Optimizing The Auto Insurance Claims Process

1
Optimizing The Auto Insurance Claims Process

• Ideas for Today and Tomorrow

2
Vision Statement

• To improve the overall efficiency of the claims
  process
• Provide faster and more accurate payments on
  claims
• Improve overall customer satisfaction

3
Goals and Objectives

• Transformation of the company taking into
  account
• the people involved
• the processes they undertake
• the technology used

4
People Objectives

• Improved output from human resources through the
  reallocation of various roles and
  responsibilities within the organization
• Downsize employee population where excesses occur
• Increase employee unity and company focus

5
Process Objectives

• Reduction in paper-based filing methods
• Reduce the number of handoffs involved in each
  claim, and reduce human intervention where
  possible
• Faster resolution of claims
• Improved interaction between employees and
  technology

6
Technology Objectives

• Improved data access for all members of the
  claims processes, including the customer, through
  local and wide area networks
• Better use of technology for decision making
  where possible
• Use of digital media for record-keeping in a
  central database, accessible by all those who
  require information

7
Todays Situation

• Antiquated technology and structure, including
  poor communication between regional offices and
  the head office
• Average duration from claim to payment much
  longer than the industry standard
• Paper-intensive process, causing delays in the
  transfer of information and requiring high
  amounts of human intervention
• A complicated claims process

8
Current Claims Process

• Customer contacts claims department
• Claims department records the information, sends
  a claims form
• Customer returns completed form to claims
  department
• If more information is required, the form is sent
  back to the customer who resends it

9
Current Claims Process (Cont.)

• The claim is evaluated by the system to determine
  whether the customer is covered
• If the customer is not covered, a written denial
  is sent
• If the customer is covered, the claim is sent to
  an adjuster

10
Current Claims Process (Cont.)

• Head office requests an adjuster to evaluate the
  case, who sends a written report back to the
  claims department
• If a specialist is needed, head office requests
  an appropriate and available specialist, who
  sends a written report back to the claims
  department

11
Current Claims Process (Cont.)

• A decision is made on the amount of payment
• A check is sent to the customer or to the garage
  where any work was completed
• A record of the case is stored and filed for
  permanent storage

12
How Did We Get Here?

• Failure to adapt to new technology as it became
  available
• Lack of organization and outlook for future
  growth of the company
• Increased competition with improved business
  models

13
Available Options

• Use of digital forms of information to improve
  the speed of communication
• Use of wireless technology where available to
  vastly increase speed of processes
• Partner with Viryanet to integrate all parties
  involved and take full advantage of new
  technologies

14
The Viryanet Advantage

• Use of a web-based portal for each member of the
  claims process, providing up-to-date information
  needed for each step of the process
• Automated information processing through
  Viryanets Service Hub

15
The New Claims Process

• Customer files claim through either of the
  following channels
• Claims form available for download through
  website, or through traditional forms
• Entering data into an online claims form
• Calling a toll-free claims reporting number at a
  centralized office

16
New Claims Process (Cont.)

• Data is entered into the system automatically by
  the customer through the online forms, or
  manually if the information is gathered through
  traditional means if the customer is not
  covered a denial is sent immediately
• System automatically makes a decision for payment
  on small claims based on preset criteria, and
  forwards large claims to an adjuster with
  proximity to the customer

17
New Claims Process (Cont.)

• Adjuster acknowledges receipt of claim through
  electronic means either through their
  personalized web portal or through their wireless
  device, and travels to evaluate the claim and
  make an estimate for payment
• Adjuster can also instantly request a specialist
  if necessary through the wireless device
• The decision is made regarding payment, and the
  customer receives instant verification of the
  amount of payment

18
Recommendations

• Utilize the capabilities of the Viryanet
  solutions, including Service Hub
• Partner with hardware providers such as Palm to
  obtain wireless devices for adjusters
• Partner with wireless service providers such as
  Verizon to utilize the wireless devices
• Evaluate current human resources and train
  employees for use of new technology

19
Costs

• Procurement of hardware, software, and
  connectivity devices
• Training of employees to adapt to the new system
• Customization of software to adapt to special
  needs

20
Benefits

• Very high levels of efficiency and organization
• Improved customer satisfaction through
• Ease and variation claim filing methods
• Claims adjustment accuracy
• Increased speed of payment
• Reduced need for legal intervention

21
Return on Investment

• Large increase in customer base through high
  customer satisfaction levels (more policies)
• Ease and low cost of future company expansion
• Better allocation of human resources within the
  company
• Lower overhead costs and increased revenues