Claims transformation. EY claims capability

Transcription

1 Claims transformation EY claims capability

2 Global insurance industry trends claims transformation According to the market point of view, claims transformation will be the focus of innovation and investment in the coming years. Investments will be primarily in the field of IT solutions to buy and customize. The potential complexity in claims will result in more sophisticated management systems than in the past and will require integrated, multichannel, flexible and rulesbased processes. EY has studied numerous claims management models across various countries and types of business to develop a leading practice model. 2

3 Broader implications for claims transformation Maximizing performance in claims management can drive value for the entire company. Customer service Quality and speed of response Satisfaction levels and retention Data management Data analytics Effective decision-making Reinsurance recoveries Incident coding Asset leverage Resource capabilities Commercial awareness Control of operational risk Incurred management Management of case reserves Accuracy of ultimate projections Control of indemnity costs and ALAE* Leakage Unnecessary costs hitting bottom line Claims portfolio management Correct case estimates Capital efficiency Supply chain Optimal supplier management Cost optimization * Allocated Loss Adjustment Expense 3

4 EY s insurance capabilities matrix Claims processing Initial reporting Segmentation and assignment Claim administration Litigation and medical management Recovery Financials Vendor management Other services Underwriting and pricing Policy processing Billing, collections and disbursements Product development and management 4

5 EY s structured approach to address claims management issues Focus Claims effectiveness Paying the appropriate amount on the claim through accurate adjustment and reduction in the costs of the goods and services supplied in the settlement. Improve decision quality and reduce claims costs Improve reserving Reduce supplier or repairer costs Improve claimant experience Claims efficiency Achieving and maintaining operational efficiency through lowering the processing and operating costs associated with claims. Reduce process cycle time and hence processing cost Improve process quality Increase productivity Offerings Claims strategy Claims health check and leakage Claims operating model Claims transformation Areas to lead and how to get there Evaluate the current claims operation and identify opportunities to improve Define how required capabilities will be delivered through people, processes, governance and technology Execute detailed implementation plan design, package selection (if required), implementation and risk management Impact areas Customer proposition Process and organization Sourcing and supply chain Technology Management information Finance and actuarial 5

6 Our capabilities: claims transformation delivery model Utilizing the Agile methodology, the following diagram illustrates the typical way in which EY coordinates and delivers work. Project management officer Onsite or onshore team Functional requirements Team manager Offshore delivery team Components for redesign Management, communication and coordination 6

7 Integration into onsite team s deliverable Technical design specifications Demonstration and sign-off of work packet Work packet Completed work packet Support Development Unit testing and quality assurance 7

8 EY credentials Claims transformation services delivered globally Client situation The client intended to have a one-stop claims management solution and reduce manual process overheads. + EY action EY provided an end-to-end claims solution for different lines of business across different releases. In some cases, we integrated legacy systems for comprehensive claims management. Our teams customized out-of-the-box solutions to suit the client s requirements. Benefits Responsive services to enhance claims productivity through automation and reduction of cost of settling claims. 8

9 Our Guidewire qualification Design and implementation process Unrivaled Guidewire knowledge Solution design Business case and deployment Program delivery and change management We were Guidewire s Partner of the Year Our resources have successfully supported over 40 Guidewire systems implementations to date. We have a global workforce of over 750 trained Guidewire practitioners on change management, technical architecture, data management, configuration, functional and testing. We bring leading claims practices to make the most of implementation. We have a successful track record in program delivery of Guidewire. We bring specific Guidewire accelerators that will help de-risk a program. UK Americas Italy Japan India Australia We have dedicated Guidewire Centers of Excellence around the globe supporting our onsite teams, allowing us to mobilize these teams quickly. Our program management and change management experience helps to deliver on time. We are currently engaged in implementing Guidewire for a number of organizations in the Americas, Europe and Asia-Pacific. 9

10 Key contacts Americas Chris Raimondo Chris is a principal in the FSO Advisory Insurance Operations practice and leads the North American Property & Casualty (P&C) claims transformation team. In addition to leading US- and Canada-based insurance clients through large-scale claims transformation programs, he has been involved as a business architect and program advisor in insurance operational and technology transformation programs across Europe, Asia-Pacific and Australia. William Smith william.smith1@ey.com William Smith is the partner responsible for technical delivery on our Guidewire projects. With over 22 years experience in large program management, systems integration, systems conversion, operational design, process design, technical requirements definition and business requirements analysis, he is a seasoned delivery executive program manager. 10

11 Europe, Middle East, India and Africa (EMEIA) Stefano Bellandi Stefano is a partner and leads the Insurance Center of Excellence in the EMEIA Region. He has extensive experience working with insurers in southern Europe while managing important online IT projects in the Italian market. He managed the merger of four insurance companies, and also a large channel composed of more than 800 agencies. He participated in the start-up of insurance companies in Italy and Spain. He has also helped to develop internet direct channels. Preetham Penddanagari ppenddanagari@uk.ey.com Preetham is a director within our Performance Improvement practice in the UK. He has over 10 years consulting experience, predominantly in the financial services market, with specific emphasis on the insurance industry, including claims transformation, strategy and business case development. Asia-Pacific Clifford Foster clifford.foster@au.ey.com Clifford is a partner in the Asia-Pacific Financial Services Organization. He has extensive experience of working with insurers in Australia, South Africa, the United Kingdom and China. He focuses on the transformation of insurance capabilities (including claims management), from inception to delivery and benefits realization. Offshore unit, India Sriman Naarayan sriman.naarayan@in.ey.com Sriman Naarayan is an executive director in our offshore IT Advisory practice. He has extensive experience in service delivery using the global distributed delivery model, large-scale program management, custom systems development, packaged application implementation and quality assurance reviews. He has played an instrumental role in the growth of our offshore IT Advisory practice since its inception. 11

12 EY Assurance Tax Transactions Advisory About EY EY is a global leader in assurance, tax, transaction and advisory services. The insights and quality services we deliver help build trust and confidence in the capital markets and in economies the world over. We develop outstanding leaders who team to deliver on our promises to all of our stakeholders. In so doing, we play a critical role in building a better working world for our people, for our clients and for our communities. EY refers to the global organization, and may refer to one or more, of the member firms of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst & Young Global Limited, a UK company limited by guarantee, does not provide services to clients. For more information about our organization, please visit ey.com EYGM Limited. All Rights Reserved. EYG no: EG0179 ED 0115 This material has been prepared for general informational purposes only and is not intended to be relied upon as accounting, tax, or other professional advice. Please refer to your advisors for specific advice.