define the Vision during an initial five-month phase of the Program. UML experts comprising both business and technology consultants worked in close collaboration with part-time team members from the client to ensure buy-in across the organization. The Vision phase focused on ensuring alignment of the business and technology goals and developed a future state blueprint for the client's Disability Benefit operations.

The Vision phase comprised of Assessment, Envision and Implementation Planning activities. Assessment activities focused on studying the existing processes and systems in order to identify gaps from both business and technology perspectives. During the Envision activities, the future state business processes and technology components were identified and elaborated upon to serve as a blueprint for future projects. Based on the blueprint, Implementation Planning activities focused on developing a realistic plan to achieve the Vision through a series of projects. UML played a crucial role in ensuring effective and timely implementation of the Program by partnering with the client to establish a Program Management Office. The PMO focused on enabling close collaboration across all the constituent projects and was also responsible for management of user expectations and ensuring effective training and change management activities.

UML consultants enabled the client to achieve timely and cost-effective implementation by leveraging its Global Delivery Model (GDM) for solution definition and solution execution activities. UML consultants provided a high quality of execution through adherence to strict quality processes across both onsite and offshore blended teams

Benefits

The benefits of the solution included:

  • Enabled the client to sell the defined and articulated Vision to the corporate committee to obtain funding approval of US$ 10 million for implementation over a three-year period
  • Position the Disability Income Benefits department to compete effectively based on improved business performance. Implementation of the Program enabled the client to transform the department's operations to achieve higher quality of claims decision-making and improved customer service
  • Successful alignment of the client's technology vision with enterprise standards. Leverage of enterprise-wide components also enabled cost-effective implementation for the entire Program
  • Reduced complexity and management effort for the client by partnering with UML. Our commitment to deliver the desired business and technology capabilities from concept to fulfillment ensured that the client could get the entire solution from a single integrated service provider with minimal overhead in terms of project related procurement and coordination activities

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