Claims Management Solution
Insurance leaders are facing new challenges every day. There has been a sharp rise of Insurtech startups incorporating digital transformation solutions in their daily operations. The pressure on other companies is increasing to either change with the flow or become irrelevant in the marketplace. Typical claims registration involves a lot of paperwork and is often repetitive in nature. This not only takes a lot of time but also causes inefficiencies.
While manual processes are forever going to be slow, they enable fraudulent activities to happen during claims as well. A digital transformation approach promises huge potential not just for the companies but also for their employees.
The Client
The client is a law firm based out of the United States that specializes in the compensation claims of employers, insurance carriers, as well as third-party administrators. They have been defending workers’ compensation claims since 1991. They also deal with willful misconduct claims for their clients and employs tech-savvy lawyers who can connect with clients through web-enabled practices as well. They also specialize in defending fraudulent claims and have an unparalleled track record of success.
The Challenge
The claim management system that the client was using involved paper files, manual processes, and multiple systems. This process was resource-intensive and consumed a lot of time as well. This disrupted their ability to handle each client claim efficiently and on time. Due to a lack of standard processes for claims handling, there was very little transparency in the claims management process. The client realized that their traditional systems had become obsolete and led to ineffective communication and collaboration. This created a negative impact on their efforts of remaining competitive in the market.
The client wanted to resolve these issues with a streamlined claim management process and was looking for better ways to manage the entire claims process from FROI to settlement/resolution. They wanted a single claims management platform that is robust, scalable, and reliable. With experience in digital transformation services and developing InsurTech solutions for different companies around the world, Experion Technologies started working on a solution to provide a redefined workers’ compensation claims management process for the client.
Our Solution
The first step of the solution was to understand the problems and pain points that the client was facing with their existing claims management process. Our team visited the client at their US headquarters and collaborated with them to understand the issues better. After analyzing the inputs and business objectives, our team created an action plan and strategic road map for a comprehensive claims management platform. We decided on adopting a multiphase engagement where modules were developed and tested in phases.
The first phase involved creating a billing module for the client. In the existing solution, the client had to pay a large user license fee and the process demanded a lot of time and effort from the attorneys. The billing module streamlined processes like calculating billing charges, automatic invoice sending, and accepting recurring payments.
The second phase involved the development of a document scanning solution that would replace their existing third-party software. Employees can use this solution to scan and organize their case documents, bills, reports, case sheets, and other documents digitally. This method saves a lot of space, makes the data secure, and can be shared easily as well.
In the third phase, the Experion team will work on a case management solution. With this, employees can create, track, and assign cases seamlessly. Processes to be followed for each case can be defined clearly and users can easily complete a case by following all the necessary steps. Once a case is finished, the solution will show how to categorize the cases, which process to follow, case status, and more.
Experion is also planning on delivering a web-based worker’s compensation claims management platform after enterprise digital transformation is complete. This would integrate with the enterprise claims management process and would enable them to leave a mark on the insurance marketplace.
Business Impact
The Experion solution helped the client in several ways. It streamlined their entire claims compensation process so that it took less time and was more accurate. This helped in enhancing the overall customer experience as their claims were getting processed faster. The solution also offers intelligent reporting and analytics to provide useful insights to the client. They were able to leverage these insights in order to achieve superior operational and business efficiency. An improvement in the time taken for processing claims leads to a reduction in the cost of claims processing.