CLIENT OVERVIEW
The company is a U.S. Midwest-based insurer founded in the late 1800s, comprising more than 30 specialty property and casualty insurance businesses.
BUSINESS CHALLENGE
The insurer struggled with long claims processing timelines and high error rates with its Workers’ Compensation (WC) FROI/SROI claims process in Guidewire ClaimCenter. Often, WC claims were submitted to ISO/ Verisk without properly verifying their accuracy and completeness, which required additional time and labor resources to correct and resubmit.
The insurer also endeavored to drive operational efficiency, optimize resource allocation, and improve productivity more generally in its claims handling process in order to deliver more rapid and exceptional customer experiences as well as alleviate the repetitive workload burden on their agents.
SOLUTION OFFERED
The insurer began by revamping the entire FROI/SROI process, implementing an error validation and correction process before claims data would be passed to ISO/Verisk. The process included verifying mandatory and conditional fields, configuring new admin tables to accommodate 32 state-specific requirements, and building an FROI/ SROI error dashboard to identify and resolve pre-submission and postsubmission errors.
The insurer then expanded its out-of-the-box ClaimCenter automated assignment functionality to accommodate existing assignment use cases. Additionally, the insurer implemented Hi Marley, an intelligent communication platform for the insurance industry, to enable adjusters, claims managers, and supervisors to communicate with customers by leveraging the two-way texting platform.
VALUE DELIVERED
With these solutions, the insurer was able to remove duplicate entries between ClaimCenter and Mitchell entirely, eliminate external manual entry (including associated third-party vendor expenses), and identify and correct existing reporting issues to their data mart.
The redesigned WC FROI/SROI claims solution in Guidewire ClaimCenter dramatically reduced claim processing time and significantly improved claims accuracy, which in turn diminished the rework burden on the insurer’s agents and drove customer satisfaction gains.
The expanded Guidewire ClaimCenter automated assignment functionality dashboard for caseload management streamlined the assignment process, eliminated manual efforts, and enabled proactive error resolution and continuous claims process improvement.
The two-way texting platform Hi Marley expedited customer response times, enhanced access to information and stakeholder collaboration, as well as drove customer satisfaction and retention.
The redesigned WC FROI/SROI claims solution in Guidewire ClaimCenter dramatically reduced claim processing time and significantly improved claims accuracy, which in turn diminished the rework burden on the insurer’s agents and drove customer satisfaction gains.
