Progressive Automated Claims Management System

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Progressive Automated Claims Management System
PACMan
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What is PACMan ??

• PACMan is an IDMS online, real time Claims
  Processing system that automates the major claims
  handling processes of the entire Claims
  Organization
• PACMan includes policy selection and coverage
  verification functions for the majority of
  products in all Progressive Divisions
• PACMan interfaces to twenty three corporate
  financial systems.

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Major Goals

• Reduce LAE by increasing efficiency
• Improve collection of claims-related data
• Improve customer satisfaction
• Greater flexibility to respond to business changes

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Risk Factors

• Geographic/organizational boundaries to be
  crossed
• Centralized system in a decentralized environment
• Progressive environment
• Lots of change
• Take short cuts - get it done quickly
• First large database system at Progressive
• No experienced IDMS programmers
• Burn-out factor for staff

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PACMan Benefits

• Productivity
• Claims office assistants 30
• Adjusters 10
• Managers 10
• Increased Collections
• Salvage 5
• Subrogation 18 (28 million)

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Indemnity Benefits

• Reduce length of time a claim is open
• Improve speed and accuracy of coverage
  verification
• Improve draft control
• Improve accuracy/consistency of payments
• Policy history data available
• Improve customer service

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Implement by Releases

• Release 1 (July 1989)
• Loss Reporting
• Policy Verification
• Payment
• Face Sheet Notes
• Diaries
• Inquiry
• System Facilities (Help, Security, problem
  Tracking)
• Interfaces
• Conversion

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Implement by Releases

• Release 2 (1990)
• Salvage
• Subrogation
• Litigation
• Management Reporting
• Correspondence
• Archiving
• Time Tracking/Billing

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External Design Process

• Interviews with key individuals
• Road shows
• Initial draft of segment
• Discussion/reviews with
• Experts for each segment
• Cross-sectional representation
• Modify draft of segment
• Review of entire document by Senior Claims
  Managers
• Modify document

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External Design Process

• Started Logical Data Model
• Reviews by Region/Division/Corporate review
  teams/Marketing/Product management
• Produce final functional requirements
• Review/approval by executive management

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Internal Design Process

• Build prototype with users representing
• All regions
• All Claims job functions
• All products
• Document changes to prototype
• Detail design
• Physical database design
• Program specifications
• Specification walkthrough
• Acceptance/signoff
• Program
• Code
• Walkthrough
• Unit test

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Testing Process

• 1. Component Testing
• Tests all online modules at an individual level
  to identify cosmetic and functional problems.
• 2. Level 1 Test
• Test all functions of an individual online
  subsystem i.e. does Loss Reporting work by
  itself as defined?

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Testing Process (cont.)

• 3. Level 2 Test
• Test all conditions occurring between online
  subsystems i.e. can Loss Reporting work properly
  with the Payment Subsystem?
• 4. Level 3 Testing
• All parts of the system come together in final
  integration

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Testing Process (cont.)

• 5. System Testing
• Verify that all performance aspects of the system
  are acceptable
• 6. Office Simulation
• On-site test environment in which Claims Office
  conditions are simulated
• 7. Parallel Testing
• Concurrent testing of PACMan online functions
  with entry into current system.

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Project Management Procedures

• 1. Design Controls
• Change control
• Open issues
• Data issues
• 2. Quality Controls
• Program standards
• Specification walkthroughs
• Program code walkthroughs
• Documentation standards
• Performance walkthroughs

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Project Management Procedures (cont.)

• 3. Management Controls
• Weekly meeting with project managers
• Weekly graphs to senior management
• Bi-weekly meetings with senior management
• Review by executive management semi-annually

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Quality Assurance Checkpoints

• Development Phase
• 1. Specifications written to Standard
• Technical walkthrough
• Testing walkthrough
• 2. Programs written to Standard
• Code walkthrough
• Signoff for testing

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Quality Assurance Checkpoints (cont.)

• Testing Phase
• 1. Edit/validation testing
• 2. Integration/script testing
• 3. System testing
• 4. Interface testing
• User Acceptance Phase
• 1. Model office testing
• 2. Parallel testing

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Training for Users

• PC based keyboarding skills
• CBT for
• Introduction to CRT
• PROFS (electronic mail)
• Stress PROFS usage
• 24 hours of PACMan CBT
• Videos
• Introduction (Marketing)
• Approach to Training
• Equipment
• 45 hours of classroom training
• Quick reference card
• Keyboard templates

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Critical Success Factors

• No turnover at senior level on project
• Strong commitment and involvement from users
• Strong team spirit
• Intense focus on goal
• Confidence in our ability to get the job done and
  done well

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PACMan Implementation Success Factors

• Planning
• Coordination
• Communication
• Discipline
• Constant Measurement

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PACMan will enhance the decision making process
by providing better data sooner.